liu.seSearch for publications in DiVA
Change search
Link to record
Permanent link

Direct link
Alternative names
Publications (10 of 65) Show all publications
Kassymova, G., Sydsjö, G., Borendal Wodlin, N., Nilsson, L. & Kjölhede, P. (2023). Effect of nurse-led telephone follow-up on postoperative symptoms and analgesics consumption after benign hysterectomy: a randomized, single-blinded, four-arm, controlled multicenter trial. Archives of Gynecology and Obstetrics, 307(2), 459-471
Open this publication in new window or tab >>Effect of nurse-led telephone follow-up on postoperative symptoms and analgesics consumption after benign hysterectomy: a randomized, single-blinded, four-arm, controlled multicenter trial
Show others...
2023 (English)In: Archives of Gynecology and Obstetrics, ISSN 0932-0067, E-ISSN 1432-0711, Vol. 307, no 2, p. 459-471Article in journal (Refereed) Published
Abstract [en]

Purpose The study aimed to determine if planned telephone follow-up, especially when adding structured, oriented coaching, reduces the intensity of postoperative symptoms and decreases analgesics consumption after benign hysterectomy. Methods A randomized, single-blinded, four-armed, controlled multicenter trial of 525 women scheduled for hysterectomy was conducted in 5 hospitals in the southeast health region of Sweden. The women were allocated 1:1:1:1 into four follow-up models: (A) no telephone follow-up (control group); (B) one planned, structured, telephone follow-up the day after discharge; (C) as B but with additional telephone follow-up once weekly for 6 weeks; and (D) as C but with oriented coaching telephone follow-up on all occasions. Postoperative symptoms were assessed using the Swedish Postoperative Symptoms Questionnaire. Analgesic consumption was registered. Unplanned telephone contacts and visits were registered during the 6 weeks of follow-up. Results In total, 487 women completed the study. Neither pain intensity, nor symptom sum score or analgesic consumption differed between the intervention groups. Altogether, 224 (46.0%) women had unplanned telephone contacts and 203 (41.7%) had unplanned visits. Independent of intervention, the women with unplanned telephone contacts had higher pain intensity and symptom sum scores, particularly if an unplanned telephone contact was followed by a visit, or an unplanned visit was preceded by an unplanned telephone contact. Conclusion Telephone follow-up did not seem to affect recovery regarding symptoms or analgesic consumption after benign hysterectomy in an enhanced recovery after surgery (ERAS) setting. Unplanned telephone contacts and visits were associated with more postoperative symptoms, especially pain. Trial registration The study is registered in ClinicalTrial.gov: NCT01526668 retrospectively from January 27; 2012. Date of enrolment of first patient: October 11; 2011.

Place, publisher, year, edition, pages
Springer Heidelberg, 2023
Keywords
Coaching; ERAS; Hysterectomy; Postoperative symptoms; Telephone follow-up
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-188422 (URN)10.1007/s00404-022-06722-x (DOI)000849308000001 ()36050542 (PubMedID)2-s2.0-85137343979 (Scopus ID)
Note

Funding Agencies|Linkoping University; Medical Research Council of Southeast Sweden [FORSS-155141, FORSS-222211, FORSS308441, FORSS-387761]; ALF Grants Region Ostergotland [RO-276871, RO-356651, RO-448391RO 607891, RO-794531]; Futurum the Academy of Health and Care; Region Jonkoping Council [FUTURUM-487481, FUTURUM 579171]

Available from: 2022-09-14 Created: 2022-09-14 Last updated: 2023-08-16
Grundström, H., Fredrikson, M., Alehagen, S., Berterö, C. & Kjölhede, P. (2023). Incidence of self-reported pelvic pain and risk factors for pain 1 year after benign hysterectomy: A register study from the Swedish National Quality Registry for Gynecological Surgery. Acta Obstetricia et Gynecologica Scandinavica, 102(10), 1359-1370
Open this publication in new window or tab >>Incidence of self-reported pelvic pain and risk factors for pain 1 year after benign hysterectomy: A register study from the Swedish National Quality Registry for Gynecological Surgery
Show others...
2023 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 102, no 10, p. 1359-1370Article in journal (Refereed) Published
Abstract [en]

