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Larsson, Britt
Publications (10 of 46) Show all publications
Larsson, B., Dragioti, E., Grimby-Ekman, A., Gerdle, B. & Ejork, J. (2019). Predictors of chronic pain intensity, spread, and sensitivity in the general population: A two-year follow-up study from the SWEPAIN cohort. Journal of Rehabilitation Medicine, 51(3), 183-192
Open this publication in new window or tab >>Predictors of chronic pain intensity, spread, and sensitivity in the general population: A two-year follow-up study from the SWEPAIN cohort
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2019 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 51, no 3, p. 183-192Article in journal (Refereed) Published
Abstract [en]

Objective: To determine whether the intensity, spread and sensitivity of chronic pain can be predicted using demographic features, socioeconomic conditions and comorbidities.

Design: A longitudinal study design was employed. Data was collected at baseline and at 2-year follow-up. Setting: General population in south-eastern Sweden.

Subjects: A representative stratified random sample of 34,000 individuals, between 18 and 85 years of age, selected from a sampling frame of 404,661 individuals based on the Swedish Total Population Register.

Methods: Eligible individuals were sent postal surveys in 2013 and 2015. The 2 surveys included the same questions about basic demographic data, comorbidities, and chronic pain intensity, spread and sensitivity.

Results: Several socio-demographic features and comorbidities at baseline were significant predictors of characteristics of pain (intensity, spread and sensitivity) at the 2-year follow-up. When characteristics of pain at baseline were included in the regression analyses they were relatively strong significant predictors of characteristics of pain after 2 years. After this adjustment there were fewer socio-demographic and comorbidity predictors; the effect estimates for those significant predictors had decreased.

Conclusion: Clinical assessment should focus on several characteristics of pain and include a broad medical screening to capture the overall burden of pain in adults from a longitudinal perspective.

Place, publisher, year, edition, pages
Uppsala, Sweden: Foundation for Rehabilitation Information, 2019
Keywords
general population; follow-up; chronic pain characteristics; sociodemographic; comorbidities
National Category
General Practice
Identifiers
urn:nbn:se:liu:diva-155547 (URN)10.2340/16501977-2519 (DOI)000460419000005 ()30815707 (PubMedID)2-s2.0-85062877324 (Scopus ID)
Note

Funding Agencies|Swedish Pain Foundation; Linkoping University; Medical Research Council of Southeast Sweden

Available from: 2019-03-26 Created: 2019-03-26 Last updated: 2019-04-01Bibliographically approved
Gerdle, B. & Larsson, B. (2018). Muscle. In: Winifried Häuser & Serge Perrot (Ed.), Fibromyalgia syndrome and widespread pain: from Construction to relevant Recognition (pp. 215-231). Wolters Kluwer
Open this publication in new window or tab >>Muscle
2018 (English)In: Fibromyalgia syndrome and widespread pain: from Construction to relevant Recognition / [ed] Winifried Häuser & Serge Perrot, Wolters Kluwer, 2018, p. 215-231Chapter in book (Other academic)
Place, publisher, year, edition, pages
Wolters Kluwer, 2018
National Category
General Practice
Identifiers
urn:nbn:se:liu:diva-155653 (URN)9781975102852 (ISBN)
Available from: 2019-03-22 Created: 2019-03-22 Last updated: 2019-03-25Bibliographically approved
Peterson, A., Berggården, M., Söderlund Schaller, A. & Larsson, B. (2018). Nurses' Advocacy of Clinical Pain Management in Hospitals: A Qualitative Study. Pain Management Nursing
Open this publication in new window or tab >>Nurses' Advocacy of Clinical Pain Management in Hospitals: A Qualitative Study
2018 (English)In: Pain Management Nursing, ISSN 1524-9042, E-ISSN 1532-8635Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND AND AIMS: In hospitals, efficient pain care given by nurses is warrented because pain prevalence in the previous 24 hours has been reported to be high. This study aims to clarify nurse's experiences with pain management as a specific responsibility added to their regular clinical duties. In addition, this study aims to elucidate these nurses' attitudes about sharing their pain knowledge with their colleagues.

DESIGN, PARTICIPANTS AND METHODS: This study includes semi-structured interviews of 17 registered staff nurses at the University Hospital, Linköping Sweden. The interviews were analyzed using a qualitative content analysis.

RESULTS: A main thematic category emerged: Selected nurses experience shortcomings and obstacles in clinical pain management and are willing to improve their knowledge and share it with their colleagues. This main category was based on the following four sub-categories: a valued but unclear assignment; the presence of facilitators and obstacles; in need of support and collaboration; and a deficit of own knowledge and future teaching of colleagues.

