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  • 1.
    Näsman, Per
    et al.
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics, Safety Research.
    Örtendahl, Monica
    Perceived consequences among pregnant and non-pregnant women of continuing or ceasing to smoke.2007In: International Journal of Gynecology & Obstetrics, ISSN 0020-7292, Vol. 99, no 2, p. 117-121Article in journal (Refereed)
    Abstract [en]

    Objective

    To examine the perception of risk of smoking-related psychological and social outcomes, and the effect of pregnancy and intention to stop smoking on the perceived risk.

    Methods

    Eighty women were asked to make judgments about the probability of outcomes for smoking-related consequences. Four subgroups were created using the variables of pregnancy (pregnant versus not pregnant) and cessation of smoking (intention to stop versus no intention to stop). Judgments were based on the decision to stop and not stop smoking.

    Result

    Intention to stop smoking affected the estimated probabilities for the occurrence of consequences for both continuing and stopping smoking, whereas pregnancy did not affect the estimated probabilities. The estimated effect of stopping smoking was statistically significant.

    Conclusion

    Health messages about smoking for all population groups should consider both future risk of mortality and immediate quality-of-life effects of smoking.

  • 2.
    Näsman, Per
    et al.
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics (closed 20110301), Safety Research (closed 20110301).
    Örtendahl, Monica
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics (closed 20110301), Safety Research (closed 20110301).
    Values and beliefs about consequences related to smoking among pregnant and non-pregnant women2007In: Journal of Obstetrics and Gynaecology, ISSN 0144-3615, E-ISSN 1364-6893, Vol. 27, no 6, p. 558-563Article in journal (Refereed)
    Abstract [en]

    The purpose of the study was to test a model based on the product of value and belief, called expected utility (EU), on the addictive behaviour of smoking. A total of 40 pregnant and 40 non-pregnant women over a period of 2 weeks performed judgements on values and beliefs about consequences related to smoking for the conditions of continuing and stopping smoking. There were no differences between pregnant and non-pregnant women in the EU of smoking. Differences in expected utility between the conditions of continuing and stopping smoking were larger for health consequences compared with psychological and social consequences and consequences related to pregnancy. Expected utility gives a good description of judgements over time. Values as well as beliefs related to health consequences should be stressed in smoking cessation programmes, especially among pregnant women.

  • 3.
    Rothman, M.
    et al.
    Uppsala Univ, Cent Hosp, Vasterås, Sweden .
    Johansson, A.
    Uppsala Univ, Cent Hosp, Vasterås, Sweden .
    Örtendahl, Monica
    KTH, School of Architecture and the Built Environment (ABE), Transport Science, Safety Research.
    Rosenblad, A.
    Uppsala Univ, Cent Hosp, Vasterås, Sweden .
    Improved quality of life, working ability and patient satisfaction after a pre-treatment multimodal assessment method in patients with mixed chronic muscular pain: A randomized controlled study2012In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 72, no 6, p. 500-500Article in journal (Other academic)
  • 4. Rothman, Mats Georg
    et al.
    Örtendahl, Monica
    KTH, School of Architecture and the Built Environment (ABE), Transport Science, Safety Research.
    Rosenblad, Andreas
    Johansson, Ann-Christin
    Improved Quality of Life, Working Ability, and Patient Satisfaction After a Pretreatment Multimodal Assessment Method in Patients With Mixed Chronic Muscular Pain A Randomized-controlled Study2013In: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 29, no 3, p. 195-204Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate whether a pretreatment multimodal (MM) assessment of patients with chronic muscular pain has an impact on treatment outcome. Methods: The present randomized-controlled study evaluated an MM assessment compared with routine multidisciplinary assessment given to a control group. The study population consisted of primary care patients with mixed chronic muscular pain. Variables assessed were: pain intensity, depression, life stress, quality of life (QOL), disability, working ability, and treatment satisfaction. Follow-up was performed at 15 months and 182 patients of 220 (83%) completed the study. Results: Univariate and multivariate logistic regression showed from baseline to 15 months a significant improvement in QOL as measured by Short-Form 36 in the MM group compared with the control group on the domains of physical function (odds ratio 2.40; 95% confidence interval 1.32-4.37), role physical (2.37; 1.10-5.09), and role emotional (2.05; 1.05-3.96). Working ability improved more significantly in the MM group (46% vs. 35%) and impairment was less (1% vs. 15%) compared with the control group (P = 0.016). Satisfaction with the assessment was, on average, higher (P < 0.001) in the MM group than in the control group. Discussion: Patients who underwent an MM assessment before treatment in comparison with patients receiving routine multidisciplinary assessment improved QOL, working ability, and were also significantly more satisfied. This result indicates that MM pretreatment assessment could be advantageous in the selection of patients for suitable rehabilitation treatment in a primary care setting, and also be used to prepare patients for future rehabilitation.

