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Nordlund, Anders
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Publications (10 of 33) Show all publications
Orwelius, L., Bergkvist, M., Nordlund, A., Simonsson, E., Nordlund, P., Bäckman, C. & Sjöberg, F. (2012). Physical effects of trauma and the psychological consequences of preexisting diseases account for a significant portion of the health-related quality of life patterns of former trauma patients. Journal of Trauma and Acute Care Surgery, 72(2), 504-512
Open this publication in new window or tab >>Physical effects of trauma and the psychological consequences of preexisting diseases account for a significant portion of the health-related quality of life patterns of former trauma patients
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2012 (English)In: Journal of Trauma and Acute Care Surgery, ISSN 2163-0755, E-ISSN 2163-0763, Vol. 72, no 2, p. 504-512Article in journal (Refereed) Published
Abstract [en]

Background: Health-related quality of life (HRQoL) is known to be significantly affected in former trauma patients. However, the underlying factors that lead to this outcome are largely unknown. In former intensive care unit (ICU) patients, it has been recognized that preexisting disease is the most important factor for the long-term HRQoL. The aim of this study was to investigate HRQoL up to 2 years after trauma and to examine the contribution of the trauma-specific, ICU-related, sociodemographic factors together with the effects of preexisting disease, and further to make a comparison with a large general population.

Methods: A prospective 2-year multicenter study in Sweden of 108 injured patients. By mailed questionnaires, HRQoL was assessed at 6 months, 12 months, and 24 months after the stay in ICU by Short Form (SF)-36, and information of preexisting disease was collected from the national hospital database. ICU-related factors were obtained from the local ICU database. Comorbidity and HRQoL (SF-36) was also examined in the reference group, a random sample of 10,000 inhabitants in the uptake area of the hospitals.

Results: For the trauma patients, there was a marked and early decrease in the physical dimensions of the SF-36 (role limitations due to physical problems and bodily pain). This decrease improved rapidly and was almost normalized after 24 months. In parallel, there were extensive decreases in the psychologic dimensions (vitality, social functioning, role limitations due to emotional problems, and mental health) of the SF-36 when comparisons were made with the general reference population.

Conclusions: The new and important finding in this study is that the trauma population seems to have a trauma-specific HRQoL outcome pattern. First, there is a large and significant decrease in the physical dimensions of the SF-36, which is due to musculoskeletal effects and pain secondary to the trauma. This normalizes within 2 years, whereas the overall decrease in HRQoL remains and most importantly it is seen mainly in the psychologic dimensions and it is due to preexisting diseases

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2012
Keywords
Multiple trauma, follow-up, critical care, comorbidity
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-17827 (URN)10.1097/TA.0b013e31821a416a (DOI)000300781000051 ()
Note

On the day of the defence date the title of this article was "Pre-existing disease is an important contributor to reduced health related quality of life after critical care in Swedish trauma patients".

Funding agencies|Health Research Council in the South-East of Sweden (FORSS)| F2004-204 |County Council of Ostergotland, Sweden||

Available from: 2009-04-22 Created: 2009-04-22 Last updated: 2017-12-13Bibliographically approved
Orwelius, L., Nordlund, A., Nordlund, P., Simonsson, E., Bäckman, C., Samuelsson, A. & Sjöberg, F. (2010). Pre-existing disease: the most important factor for health related quality of life long-term after critical illness: a prospective, longitudinal, multicentre trial. Critical Care, 14(2)
Open this publication in new window or tab >>Pre-existing disease: the most important factor for health related quality of life long-term after critical illness: a prospective, longitudinal, multicentre trial
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2010 (English)In: Critical Care, ISSN 1364-8535, E-ISSN 1466-609X, Vol. 14, no 2Article in journal (Refereed) Published
Abstract [en]

Introduction

The aim of the present multicenter study was to assess long term (36 months) health related quality of life in patients after critical illness, compare ICU survivors health related quality of life to that of the general population and examine the impact of pre-existing disease and factors related to ICU care on health related quality of life.

