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Thyberg, Ingrid
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Publications (10 of 49) Show all publications
Östlund, G., Björk, M., Thyberg, I., Valtersson, E. & Sverker, A. (2018). Womens situation-specific strategies in managing participation restrictions due to early rheumatoid arthritis: A gender comparison. Musculoskeletal Care, 16(2), 251-259
Open this publication in new window or tab >>Womens situation-specific strategies in managing participation restrictions due to early rheumatoid arthritis: A gender comparison
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2018 (English)In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 16, no 2, p. 251-259Article in journal (Refereed) Published
Abstract [en]

The present study explored how women describe their use of situation-specific strategies when managing rheumatoid arthritis (RA). The aim was also to compare womens strategies with those of men, and see the extent to which they used the same strategies.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2018
Keywords
chronic disease; coping strategies; gender perspective; rehabilitation; rheumatology
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-152537 (URN)10.1002/msc.1225 (DOI)29316201 (PubMedID)
Available from: 2019-03-07 Created: 2019-03-07 Last updated: 2019-03-08
Ahlstrand, I., Vaz, S., Falkmer, T., Thyberg, I. & Björk, M. (2017). Self-efficacy and pain acceptance as mediators of the relationship between pain and performance of valued life activities in women and men with rheumatoid arthritis. Clinical Rehabilitation, 31(6), 824-834
Open this publication in new window or tab >>Self-efficacy and pain acceptance as mediators of the relationship between pain and performance of valued life activities in women and men with rheumatoid arthritis
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2017 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, no 6, p. 824-834Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To study whether personal factors (self-efficacy and pain acceptance) mediate the relationship between pain and performance of valued life activities in persons with rheumatoid arthritis.

METHODS: Persons with rheumatoid arthritis for at least four years (n = 737; 73% women) answered a questionnaire measuring self-efficacy, pain acceptance, performance of valued life activities, and self-rated pain. Relationships among these constructs were explored using univariate and multivariate analyses. Structural equation modelling was then used to examine the mediational role of personal factors on the relationship between pain and performance of valued life activities.

RESULTS: A direct negative association between pain and performance of valued life activities was identified (Beta = .34, P < .001). This suggests that people with rheumatoid arthritis who had higher levels of pain has increased difficulties in performing valued life activities. Self-efficacy and activity engagement component of pain acceptance mediated the relationship between pain and performance of valued life activities, however the pain willingness component of pain acceptance did not influence participation in valued life activities.

CONCLUSION: These findings highlight the importance of considering personal factors, such as pain acceptance and self-efficacy, in facilitating participation in valued life activities.

Place, publisher, year, edition, pages
Sage Publications, 2017
Keywords
Disability, ICF, mediation, pain, personal factors, rheumatoid arthritis, structural equation modelling, valued life activities scale
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:liu:diva-129964 (URN)10.1177/0269215516646166 (DOI)000401719500013 ()27146888 (PubMedID)
Note

Funding agencies: Medical Research Council of Southeast Sweden; Futurum - the academy for healthcare Region Jonkoping County; Swedish Rheumatism Fund; Swedish Association of Occupational Therapy; Axel Fugl-Meyer Memorial fund

Available from: 2016-07-02 Created: 2016-07-02 Last updated: 2018-05-02Bibliographically approved
Östlund, G., Thyberg, I., Valtersson, E., Björk, M. & Sverker, A. (2016). The Use of Avoidance, Adjustment, Interaction and Acceptance Strategies to Handle Participation Restrictions Among Swedish Men with Early Rheumatoid Arthritis.. Musculoskeletal Care, 14(4), 206-218
Open this publication in new window or tab >>The Use of Avoidance, Adjustment, Interaction and Acceptance Strategies to Handle Participation Restrictions Among Swedish Men with Early Rheumatoid Arthritis.
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2016 (English)In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 14, no 4, p. 206-218Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Living with a chronic disease means learning to live under new circumstances and involves a continuous adaptation to new ways of living. There is increasing knowledge about how people cope with stressful life events and adapt to new life situations. Approximately a third of patients diagnosed with rheumatoid arthritis (RA) are men; however, few studies have described the needs and experiences of men living with RA. The aim of the present study was to explore men's strategies for handling challenges related to participation in everyday life.