CONCLUSIONS: Overall, the nurses maintained a constructive attitude about their responsibilities to teach colleagues about pain management in spite the difficulties they experienced fulfilling all their responsibilities. Nurses who have the added responsibility to teach their colleagues pain management need specialized education in pain management and pedagogic skills for teaching clinical pain management. Moreover, these nurses need to be given the time, support, and collaborative opportunities to develop their knowledge. A nursing model that provides nurses trained in pain management education should be developed and evaluated.

Place, publisher, year, edition, pages
Saunders Elsevier, 2018
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-154939 (URN)10.1016/j.pmn.2018.09.003 (DOI)30528362 (PubMedID)
Available from: 2019-03-07 Created: 2019-03-07 Last updated: 2019-03-07
Järemo, P., Arman, M., Gerdle, B., Larsson, B. & Gottberg, K. (2017). Illness beliefs among patients with chronic widespread pain - associations with self-reported health status, anxiety and depressive symptoms and impact of pain. BMC Psychology, 5(24)
Open this publication in new window or tab >>Illness beliefs among patients with chronic widespread pain - associations with self-reported health status, anxiety and depressive symptoms and impact of pain
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2017 (English)In: BMC Psychology, E-ISSN 2050-7283, Vol. 5, no 24Article in journal (Refereed) Published
Abstract [en]

Chronic widespread pain (CWP) is a disabling condition associated with a decrease in health. Illness beliefs are individual and are acquired during life. Constraining beliefs may prevent patients from regaining health. Understanding these patients’ illness beliefs may be a way to improve the health care they are offered. The aim of this study was to describe illness beliefs among patients with CWP and associations with self-reported health, anxiety and depressive symptoms, and impact of pain.

Place, publisher, year, edition, pages
BioMed Central, 2017
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-146264 (URN)10.1186/s40359-017-0192-1 (DOI)28679446 (PubMedID)
Available from: 2018-04-05 Created: 2018-04-05 Last updated: 2018-04-26
Jöud, A., Björk, J., Gerdle, B., Grimby-Ekman, A. & Larsson, B. (2017). The association between pain characteristics, pain catastrophizing and health care use: Baseline results from the SWEPAIN cohort. Scandinavian Journal of Pain, 16, 122-128, Article ID S1877-8860(17)30122-2.
Open this publication in new window or tab >>The association between pain characteristics, pain catastrophizing and health care use: Baseline results from the SWEPAIN cohort
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2017 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 16, p. 122-128, article id S1877-8860(17)30122-2Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND AIM: Pain is common and adds to the global burden of disease. However, individuals suffering from pain are a heterogeneous group in terms of pain spreading, intensity and duration. While pain influences overall health care consultation not everyone with pain consult health care. To be able to provide health care matching the patients' needs increased knowledge about what factors determines the decision to consult health care is essential. The aim of this study was to explore the combined importance of pain spreading, intensity, duration and pain catastrophizing for consulting health care.

METHODS: In this cross-sectional study we used population based survey data from southeast Sweden (SWEPAIN) including 7792 individuals' aged 16-85 reporting pain. We used Modified Poisson regressions to analyse factors of importance related to the decision to consult health care.

RESULTS: High and moderate pain intensity, as compared to low, increases the probability of consulting health care (High PR=1.7 [95% CI 1.51-1.88], moderate PR=1.2 [1.15-1.41]). Having widespread pain, as compared to localised pain, increased the probability of consulting health (PR=1.2 [1.03-1.36). Pain duration was not associated with increased probability of consulting health care (PR=1.0 CI0.88-1.07). However an interaction (p=0.05) between pain duration and pain catastrophizing beliefs was seen indicating a combined importance of the two when consulting health care.

CONCLUSION: Our result suggests that pain intensity, pain spreading and pain catastrophizing independently influence the decision to consult health care while there is an interaction effect between pain duration and pain catastrophizing beliefs where the importance of pain catastrophizing believes differ with pain duration; the importance of pain catastrophizing believes differ with pain duration.

IMPLICATIONS: Treatment and rehabilitation strategies should incorporate this finding in order to meet the individual's needs focusing on the biopsychosocial model within health care focusing not only on actual pain reliefs but also on for example acceptance and behavioural changes.