Methods

Prospective, longitudinal, multicentre trial in three combined medical and surgical intensive care units of one university and two general hospitals in Sweden. By mailed questionnaires, health related quality of life was assessed at 6, 12, 24 and 36 months after the stay in ICU by EQ-5D and SF-36, and information of pre-existing disease was collected at the 6 months measure. ICU related factors were obtained from the local ICU database. Comorbidity and health related quality of life (EQ-5D; SF-36) was examined in the reference group. Among the 5306 patients admitted, 1663 were considered eligible (>24 hrs in the intensive care unit, and age ≥ 18 yrs, and alive 6 months after discharge). At the 6 month measure 980 (59%) patients answered the questionnaire. Of these 739 (75%) also answered at 12 month, 595 (61%) at 24 month, and 478 (47%) answered at the 36 month measure. As reference group, a random sample (n = 6093) of people from the uptake area of the hospitals were used in which concurrent disease was assessed and adjusted for.

Results

Only small improvements were recorded in health related quality of life up to 36 months after ICU admission. The majority of the reduction in health related quality of life after care in the ICU was related to the health related quality of life effects of pre-existing diseases. No significant effect on the long-term health related quality of life by any of the ICU-related factors was discernible.

Conclusions

A large proportion of the reduction in the health related quality of life after being in the ICU is attributable to pre-existing disease. The importance of the effect of pre-existing disease is further supported by the small, long term increment in the health related quality of life after treatment in the ICU. The reliability of the conclusions is supported by the size of the study populations and the long follow-up period.

 

Place, publisher, year, edition, pages
BioMed Central, 2010
Keywords
Critical care, Follow-up, Longitudinal, Comorbidity
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-17826 (URN)10.1186/cc8967 (DOI)20398310 (PubMedID)
Available from: 2009-04-22 Created: 2009-04-22 Last updated: 2017-12-13Bibliographically approved
Medin, J., Ekberg, K., Nordlund, A. & Eklund, J. (2008). Organisational change, job strain and increased risk of stroke?: a pilot study. Work: A journal of Prevention, Assesment and rehabilitation, 31(4), 443-449
Open this publication in new window or tab >>Organisational change, job strain and increased risk of stroke?: a pilot study
2008 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 31, no 4, p. 443-449Article in journal (Refereed) Published
Abstract [en]

Aims: The objective of this pilot study was to explore whether organisational change and work-related stress, as measured by the Job Content Questionnaire, were associated with first-ever stroke among working people aged 30–65.

Methods: In a case-control study a total of 65 consecutive cases, aged 30–65 years of age, with first-ever stroke were recruited from four hospitals in Sweden during 2000–2002. During the same period, 103 random population controls in the same age interval were recruited. Data on job-related stress and traditional medical risk factors were collected by a questionnaire.

Results: In the multivariate analyses, organisational change (OR 3.38) increased the likelihood of stroke, while experiencing an active job (OR 0.37) decreased the likelihood of stroke. Regarding risk factors outside work, age (OR 1.11), low physical activity (OR 5.21), low education (OR 2.48) and family history of stroke (OR 2.59) were associated with increased likelihood of stroke.

Conclusion: This study suggests an association between organisational change, work-related stress and stroke. The likelihood of stroke was lower for people in active job situations.

Keywords
Stroke, downsizing, work-related stress
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-16715 (URN)
Available from: 2009-02-14 Created: 2009-02-13 Last updated: 2017-12-14Bibliographically approved
Liljegren, M., Nordlund, A. & Ekberg, K. (2008). Personality and Social Sciences: Psychometric evaluation and further validation of the Hagedoorn et al. modified EVLN measure. Scandinavian Journal of Psychology, 49(2), 169-177
Open this publication in new window or tab >>Personality and Social Sciences: Psychometric evaluation and further validation of the Hagedoorn et al. modified EVLN measure
2008 (English)In: Scandinavian Journal of Psychology, ISSN 0036-5564, Vol. 49, no 2, p. 169-177Article in journal (Refereed) Published
Abstract [en]

The aim of the present study was to evaluate and further validate a modified Exit, Voice, Loyalty and Neglect (EVLN) instrument (Hagedoorn, Van Yperen, Van de Vliert & Buunk, 1999), in a Swedish sample (n= 792). To test the underlying scaling assumptions, the convergent and divergent validity, a multitrait/multi-item analysis was conducted and factor analyses were used to evaluate the factor structure. The concurrent validity was tested by using the modified EVLN instrument as predictor and three different forms of justice as criteria in the analysis. The criterion-related validity was tested and an association between exit behavioral response and actual exit behavior was found (predictive validity). The results showed that the instrument may be considered to be a valid measure with the exception of the aggressive voice scale.