METHODS: The present study was associated with the prospective Swedish multicentre early arthritis project (given the Swedish acronym TIRA), which, in 2006-2009, included patients with early RA, contemporarily treated, with a mean disease duration of three years. From this cohort, 25 men, aged 20-63 years, were recruited consecutively. Data were collected in individual interviews, using the critical incident technique. The strategies for dealing with the challenges of RA in everyday life were analysed and categorized using content analysis.

RESULTS: Men with RA described four types of strategy for dealing with participation restrictions in everyday life: (i) Adjustment strategies - adjust behaviour, movements, medication, equipment and clothing to find new ways to conduct tasks or activities; (ii) Avoidance strategies - avoid activities, movements, social contacts and sometimes medication; (iii) Interaction strategies - say no, ask for help and work together to handle participation restrictions; and (iv) Acceptance strategies - learn to accept RA, with the pain, the slower work pace and the extended time needed.

CONCLUSIONS: According to men's lived experiences, a combination of strategies was used to deal with RA, depending on the situation and the experienced restriction. The results provided an understanding of how men with RA manage their disease, to reduce physical, social and emotional challenges. This knowledge may be used further to develop multi-professional interventions and patient education tailored to men with RA.

Place, publisher, year, edition, pages
John Wiley & Sons, 2016
Keywords
Male adaptation; chronic illness; coping; patient perspective
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-126435 (URN)10.1002/msc.1131 (DOI)26880258 (PubMedID)2-s2.0-84959097417 (Scopus ID)
Available from: 2016-03-24 Created: 2016-03-24 Last updated: 2018-03-20Bibliographically approved
Sverker, A., Östlund, G., Thyberg, M., Thyberg, I., Valtersson, E. & Björk, M. (2015). Dilemmas of participation in everyday life in early rheumatoid arthritis: a qualitative interview study (The Swedish TIRA Project). Disability and Rehabilitation, 37(14-15), 1251-1259
Open this publication in new window or tab >>Dilemmas of participation in everyday life in early rheumatoid arthritis: a qualitative interview study (The Swedish TIRA Project)
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2015 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 14-15, p. 1251-1259Article in journal (Refereed) Published
Abstract [en]

Abstract Purpose: To explore the experiences of today's patients with early rheumatoid arthritis (RA) with respect to dilemmas of everyday life, especially regarding patterns of participation restrictions in valued life activities. Methods: A total of 48 patients, aged 20-63, three years post-RA diagnosis were interviewed using the Critical Incident Technique. Transcribed interviews were condensed into meaningful units describing actions/situations. These descriptions were linked to ICF participation codes according to the International Classification of Functioning, Disability and Health (ICF) linking rules. Results: Dilemmas in everyday life were experienced in domestic life, interpersonal interactions and relationships, community, social and civic life. Most dilemmas were experienced in domestic life, including participation restrictions in, e.g. gardening, repairing houses, shovelling snow, watering pot plants, sewing or walking the dog. Also many dilemmas were experienced related to recreation and leisure within the domain community, social and civic life. The different dilemmas were often related to each other. For instance, dilemmas related to community life were combined with dilemmas within mobility, such as lifting and carrying objects. Conclusions: Participation restrictions in today's RA patients are complex. Our results underline that the health care needs to be aware of the patients' own preferences and goals to support the early multi-professional interventions in clinical practice. Implications of Rehabilitation Today's rheumatoid arthritis (RA) patients experience participation restrictions in activities not included in International Classification of Functioning, Disability and Health (ICF) core set for RA or in traditionally questionnaires with predefined activities. The health care need to be aware of the patients' own preferences and goals to meet the individual needs and optimize the rehabilitation in early RA in clinical practice.

Place, publisher, year, edition, pages
Informa Healthcare, 2015
National Category
Clinical Medicine Basic Medicine
Identifiers
urn:nbn:se:liu:diva-113134 (URN)10.3109/09638288.2014.961658 (DOI)000357763700006 ()25243767 (PubMedID)
Available from: 2015-01-12 Created: 2015-01-12 Last updated: 2018-01-11
Barns, A., Svanholm, F., Kjellberg, A., Thyberg, I. & Falkmer, T. (2015). Living in the present: Women's everyday experiences of living with rheumatoid arthritis. SAGE Open, 5(4), 1-13
Open this publication in new window or tab >>Living in the present: Women's everyday experiences of living with rheumatoid arthritis
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2015 (English)In: SAGE Open, ISSN 2158-2440, E-ISSN 2158-2440, Vol. 5, no 4, p. 1-13Article in journal (Refereed) Published
Abstract [en]

This article presents the findings from a qualitative research project exploring eight women’s experiences of living with rheumatoid arthritis (RA). Through semistructured interviews, the women provided insights into the physical, emotional, and social impacts of RA and the “work” involved in negotiating its influence in the everyday life. In narrating their experiences of adapting to RA, the women express a common desire for “normalcy,” to return to a time and space before the disruption of RA. The women’s accounts also emphasized the interrelatedness between bodily experience and constructions of self, highlighting the corporeal nature of RA and the constant shaping and reshaping of personal meanings and values.