Introduction The primary aim of this study was to determine the incidence of patient-reported pain 1 year after hysterectomy for benign gynecological conditions in relation to occurrence of preoperative pain. The secondary aim was to analyze clinical risk factors for pain 1 year after the hysterectomy in women with and without preoperatively reported pelvic/lower abdominal pain. Material and methods This was a historical cohort study using data from the Swedish National Quality Registry for Gynecological Surgery on 16 694 benign hysterectomies. Data were analyzed using multivariable logistic regression models. Results One year after surgery, 22.4% of women with preoperative pain reported pelvic pain and 7.8% reported de novo pelvic pain. For those with preoperative pain younger age (adjusted odds ratio [aOR] 1.75, 95% confidence interval [CI] 1.38-2.23 and aOR 1.21, 95% CI 1.10-1.34 for women aged <35 and 35-44 years, respectively), not being gainfully employed (aOR 1.43, 95% CI 1.26-1.63), pelvic pain as the main symptom leading to hysterectomy (aOR 1.51, 95% CI 1.19-1.90), endometriosis (aOR 1.18, 95% CI 1.06-1.31), and laparoscopic hysterectomy (aOR 1.30, 95% CI 1.07-1.58), were clinically relevant independent risk factors for pelvic/lower abdominal pain 1 year after surgery, as were postoperative complications within 8 weeks after discharge. Meanwhile, clinically relevant independent risk factors for reporting de novo pain 1 year after surgery were younger age (aOR 2.05, 95% CI 1.08-3.86 and aOR 1.29, 95% CI 1.04-1.60 for women aged <35 and 35-44 years, respectively), and postoperative complications within 8 weeks after discharge. Conclusions The incidence of pelvic pain and de novo pain 1 year after hysterectomy was relatively high. Women with and without reported preoperative pelvic/lower abdominal pain represented clinically different populations. The risk factors for pelvic pain seemed to differ in these two populations. The differences in risk factors could be taken into consideration in the preoperative counseling and in the decision-making concerning method of hysterectomy, provided that large well-designed studies confirm these risk factors.

Place, publisher, year, edition, pages
Wiley, 2023
Keywords
epidemiology; hysterectomy; incidence; lower abdominal pain; pelvic pain; risk factors
National Category
General Practice
Identifiers
urn:nbn:se:liu:diva-188576 (URN)10.1111/aogs.14455 (DOI)000852493100001 ()36073635 (PubMedID)
Note

Funding Agencies|County council of Ostergotland; Linkoping University

Available from: 2022-09-19 Created: 2022-09-19 Last updated: 2023-11-30Bibliographically approved
Borendal Wodlin, N., Oliv, E., Kjölhede, P. & Nilsson, L. (2023). Influence of Regional Analgesia on Self-Reported Quality of Sleep After Gynecological Abdominal Surgery: A Secondary Analysis of a Randomized Trial. Journal of Obstetrics and Gynaecology Canada
Open this publication in new window or tab >>Influence of Regional Analgesia on Self-Reported Quality of Sleep After Gynecological Abdominal Surgery: A Secondary Analysis of a Randomized Trial
2023 (English)In: Journal of Obstetrics and Gynaecology Canada, ISSN 1701-2163Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objectives: To determine whether intrathecal morphine (ITM) analgesia in abdominal surgery for presumed gynecological malignancy was associated with better self-reported sleep quality postoperatively compared with epidural analgesia (EDA), and to evaluate risk factors for bad sleep quality. Methods: A secondary analysis of a randomized open controlled trial, comparing ITM and EDA as postoperative analgesia in 80 women undergoing laparotomy under general anaesthesia in an enhanced recovery after surgery framework. A total of 38 women allocated to ITM and 39 to EDA completed the study. The Swedish Postoperative Symptoms Questionnaire assessed symptoms and sleep quality during the first postoperative week. Multiple logistic regression models evaluated risk factors. The results are presented as adjusted odds ratios with 95% CIs. Results: The sleep quality night-by-night did not differ significantly between the women who had ITM or EDA. Risk factors for bad sleep quality for night 1 were age (0.91; 0.84–0.99), operation time (1.02; 1.00–1.03), and opioid consumption (0.96; 0.91–0.99). For night 2, regular use of hypnotics preoperatively (15.81; 1.52–164.27) and opioid consumption (1.07; 1.00–1.14) were independent risk factors for bad sleep. After the second night, no risk factors were disclosed. Conclusions: ITM and EDA did not appear to affect the sleep quality postoperatively differently in women undergoing laparotomy for presumed gynecological malignancy. Risk factors for self-reported bad sleep quality varied during the first 3 days after surgery. Younger age, longer operation time, and preoperative use of hypnotics were associated with bad sleep quality, whereas the effect of opioid consumption on sleep quality varied depending on the time since surgery. These findings merit further studies. © 2023 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada

Place, publisher, year, edition, pages
Elsevier Inc., 2023
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-200762 (URN)10.1016/j.jogc.2023.102228 (DOI)2-s2.0-85175264043 (Scopus ID)
Note