Place, publisher, year, edition, pages
Walter de Gruyter, 2017
Keywords
Chronic pain, Health care utilisation, Pain catastrophizing
National Category
Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-146111 (URN)10.1016/j.sjpain.2017.04.071 (DOI)28850387 (PubMedID)2-s2.0-85019552538 (Scopus ID)
Available from: 2018-03-28 Created: 2018-03-28 Last updated: 2018-05-04Bibliographically approved
Peterson, A., Carlfjord, S., Schaller, A., Gerdle, B. & Larsson, B. (2017). Using education and support strategies to improve the way nurses assess regular and transient pain: A quality improvement study of three hospitals. Scandinavian Journal of Pain, 16(1), 15-21
Open this publication in new window or tab >>Using education and support strategies to improve the way nurses assess regular and transient pain: A quality improvement study of three hospitals
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2017 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 16, no 1, p. 15-21Article in journal (Refereed) Published
Abstract [en]

Background and aims

Systematic and regular pain assessment has been shown to improve pain management. Well-functioning pain assessments require using strategies informed by well-established theory. This study evaluates documented pain assessments reported in medical records and by patients, including reassessment using a Numeric Rating Scale (NRS) after patients receive rescue medication.

Methods

Documentation surveys (DS) and patient surveys (PS) were performed at baseline (BL), after six months, and after 12 months in 44 in-patient wards at the three hospitals in Östergötland County, Sweden. Nurses and nurse assistants received training on pain assessment and support. The Knowledge to Action Framework guided the implementation of new routines.

Results

According to DS pain assessment using NRS, pain assessment increased significantly: from 7% at baseline to 36% at 12 months (p < 0.001). For PS, corresponding numbers were 33% and 50% (p < 0.001). According to the PS, the proportion of patients who received rescue medication and who had been reassessed increased from 73% to 86% (p = 0.003). The use of NRS to document pain assessment after patients received rescue medication increased significantly (4% vs. 17%; p < 0.001).

Conclusions

After implementing education and support strategies, systematic pain assessment increased, an encouraging finding considering the complex contexts of in-patient facilities. However, the achieved assessment levels and especially reassessments related to rescue medication were clinically unsatisfactory. Future studies should include nursing staff and physicians and increase interactivity such as providing online education support. A discrepancy between documented and reported reassessment in association with given rescue medication might indicate that nurses need better ways to provide pain relief.

Implications

The fairly low level of patient-reported pain via NRS and documented use of NRS before and 12 months after the educational programme stresses the need for education on pain management in nursing education. Implementations differing from traditional educational attempts such as interactive implementations might complement educational programmes given at the work place. Standardized routines for pain management that include the possibility for nurses to deliver pain medication within well-defined margins might improve pain management and increase the use of pain assessments. Further research is needed that examines the large discrepancy between patient-reported pain management and documentation in the medical recording system of transient pain.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Assessment; Documentation; Implementation; Observation; Pain
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-145287 (URN)10.1016/j.sjpain.2017.01.013 (DOI)28850394 (PubMedID)2-s2.0-85013638729 (Scopus ID)
Available from: 2018-02-23 Created: 2018-02-23 Last updated: 2018-03-01Bibliographically approved
Gerdle, B., Ernberg, M., Mannerkorpi, K., Larsson, B., Kosek, E., Christidis, N. & Ghafouri, B. (2016). Increased Interstitial Concentrations of Glutamate and Pyruvate in Vastus Lateralis of Women with Fibromyalgia Syndrome Are Normalized after an Exercise Intervention: a Case-Control Study. PLoS ONE, 11(10), Article ID e0162010.
Open this publication in new window or tab >>Increased Interstitial Concentrations of Glutamate and Pyruvate in Vastus Lateralis of Women with Fibromyalgia Syndrome Are Normalized after an Exercise Intervention: a Case-Control Study
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2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 10, p. 14article id e0162010Article in journal (Refereed) Published
Abstract [en]

Background Fibromyalgia syndrome (FMS) is associated with central alterations, but controversies exist regarding the presence and role of peripheral factors. Microdialysis (MD) can be used in vivo to study muscle alterations in FMS. Furthermore for chronic pain conditions such as FMS, the mechanisms for the positive effects of exercise are unclear. This study investigates the interstitial concentrations of algesics and metabolites in the vastus lateralis muscle of 29 women with FMS and 28 healthy women before and after an exercise intervention. Methods All the participants went through a clinical examination and completed a questionnaire. In addition, their pressure pain thresholds (PPTs) in their upper and lower extremities were determined. For both groups, MD was conducted in the vastus lateralis muscle before and after a 15-week exercise intervention of mainly resistance training of the lower limbs. Muscle blood flow and interstitial muscle concentrations of lactate, pyruvate, glutamate, glucose, and glycerol were determined. Results FMS was associated with significantly increased interstitial concentrations of glutamate, pyruvate, and lactate. After the exercise intervention, the FMS group exhibited significant decreases in pain intensity and in mean interstitial concentrations of glutamate, pyruvate, and glucose. The decrease in pain intensity in FMS correlated significantly with the decreases in pyruvate and glucose. In addition, the FMS group increased their strength and endurance. Conclusion This study supports the suggestion that peripheral metabolic and algesic muscle alterations are present in FMS patients and that these alterations contribute to pain. After an exercise intervention, alterations normalized, pain intensity decreased (but not abolished), and strength and endurance improved, all findings that suggest the effects of exercise are partially peripheral.