  • 5.
    Örtendahl, Monica
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics (closed 20110301), Safety Research (closed 20110301).
    Coping Mechanisms Actually and Hypothetically Used by Pregnant and Non-Pregnant Women in Quitting Smoking2008In: Journal of Addictive Diseases, ISSN 1055-0887, E-ISSN 1545-0848, Vol. 27, no 4, p. 61-68Article in journal (Refereed)
    Abstract [en]

    The purpose of this article was to investigate how pregnant and non-pregnant women use various coping techniques when attempting to refrain from smoking. Eighty women with subgroups formed by the variables of pregnant/not pregnant and quitting/not quitting smoking were studied over a 2-week period. The general strategy was to follow smokers who had stated an intention to quit smoking. Smokers, pregnant and non-pregnant, who did not intend to quit were also followed with respect to the coping techniques they would hypothetically be using if they were trying to quit. Pregnant women used coping strategies more often than non-pregnant women. Differences found between pregnant and non-pregnant women were evenly distributed for behavioral and cognitive methods. The goal of becoming a non-smoker, especially during pregnancy, needs to be addressed to include psychological and physical factors. In these efforts, the framework introduced by the study involving a time-related approach could be useful.

  • 6.
    Örtendahl, Monica
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics (closed 20110301), Safety Research (closed 20110301).
    Different time perspectives of the doctor and the patient reduce quality in health care2008In: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 17, no 2, p. 136-139Article in journal (Refereed)
    Abstract [en]

    Time-related problems interfere with treatment decisions and evaluations in health care, both from the perspective of the doctor and from the perspective of the patient. The compliance level of the patient and subsequent evaluations in clinical practice might be affected by a discrepancy in the time perspective. Context factors related to time and health perspectives are relevant to clinical decisions and quality management. A summary of evaluation factors in quality management is presented: (a) the time perspective of the patient is different from the time perspective of the doctor, both in an objective and in a subjective manner; (b) disease chronicity chronic affects the perception of time; (c) assessments need to extend over a period sufficiently long for variations in a disease activity to be noticed; (d) there is variation both in time for an outcome to occur and in time span for that outcome; (e) the number of patients benefiting from certain drugs and variability over time is valuable information; (f) the outcome of a specified treatment could be estimated for different periods in a sequence; and (g) changes occur in judgments and decisions over time both for the doctor and for the patient.

  • 7.
    Örtendahl, Monica
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics (closed 20110301), Safety Research (closed 20110301).
    Models based on value and probability in health improve shared decision making2008In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 14, no 5, p. 714-717Article in journal (Refereed)
    Abstract [en]

    Rationale, aims and objectives Diagnostic reasoning and treatment decisions are a key competence of doctors. A model based on values and probability provides a conceptual framework for clinical judgments and decisions, and also facilitates the integration of clinical and biomedical knowledge into a diagnostic decision. Method Both value and probability are usually estimated values in clinical decision making. Therefore, model assumptions and parameter estimates should be continually assessed against data, and models should be revised accordingly. Introducing parameter estimates for both value and probability, which usually pertain in clinical work, gives the model labelled subjective expected utility. Estimated values and probabilities are involved sequentially for every step in the decision-making process. Results Introducing decision-analytic modelling gives a more complete picture of variables that influence the decisions carried out by the doctor and the patient. Conclusion A model revised for perceived values and probabilities by both the doctor and the patient could be used as a tool for engaging in a mutual and shared decision-making process in clinical work.

  • 8.
    Örtendahl, Monica
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics (closed 20110301), Safety Research (closed 20110301).
    Predicting lapse when stopping smoking among pregnant and non-pregnant women2007In: Journal of Obstetrics and Gynaecology, ISSN 0144-3615, E-ISSN 1364-6893, Vol. 27, no 2, p. 138-143Article in journal (Refereed)
    Abstract [en]

    This study aimed to investigate factors predicting lapse among pregnant and non-pregnant women when trying to stop smoking. A total of 40 women, pregnant and non-pregnant, were investigated over a 2-week period when trying to stop smoking. One-quarter of the women lapsed every day. Not being pregnant was a significant predictor for the occurrence of any lapse during the time period, whereas age, number of years of smoking, number of earlier attempts to stop smoking, and number of cigarettes smoked per day did not predict lapse. There was a four times higher risk for lapse in non-pregnant compared with pregnant women. Being pregnant gives an opportunity to help stop smoking with a considerably lower risk of lapse compared with non-pregnant women.