Keywords
Psychometric evaluation • validation • EVLN • behavioral responses
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-13223 (URN)10.1111/j.1467-9450.2007.00620.x (DOI)
Available from: 2008-04-28 Created: 2008-04-28 Last updated: 2013-09-03
Orwelius, L., Nordlund, A., Nordlund, P., Edéll-Gustafsson, U. & Sjöberg, F. (2008). Prevalence of sleep disturbances and long-term reduced health-related quality of life after critical care: a prospective multicenter cohort study. Critical care (London, England), 12(4), R97
Open this publication in new window or tab >>Prevalence of sleep disturbances and long-term reduced health-related quality of life after critical care: a prospective multicenter cohort study
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2008 (English)In: Critical care (London, England), ISSN 1466-609X, Vol. 12, no 4, p. R97-Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: The aim of the present prospective multicenter cohort study was to examine the prevalence of sleep disturbance and its relation to the patient's reported health-related quality of life after intensive care. We also assessed the possible underlying causes of sleep disturbance, including factors related to the critical illness.

METHODS: Between August 2000 and November 2003 we included 1,625 consecutive patients older than 17 years of age admitted for more than 24 hours to combined medical and surgical intensive care units (ICUs) at three hospitals in Sweden. Conventional intensive care variables were prospectively recorded in the unit database. Six months and 12 months after discharge from hospital, sleep disturbances and the health-related quality of life were evaluated using the Basic Nordic Sleep Questionnaire and the Medical Outcomes Study 36-item Short-form Health Survey, respectively. As a nonvalidated single-item assessment, the quality of sleep prior to the ICU period was measured. As a reference group, a random sample (n = 10,000) of the main intake area of the hospitals was used.

RESULTS: The prevalence of self-reported quality of sleep did not change from the pre-ICU period to the post-ICU period. Intensive care patients reported significantly more sleep disturbances than the reference group (P < 0.01). At both 6 and 12 months, the main factor that affected sleep in the former hospitalised patients with an ICU stay was concurrent disease. No effects were related to the ICU period, such as the Acute Physiology and Chronic Health Evaluation score, the length of stay or the treatment diagnosis. There were minor correlations between the rate and extent of sleep disturbance and the health-related quality of life.

CONCLUSION: There is little change in the long-term quality of sleep patterns among hospitalised patients with an ICU stay. This applies both to the comparison before and after critical care as well as between 6 and 12 months after the ICU stay. Furthermore, sleep disturbances for this group are common. Concurrent disease was found to be most important as an underlying cause, which emphasises that it is essential to include assessment of concurrent disease in sleep-related research in this group of patients.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-17825 (URN)10.1186/cc6973 (DOI)18673569 (PubMedID)
Note

Original Publication: Lotti Orvelius, Anders Nordlund, Peter Nordlund, Ulla Edéll-Gustafsson and Folke Sjöberg, Prevalence of sleep disturbances and long-term reduced health-related quality of life after critical care: a prospective multicenter cohort study, 2008, Critical care (London, England), (12), 4, R97. http://dx.doi.org/10.1186/cc6973 Licencee: BioMed Central http://www.biomedcentral.com/

Available from: 2009-04-22 Created: 2009-04-22 Last updated: 2014-01-10Bibliographically approved
Medin, J., Nordlund, A. & Ekberg, K. (2007). Sick leave, disability pension and health-care-seeking behaviour prior to stroke, among people aged 30–65: a case–control study. Brain Injury, 21(5), 457-463
Open this publication in new window or tab >>Sick leave, disability pension and health-care-seeking behaviour prior to stroke, among people aged 30–65: a case–control study
2007 (English)In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 21, no 5, p. 457-463Article in journal (Refereed) Published
Abstract [en]

Primary objective: To explore sick leave, disability pension and health-care-seeking behaviour among people 30–65 years of age prior to their stroke in 2001 in the county of Östergötland, Sweden.

Research design: A register-based, retrospective case–control study for the period 1 January 1998–31 December 2000. Cases (n = 212): patients aged 30–65 with first-ever stroke in 2001. Controls (n = 4606): people aged 30–65, randomly selected from the same base population.