Place, publisher, year, edition, pages
Public Library of Science, 2016. p. 14
National Category
Clinical Medicine Public Health, Global Health, Social Medicine and Epidemiology Nursing
Identifiers
urn:nbn:se:liu:diva-131423 (URN)10.1371/journal.pone.0162010 (DOI)000385553100010 ()
Note

Funding agencies:

This work was funded by the Swedish Rheumatism Association, the Swedish Research Council, the Health and Medical Care Executive Board of Vastra Gotaland Region, ALF-LUA at Sahlgrenska University Hospital and Linkbping University Hospital, Linkbping University, Gothenburg Centre for Person Centred Care (GPCC) and AFA Insurance. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Available from: 2016-09-02 Created: 2016-09-02 Last updated: 2017-11-21Bibliographically approved
Hadrévi, J., Turkina, M., Carlsson, A., Gerdle, B., Larsson, B., Hellström, F. & Ghafouri, B. (2016). Myosin light chain and calcium regulating protein differences in chronic musculoskeletal neck and shoulder pain. Journal of Integrated OMICS, 6(1), 1-8
Open this publication in new window or tab >>Myosin light chain and calcium regulating protein differences in chronic musculoskeletal neck and shoulder pain
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2016 (English)In: Journal of Integrated OMICS, ISSN 2182-0287, Vol. 6, no 1, p. 1-8Article in journal (Refereed) Published
Abstract [en]

Proteomic screening analysis has detected myosin light chain (MLC) as a protein implied to be involved in chronic musculoskeletal neck and shoulder pain. Several analyses of MLC proteins have stated a difference in phosphorylation being the determining factor for protein activation hence altered contrability of the muscle in i.e. senescence. In continuation of a previous publication, this study is an attempt to analyze the different MLC isoforms by mass spectrometry and immune-analyses in myalgic and healthy trapezius muscle. In the present study no differences in phosphorylation level between the corresponding individual proteins were detected using LC-MSMS and immunoblotting; instead we assigned different isoforms of regulatory MLCs. To further elucidate the contrability: calcium (Ca2+) regulatory proteins, sarco(endo)plasmic reticulum Ca2+ ATPase 1 (SERCA-1) and calsequestrine (CSQ) were analyzed by western blot. The analysis revealed a significantly increased abundance of SERCA-1 protein in the myalgic muscle and a significantly increased abundance of CSQ in healthy muscle. Myalgic muscle contraction patterns have in previous studies shown to differ from healthy muscle which may be connected to the Ca2+ availability in the muscle. Here we present the proteomic characterization of differences in Ca2+ regulating proteins and particularly regulatory MLCs in trapezius muscle of women with chronic musculoskeletal neck and shoulder pain.

Place, publisher, year, edition, pages
Proteomass Scientific Society, 2016
National Category
Biochemistry and Molecular Biology
Identifiers
urn:nbn:se:liu:diva-130539 (URN)10.5584/jiomics.v6i1.191 (DOI)
Available from: 2016-08-15 Created: 2016-08-15 Last updated: 2018-01-17
Grimby-Ekman, A., Gerdle, B., Bjork, J. & Larsson, B. (2015). Comorbidities, intensity, frequency and duration of pain, daily functioning and health care seeking in local, regional, and widespread pain-a descriptive population-based survey (SwePain). BMC Musculoskeletal Disorders, 16(165)
Open this publication in new window or tab >>Comorbidities, intensity, frequency and duration of pain, daily functioning and health care seeking in local, regional, and widespread pain-a descriptive population-based survey (SwePain)
2015 (English)In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 16, no 165Article in journal (Refereed) Published
Abstract [en]