  • 9.
    Örtendahl, Monica
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics (closed 20110301), Safety Research (closed 20110301).
    Shared decision-making based on different features of risk in the context of diabetes mellitus and rheumatoid arthritis2007In: Therapeutics and Clinical Risk Management, ISSN 1176-6336, E-ISSN 1178-203X, Vol. 3, no 6, p. 1175-1180Article, review/survey (Refereed)
    Abstract [en]

    There is an increased awareness about patients' involvement in the clinical decision process where uncertainty is an unavoidable condition. The impact of psychological factors like risk aversion, risk aversion and time, asymmetry in risk aversion, and risk and control on shared decision-making is discussed. In addition to differences in risk estimates, doctors and patients may exhibit a difference in perception of time perspectives, and losses versus gains. A summary of valuation factors in shared decision-making is presented: (a) the doctors tend to follow expected value combinations more closely, while the patient is more risk aversive; (b) unwillingness to take risks increases for rare outcomes; (c) there is an increased tendency to take risks with delayed outcomes of the decisions; (d) the doctor is generally well informed about risk and time aspects for different diseases, whereas this might not always be the case with the patient; (e) rheumatoid arthritis and diabetes mellitus are chronic diseases, and both create a vulnerability to a variety of complications over time; (f) rheumatoid arthritis demands different combinations of treatments sequentially over time, whereas diabetes mellitus is treated with insulin; (g) many diseases, like rheumatoid arthritis and diabetes mellitus, are not completely affected by control, as the disease may constantly progress.

  • 10.
    Örtendahl, Monica
    et al.
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics (closed 20110301), Safety Research (closed 20110301).
    Näsman, Per
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics (closed 20110301), Safety Research (closed 20110301).
    Factors Affecting Continuation of Smoking by Pregnant and Non-pregnant Women2009In: Substance Abuse, ISSN 0889-7077, E-ISSN 1573-6733, Vol. 30, no 2, p. 150-157Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to test a framework based upon the value and the probability of outcomes related to smoking. Over a 2-week period, 80 women were asked to perform judgments of value and probability of the outcome for smoking-related consequences. Subgroups were formed by the two variables of pregnancy and intent to quit smoking. Judgments were performed given the conditions of quitting and not quitting smoking. The intent to quit or not quit smoking had an impact on expected utility of smoking. Moreover, there was a difference between expected utility given the conditions of not quitting smoking and quitting smoking. A framework based upon values and beliefs appears to be useful in describing the addictive behavior of smoking and can be applied in developing smoking-cessation education.

  • 11.
    Örtendahl, Monica
    et al.
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics, Safety Research.
    Näsman, Per
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics, Safety Research.
    Judgments of Risk for Consequences of Continuing or Quitting Smoking: A Study of Pregnant and Nonpregnant Women Intending and not Intending to Quit2008In: American journal of drug and alcohol abuse, ISSN 0095-2990, E-ISSN 1097-9891, Vol. 34, no 2, p. 225-233Article in journal (Refereed)
    Abstract [en]

     Objectives: To study perceived smoking-related consequences of continuing and of quitting smoking. Methods: Eighty women, with subgroups formed by pregnant/nonpregnant women and trying/not trying to quit smoking, performed judgments of the probability for consequences to occur given the conditions of continuing or quitting smoking. Results: For both the pregnant and nonpregnant women, the probability that consequences will occur was rated as less likely given the condition of quitting smoking. The condition of quitting had its greatest effect on the probability that somatic consequences would occur. Conclusion: Consequences of smoking for somatic health should be stressed in health promotion, especially to pregnant women.

  • 12.
    Örtendahl, Monica
    et al.
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics, Safety Research.
    Näsman, Per
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics, Safety Research.
     Perception of smoking-related health consequences among pregnant and non-pregnant women2007In: American Journal on Addictions, ISSN 1055-0496, E-ISSN 1521-0391, Vol. 16, no 6, p. 521-527Article in journal (Refereed)
    Abstract [en]

    The objective was to examine the perception of smoking-related health consequences and its relationship to pregnancy and intent to quit. Over a two-week period, pregnant and non-pregnant women, intending and not intending to quit smoking, rated the probability for smoking-related health consequences to occur, given continuing to smoke and quitting smoking. Pregnant women who did not intend to quit smoking exhibited the lowest estimated probability for the smoking-related health consequences to occur if they continued smoking. For all women, there was a statistically significant estimated effect of quitting smoking. Renewed attention needs to be given to perceptions of health risks of smoking, especially among pregnant women.