Main outcomes and results: More than 91 days of accumulated sick leave among women was associated with increased likelihood of developing stroke (OR = 1.89). Among men, 29–90 days and more than 91 days on sick leave increased the likelihood of stroke (OR = 2.34 and OR = 3.43, respectively).

Conclusion: Frequent health-care-seeking behaviour is not a tool for identifying women who develop stroke, while it may be an indicator for men. Accumulated sick leave may be a tool for identifying men and women with higher risk of stroke.

Read More: http://informahealthcare.com/doi/abs/10.1080/02699050701317643

Keywords
Sick-leave, stroke, public health, health-care seeking behaviour
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-38631 (URN)10.1080/02699050701317643 (DOI)45108 (Local ID)45108 (Archive number)45108 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13Bibliographically approved
Bernfort, L., Persson, J., Ekberg, K., Öberg, B. & Nordlund, A. (2006). Economic evaluation in a cluster randomized controlled study of work place intervention in south-east Sweden. In: International workshop Economic Evaluations of Occupational Health Interventions,2006.
Open this publication in new window or tab >>Economic evaluation in a cluster randomized controlled study of work place intervention in south-east Sweden
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2006 (English)In: International workshop Economic Evaluations of Occupational Health Interventions,2006, 2006Conference paper, Published paper (Refereed)
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-37150 (URN)33801 (Local ID)33801 (Archive number)33801 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2013-09-03
Ekberg, K., Strindlund, L. & Nordlund, A. (2006). Effort-Reward Imbalance and Overcomittment among Sick-listed Health Care Workers with Mental Adjustment Problems. In: 28th International Congress on Occupational Health,2006 (pp. 56-56).
Open this publication in new window or tab >>Effort-Reward Imbalance and Overcomittment among Sick-listed Health Care Workers with Mental Adjustment Problems
2006 (English)In: 28th International Congress on Occupational Health,2006, 2006, p. 56-56Conference paper, Published paper (Other academic)
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-37506 (URN)36435 (Local ID)36435 (Archive number)36435 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2013-09-03
Barajas, J., Nordlund, A. & Ekberg, K. (2006). Employee-Perceived Leadership Behaviour and Effort-Reward Imbalance & Overcomittment. In: 28th International Congress on Occupational Health,2006 (pp. 105-105).
Open this publication in new window or tab >>Employee-Perceived Leadership Behaviour and Effort-Reward Imbalance & Overcomittment
2006 (English)In: 28th International Congress on Occupational Health,2006, 2006, p. 105-105Conference paper, Published paper (Other academic)
Abstract [en]

  

National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-37504 (URN)36433 (Local ID)36433 (Archive number)36433 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2013-09-03
Ydreborg, B., Ekberg, K. & Nordlund, A. (2006). Health, quality of life, social network and use of public health: A comparison between those granted and those not granted disability pension. Disability and Rehabilitation, 28(1), 25-32
Open this publication in new window or tab >>Health, quality of life, social network and use of public health: A comparison between those granted and those not granted disability pension
2006 (English)In: Disability and Rehabilitation, ISSN 0963-8288, Vol. 28, no 1, p. 25-32Article in journal (Refereed) Published
Abstract [en]

Purpose. The aim was to compare self-rated health, health-related quality of life (HRQoL), social networks and health care utilisation of those granted disability pension (DP) and those not granted disability pension (nDP).

Method. Demographic data and medical diagnoses were obtained from the records of the social insurance office. Data concerning self-reported health, HRQoL social networks, and use of health care were collected by a postal questionnaire. The nDP group included all those not granted full DPs between 1999 and 2000 (n = 99). The DP group were a random sample of those granted full DPs, during the same period (n = 197).

Results. The nDP group had more often multiple diagnoses, and lower self-reported health and HRQoL compared to those granted DP. In particular, their average scores were lower on the SF-36 scales social functioning, role limitations due to physical problems and mental health. The nDP group also had significantly smaller social networks.

Conclusions. Contrary to expectations, those not granted a disability pension do not seem to have better health, but rather to suffer from more sickness than those who were granted a disability pension.

Keywords
Disability pension; self-reported health; social networks; vulnerable group
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13762 (URN)10.1080/09638280500165179 (DOI)
Available from: 2006-01-24 Created: 2006-01-24 Last updated: 2013-09-03
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