Place, publisher, year, edition, pages
Sage Publications, 2015
Keywords
arthritis, disability, lived body, women, qualitative research
National Category
Occupational Therapy
Identifiers
urn:nbn:se:liu:diva-128178 (URN)10.1177/2158244015616163 (DOI)
Available from: 2016-05-19 Created: 2016-05-19 Last updated: 2018-03-17
Ahlstrand, I., Thyberg, I., Falkmer, T., Dahlström, Ö. & Björk, M. (2015). Pain and activity limitations in women and men with contemporary treated early RA compared to 10 years ago: the Swedish TIRA project. Scandinavian Journal of Rheumatology, 44(4), 259-264
Open this publication in new window or tab >>Pain and activity limitations in women and men with contemporary treated early RA compared to 10 years ago: the Swedish TIRA project
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2015 (English)In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 44, no 4, p. 259-264Article in journal (Refereed) Published
Abstract [en]

Objectives: To study differences regarding pain and activity limitations during the 3 years following diagnosis in women and men with contemporary treated early RA compared with their counterparts who were diagnosed 10 years earlier. Method: This study was based on patients recruited to the Early Intervention in RA (TIRA) project. In the first cohort (TIRA-1) 320 patients were included in time for diagnosis during 1996-1998 and 463 patients were included in the second cohort (TIRA-2) during 2006-2009. Disease activity, pain intensity (Visual Analogue Scale, VAS), bodily pain (BP) in the 36-item Short Form Health Survey (SF-36), activity limitations (Health Assessment Questionnaire, HAQ), and medication were reported at inclusion and at follow-up after 1, 2, and 3 years. Results: Disease activity, pain, and activity limitations were pronounced at inclusion across both genders and in both cohorts, with some improvement observed during the first year after diagnosis. Disease activity did not differ between cohorts at inclusion but was significantly lower at the follow-ups in the TIRA-2 cohort, in which the patients were prescribed traditional disease-modifying anti-rheumatic drugs (DMARDs) and biological agents more frequently. In TIRA-2, patients reported significantly lower pain and activity limitations at all follow-ups, with men reporting lower pain than women. Women reported significantly higher activity limitations at all time points in TIRA-2. Conclusions: Pain and activity limitations were still pronounced in the contemporary treated early RA cohort compared with their counterparts diagnosed 10 years earlier and both of these factors need to be addressed in clinical settings.

Place, publisher, year, edition, pages
Informa Healthcare, 2015
National Category
Basic Medicine
Identifiers
urn:nbn:se:liu:diva-121326 (URN)10.3109/03009742.2014.997285 (DOI)000359960100001 ()25786818 (PubMedID)
Note

Funding Agencies|Medical Research Council of Southeast Sweden (FORSS); Academy for Health and Care Jonkoping County Council (Futurum)

Available from: 2015-09-14 Created: 2015-09-14 Last updated: 2018-04-07Bibliographically approved
Ahlstrand, I., Björk, M., Thyberg, I. & Falkmer, T. (2015). Pain and difficulties performing valued life activities in women and men with rheumatoid arthritis. Clinical Rheumatology, 34(8), 1353-1362
Open this publication in new window or tab >>Pain and difficulties performing valued life activities in women and men with rheumatoid arthritis
2015 (English)In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 34, no 8, p. 1353-1362Article in journal (Refereed) Published
Abstract [en]

This study aimed to examine the difficulties with performing valued life activities in relation to pain intensity in women and men with rheumatoid arthritis (RA). In total, 737 persons with RA (73 % women) from three rheumatology units in Sweden responded to a questionnaire measuring performance of 33 valued life activities and self-rated pain. The relationships between performance of valued life activities (VLAs) and pain (measured by visual analogue scale (VAS)) were analysed based on gender. Multiple linear regression analyses were conducted with the total VLA score as dependent variable. Women reported more pain and difficulties in performing valued life activities than men. Across genders, 85 % reported at least one valued life activity affected by RA. Significantly more women than men encountered difficulties in performing some activities such as cooking, gardening and meeting new people. Women reported higher pain intensity (35 mm) than men (31 mm). Almost all 33 difficulty ratings for valued life activities were higher among persons with high pain (greater than 40 mm) than persons with lower pain. Difficulty ratings for valued life activities correlated positively with pain in persons with lower pain, but not among those with high pain. The results highlight the importance of addressing pain, especially among women with RA, as they reported pain to impact on their valued life activities. Interestingly, this was evident also in women with lower levels of pain.