  • 13.
    Örtendahl, Monica
    et al.
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics, Safety Research.
    Näsman, Per
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics, Safety Research.
    Quitting smoking is perceived to have an effect on somatic health among pregnant and non-pregnant women2008In: The Journal of Maternal-Fetal & Neonatal Medicine, ISSN 1476-7058, E-ISSN 1476-4954, Vol. 21, no 4, p. 239-246Article in journal (Refereed)
    Abstract [en]

    Objective. To examine the association of pregnancy and intent to quit smoking with perception of the somatic health risk of smoking and the effect on risk of quitting smoking. Methods. Pregnant and non-pregnant women, intending and not intending to quit smoking, (n = 80) over a two-week period rated the probability for smoking-related health consequences to occur, given both conditions of not quitting smoking and of quitting smoking. Results. Groups were the determining variable accounting for differences in risk perception. For pregnant women who did not intend to quit smoking, the estimated probability for the consequences to occur was generally low given the condition of continuing to smoke. There was no effect for time. The estimated effect of quitting smoking was statistically significant. Conclusions. Future campaigns need to integrate risk information so that it can be grounded cognitively in order to increase the personal responsibility that women take for their own health and the health of the fetus.

  • 14.
    Örtendahl, Monica
    et al.
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics, Safety Research.
    Näsman, Per
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics, Safety Research.
    Somatic, psychological and social judgments related to smoking among pregnant and non-pregnant women2007In: Journal of Addictive Diseases, ISSN 1055-0887, E-ISSN 1545-0848, Vol. 26, no 4, p. 69-77Article in journal (Refereed)
    Abstract [en]

    Purpose: To examine the association between pregnancy and judgments about a range of somatic, psychological and social events and conditions related to smoking. Basic Procedures: Pregnant and non-pregnant women smokers, intending and not intending to quit, were contacted in family practices in Bulgaria where they were under ordinary medical observation. All 80 women in the study were asked to rate consequences related to smoking in terms of how good or bad they were. Results: Being pregnant or not pregnant had the main effect on rated values of smoking-related consequences, with non-pregnant women giving the least positive ratings across the time-span of the study and whether or not they intended to quit. No statistically significant difference was obtained between the quitting and non-quitting women, and there was only one statistically significant difference for different days. Conclusions: The physical variable of pregnancy has a larger impact on judgments about smoking compared to the motivational aspect of intending to quit.

  • 15.
    Örtendahl, Monica
    et al.
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics, Safety Research.
    Näsman, Per
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics, Safety Research.
    Use of coping techniques as a predictor of lapse when quitting smoking among pregnant and non-pregnant women2007In: American Journal on Addictions, ISSN 1055-0496, E-ISSN 1521-0391, Vol. 16, no 3, p. 238-243Article in journal (Refereed)
    Abstract [en]

    We examined the number of lapses among pregnant and non-pregnant women when trying to quit smoking, number of coping techniques used, and the relationship between any lapse and usage of coping techniques. Forty women were followed over a two-week period. On day 14, the women rated how often eleven different coping techniques were used. One-fourth of the women lapsed every day. If non-pregnant, the odds ratio was eight times higher compared to being pregnant for any lapse during the period. Being pregnant gives a higher success rate in attempts to quit smoking.

  • 16.
    Örtendahl, Monica
    et al.
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics, Safety Research.
    Uttermalm, Alf
    Simonsson, Bo
    Näsman, Per
    KTH, School of Architecture and the Built Environment (ABE), Transport and Economics, Safety Research.
    Wallsten, Tuula
    Estimated Time for Occurrence of Smoking-Related Consequences among Pregnant and Non-Pregnant Women2009Article in journal (Refereed)
    Abstract [en]

    Objectives: To study time estimates by women smokers for when smokingrelated consequences will occur given continuing or quitting smoking. The relationship of these estimates to pregnancy and intent to quit smoking was also investigated. Methods: Over a two-week period, eighty women, selected to constitute four subgroups formed by pregnant vs. non-pregnant and trying vs. not trying to quit smoking, rated times at which they would expect smoking-related consequences to occur given continuing or quitting smoking. Results: Somatic health consequences were estimated to occur later than consequences related to mood and social relations. All consequences were estimated to occur later given quitting smoking. Pregnancy had an effect on the estimated time that consequences would occur, with pregnant women estimating earlier occurrence of consequences related to mood and social relations than non-pregnant women did. Conclusion: Health messages should stress consequences for somatic health in quitting smoking, since outcomes later in time might have too low a value to exert a positive effect on decisions to quit smoking.

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