Background: The clinical knowledge of factors related to the spread of pain on the body has increased and understanding these factors is essential for effective pain treatment. This population-based study examines local (LP), regional (RP), and widespread pain (WSP) on the body regarding comorbidities, pain aspects, and impact of pain and elucidates how the spread of pain varies over time. Material and methods: A postal questionnaire that addressed pain aspects (intensity, frequency, duration and anatomical spreading on a body manikin), comorbidities and implications of pain (i.e., work situation, physical activity, consumption of health care and experience of hospitality and treatment of health care) was sent to 9000 adults living in southeastern Sweden. Of these, 4774 (53 %) completed and returned the questionnaire. After 9 weeks, a follow-up questionnaire was sent to the 2983 participants who reported pain in the first questionnaire (i.e. 62 % of 4774 subjects). Of these, 1940 completed and returned the questionnaire (i.e. 65 % of 2983 subjects). The follow-up questionnaire included the same items as the first questionnaire. Results: This study found differences in intensity, frequency and duration of pain, comorbidities, aspects of daily functioning and health care seeking in three pain categories based on spreading of pain: LP, RP and WSP. Compared to the participants with RP and LP, the participants with WSP had lower education and worse overall health, including more frequent heart disease and hypertension. In addition, participants with WSP had more intense, frequent, and long-standing pain, required more medical consultations, and experienced more impact on work. The participants with RP constituted an intermediate group regarding frequency and intensity of pain, and impact on work. The participants with LP were the least affected group regarding these factors. A substantial transition to RP had occurred by the 9-week follow-up. Conclusions: This study shows an association between increased spread of pain and prevalence of heart disease, hypertension, more severe pain characteristics (i.e., intensity, frequency and duration), problems with common daily activities and increased health care seeking. The WSP group was the most affected group and the LP group was the least affected group. Regarding these factors, RP was an obvious intermediate group. The transitions between the pain categories warrant research that broadly investigates factors that increase and decrease pain.

Place, publisher, year, edition, pages
BioMed Central / Springer Verlag (Germany), 2015
Keywords
Population-based; Local pain; Regional pain; Widespread pain; Comorbidities; Implications; Transition
National Category
Basic Medicine
Identifiers
urn:nbn:se:liu:diva-120646 (URN)10.1186/s12891-015-0631-1 (DOI)000358403500001 ()26205125 (PubMedID)
Note

Funding Agencies|Swedish Pain Foundation; Linkoping University; Medical Research Council of Southeast Sweden

Available from: 2015-08-20 Created: 2015-08-20 Last updated: 2018-01-11
Schaller, A., Larsson, B., Lindblad, M. & Liedberg, G. M. (2015). Experiences of Pain: A Longitudinal, Qualitative Study of Patients with Head and Neck Cancer Recently Treated with Radiotherapy. Pain Management Nursing, 16(3), 336-345
Open this publication in new window or tab >>Experiences of Pain: A Longitudinal, Qualitative Study of Patients with Head and Neck Cancer Recently Treated with Radiotherapy
2015 (English)In: Pain Management Nursing, ISSN 1524-9042, E-ISSN 1532-8635, Vol. 16, no 3, p. 336-345Article in journal (Refereed) Published
Abstract [en]

It is not unusual for patients with head and neck cancer (HNC) to suffer from both tumor- and treatment-related pain that is difficult to alleviate despite individualized pain management. The aim of this qualitative study was to describe how HNC patients experience pain and how pain influences those who are treated with radiotherapy (RT). Qualitative semistructured interviews were performed 1 and 6 months after patients completed RT. The interviews addressed symptoms, moods, and suffering. The study included 26 patients with HNC who had recently completed RT. The interviews were analyzed using manifest content analysis. The main category was: HNC patients did not report that their severe physical pain influenced their psychological suffering, but it did influence their social lives. Furthermore, four categories were revealed: pain in the head and neck region, overwhelming fatigue, altered mood and preoccupied mind, and decreased participation and changed relationships. Physical pain, psychological distress, and social withdrawal were prominent at both interviews and consequently their situation can be considered as chronic. Remarkably, patients did not express a clear relationship between pain and psychological load. This may imply a biomedical view of pain or may reflect the difficult situation patients were in (i.e., facing a possibly life-threatening cancer). Thus, their situation might require a prioritization and might negatively affect the possibility of identifying the interaction between the different pain dimensions. The biopsychosocial model of chronic pain aims to understand the interaction between pain and psychosocial factors. Interventions aiming to teach patients with HNC how to internalize the biopsychosocial model framework to manage pain could be useful and should be evaluated in future research.

National Category
Basic Medicine
Identifiers
urn:nbn:se:liu:diva-115363 (URN)10.1016/j.pmn.2014.08.010 (DOI)000355212500022 ()25532691 (PubMedID)
Available from: 2015-03-13 Created: 2015-03-13 Last updated: 2018-04-13
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