Place, publisher, year, edition, pages
Springer Verlag (Germany), 2015
Keywords
Disability; Gender; HAQ; Participation restrictions; VAS; VLA
National Category
Basic Medicine
Identifiers
urn:nbn:se:liu:diva-120864 (URN)10.1007/s10067-015-2874-5 (DOI)000359267100006 ()25618175 (PubMedID)
Note

Funding Agencies|Medical Research Council of Southeast Sweden (FORSS); Academy for Health and Care, Jonkoping County Council (Futurum); Swedish Rheumatism Association

Available from: 2015-08-28 Created: 2015-08-28 Last updated: 2018-03-17
Kalkan, A., Husberg, M., Hallert, E., Roback, K., Thyberg, I., Skogh, T. & Carlsson, P. (2015). Physician Preferences and Variations in Prescription of Biologic Drugs for Rheumatoid Arthritis: A Register-Based Study of 4,010 Patients in Sweden. Arthritis care & research, 67(12), 1679-1685
Open this publication in new window or tab >>Physician Preferences and Variations in Prescription of Biologic Drugs for Rheumatoid Arthritis: A Register-Based Study of 4,010 Patients in Sweden
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2015 (English)In: Arthritis care & research, ISSN 2151-464X, E-ISSN 2151-4658, Vol. 67, no 12, p. 1679-1685Article in journal (Refereed) Published
Abstract [en]

Objective. The prescription of biologic drugs for rheumatoid arthritis (RA) patients has varied considerably across different regions. Previous studies have shown physician preferences to be an important determinant in the decision to select biologic disease-modifying antirheumatic drugs (bDMARDs) rather than nonbiologic, synthetic DMARDs (sDMARDs) alone. The aim of this study was to test the hypothesis that physician preferences are an important determinant for prescribing bDMARDs for RA patients in Sweden. Methods. Using data from the Swedish Rheumatology Quality Register, we identified 4,010 RA patients who were not prescribed bDMARDs during the period 2008-2012, but who, on at least 1 occasion, had an sDMARD prescription and changed treatment for the first time to either a new sDMARD or a bDMARD. Physician preference for the use of bDMARDs was calculated using data on each physicians prescriptions during the study period. The relationship between prescription of a bDMARD and physician preference, controlling for patient characteristics, disease activity, and the physicians local context was evaluated using multivariate logistic regression. Results. When adjusting for patient characteristics, disease activity, and the physicians local context, physician preference was an important predictor for prescription of bDMARDs. Compared with patients of a physician in the lowest preference tertile, patients of physicians in the highest and middle tertiles had an odds ratio for receiving bDMARDs of 2.8 (95% confidence interval [95% CI] 2.13-3.68) and 1.28 (95% CI 1.05-1.57), respectively. Conclusion. Physician preference is an important determinant for prescribing bDMARDs.

Place, publisher, year, edition, pages
WILEY-BLACKWELL, 2015
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-124498 (URN)10.1002/acr.22640 (DOI)000367681900008 ()26097219 (PubMedID)
Note

Funding Agencies|Norrbacka-Eugenia Foundation; Swedish Rheumatism Association

Available from: 2016-02-02 Created: 2016-02-01 Last updated: 2017-11-30
Thyberg, M., Arvidsson, P., Thyberg, I. & Nordenfelt, L. (2015). Simplified bipartite concepts of functioning and disability recommended for interdisciplinary use of the ICF.. Disability and Rehabilitation, 37(19), 1783-1792
Open this publication in new window or tab >>Simplified bipartite concepts of functioning and disability recommended for interdisciplinary use of the ICF.
2015 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 19, p. 1783-1792Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To argue for and propose bipartite concepts of functioning and disability, to tally with the structure of the ICF classification list, concepts of social models and clinical needs.

METHOD: The ICF concepts are discussed in relation to the history of ideas regarding disability concepts and the needs for such concepts in interdisciplinary rehabilitation.

RESULTS: Bipartite concepts are presented; they refer to actual functioning, simply body functions/structures and participation, including functioning in standardized environments. Participation refers to actually performed "activities", with "activities" simply denoting things that people may do. Bipartite concepts are congruent with the ICF classification and the structure of social models of disability, suitable for clinical and interdisciplinary use and easy to understand. The issue of standardized environments represents a methodological issue rather than the conceptual issue of defining functioning and disability. An individual perspective on activity and activity limitations, i.e. the middle part of the tripartite ICF concept, is somewhat similar to concepts of traditional language that were regarded as too generalizing already in 1912, when the interactional concept of "disability in a social sense" was introduced in rehabilitation practices.

CONCLUSION: Bipartite concepts of functioning and disability are recommended for interdisciplinary use of the ICF.

IMPLICATIONS FOR REHABILITATION: The ICF classification is useful, but the ICF concept of activities in an individual perspective is confusing. We suggest a use of the term "activities" simply to denote things that people may do and "participation" to denote actually performed activities. Estimations of ability should be explicit about how they are related to environmental factors.

Keywords
Activity limitation; ICF; interaction; interdisciplinary; participation; social model
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:liu:diva-124397 (URN)10.3109/09638288.2014.978506 (DOI)25365700 (PubMedID)
Available from: 2016-01-28 Created: 2016-01-28 Last updated: 2017-11-30
Sverker, A., Björk, M., Thyberg, I., Thyberg, M., Valtersson, E. & Östlund, G. (2014). AB1154-HPR Men's Strategies of Handling Participation Restrictions Related to Rheumatoid Arthritis (The Swedish Tira Study). In: : . Paper presented at Ann Rheum Dis 2014 (pp. 141-142). , 73
Open this publication in new window or tab >>AB1154-HPR Men's Strategies of Handling Participation Restrictions Related to Rheumatoid Arthritis (The Swedish Tira Study)
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2014 (Swedish)Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Background: In spite of early interventions and advancements in medication disability and restricted work capacity is closely related to rheumatoid arthritis (RA). Around 1/3 of diagnosed patients are men, however few studies describe men's need and experiences of living with RA [1].Objectives: To explore male strategies of handling participating restriction in everyday life.Methods: In this study 25 men with early RA from the TIRA2 cohort [2], age 20 – 63, were interviewed about participation restrictions with Critical Incident Technique [3]. Transcribed interviews were synthesized into dilemmas and linked to ICF participation [4] codes and the strategies in handling these dilemmas were analyzed and categorized using content analysis [5].Results: The men described four types of strategies of handling participating restriction in everyday life. Resilience strategies; to find enjoyments, develop self-trust, and a new body-knowledge. Daily routine strategies; use more time on each task and rest in between activities, adjust medication to activity, adjust movements finding new ways to conduct work tasks and physical training. Avoidance strategies; avoid alcohol, social contacts after work, inform of RA and sometimes medicine. Action strategies; continue activities, attend activities as a spectator instead of being an active participant, go home if needed, say no, ask for help, and talk about RA. Acceptance strategies; accept pain, accept less work pace, accept less endurance and fewer activities.Conclusions: Men described dilemmas in everyday life due to RA, but not all experienced being restricted in life they rather expressed reorganizing their everyday lives.References:Shuttleworth RP (2004). Disabled masculinity; Expanding the masculine repertoire. In Smith BG, Hutchinson B (Eds). Gendering disability, New Brunswick, NJ; Rutgers University Press.Björk M, Thyberg I, Rikner K, Balogh I, Gerdle B. Sick leave before and after diagnosis of rheumatoid arthritis: a report from the Swedish TIRA project. J Rheumatol 2009;36:1170-1179.Flanagan, C (1954). The critical incident technique. Psychological Bulletin, 51: p. 327-358.Cieza A, Geyh S, Chatterji S, Kostanjsek N, Ustun B, Stucki G ICF linking rules: an update based on lessons learned. J Rehabil Med. 2005;37:212-8.Sverker A, Thyberg I, Östlund G, Valtersson E, Thyberg M. (2013). Participation in work in early rheumatoid arthritis: A qualitative interview study interpreted in terms of the ICF. Disability & Rehabilitation May (3); ISSN1464-5165

National Category
Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-114604 (URN)10.1136/annrheumdis-2014-eular.3717 (DOI)
Conference
Ann Rheum Dis 2014
Available from: 2015-02-26 Created: 2015-02-26 Last updated: 2015-06-11
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