Cited by: 0

Available from: 2024-02-07 Created: 2024-02-07 Last updated: 2024-02-07
Olsson, C., Wilde Larsson, B., Larsson, M., Holmberg, E., Marcickiewicz, J., Tholander, B., . . . Borgfeldt, C. (2022). Adaption of the Quality From the Patient’s Perspective Instrument for Use in Assessing Gynecological Cancer Care and Patients’ Perceptions of Quality Care Received. Cancer Care Research Online, 2(1), e019-e019
Open this publication in new window or tab >>Adaption of the Quality From the Patient’s Perspective Instrument for Use in Assessing Gynecological Cancer Care and Patients’ Perceptions of Quality Care Received
Show others...
2022 (English)In: Cancer Care Research Online, E-ISSN 2691-3623, Vol. 2, no 1, p. e019-e019Article in journal (Refereed) Published
Abstract [en]

Background: Research focusing on patients’ perceptions of the quality of gynecological cancer care is needed.

Objective: To adapt the Quality from the Patient’s Perspective instrument for use in gynecological cancer care (QPP-GynCa) and describe patients’ perceptions of their quality of care in terms of the care received and the subjective importance of the aspects of care.

Methods: A cross-sectional study 6–8 months after diagnosis was conducted, involving 1511 patients (response rate of 50.4%) included in the Swedish quality registry for gynecologic cancer.

Results: The exploratory factor analysis (n = 1431) resulted in the QPP-GynCa with a 5-factor structure and an eigenvalue of ≥1, explaining 73.1% of the total scale variance. The final 27-item version of the QPP-GynCa consisted of 18 items with 8 additional single items and 1 global single item. The Cronbach’s alpha was acceptable for most factors (>.80). Subjective importance scores were higher than corresponding quality of care scores for care received (P ≤ .01)in all dimensions, factors, and items.

Conclusions: The QPP-GynCa instrument reflects all 4 dimensions of the theoretical model of quality of care and achieved good validity as a reliable instrument in assessing the quality of gynecological cancer care.

Implication for Practice: Information related to self-care, aspects of sexuality, and reducing patient waiting times need improvement.

What Is Foundational: This study contributes to a better understanding of quality of gynecological cancer treatment and care. The validated QPP-GynCa instrument will be a platform for more research on how this group of patients experience their received care, as well as importance of each aspect of care.

Place, publisher, year, edition, pages
Wolters Kluwer, 2022
Keywords
factor analysis; gynecological cancer care; instrument development; patient perspectives; quality of health care
National Category
Nursing Cancer and Oncology
Identifiers
urn:nbn:se:liu:diva-192131 (URN)10.1097/cr9.0000000000000019 (DOI)
Available from: 2023-03-03 Created: 2023-03-03 Last updated: 2023-03-23
Radestad, A. F., Dahm-Kahler, P., Holmberg, E., Bjurberg, M., Hellman, K., Högberg, T., . . . Borgfeldt, C. (2022). Long-term incidence of endometrial cancer after endometrial resection and ablation: A population based Swedish gynecologic cancer group (SweGCG) study. Acta Obstetricia et Gynecologica Scandinavica, 101(8), 923-930
Open this publication in new window or tab >>Long-term incidence of endometrial cancer after endometrial resection and ablation: A population based Swedish gynecologic cancer group (SweGCG) study
Show others...
2022 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 101, no 8, p. 923-930Article in journal (Refereed) Published
Abstract [en]

Introduction Minimally invasive methods to reduce menorrhagia were introduced in the 1980s and 1990s. Transcervical endometrial resection (TCRE) and endometrial ablation (EA) are two of the most frequently used methods. As none of them can guarantee a complete removal of the endometrium, there are concerns that the remaining endometrium may develop to endometrial cancer (EC) later in life. The primary aim was to analyze the long-term incidence of EC after TCRE and EA in a nationwide population. The secondary aim was to assess the two treatment modalities separately. Material and Methods The Swedish National Patient Registry and National Quality Registry for Gynecological Surgery were used for identification of women who had TCRE or EA performed between 1997-2017. The cohort was followed from the first TCRE or EA until hysterectomy, diagnosis of EC, or death. Follow-up data were retrieved from the National Cancer Registry and the National Death Registry. Expected incidence for EC in Swedish women was calculated using Swedish data retrieved from the NORDCAN project after having taken into account differences of age and follow-up time. Cumulative incidence of EC after TCRE and EA, was calculated. A standardized incidence ratio was calculated based on the expected and observed incidence, stratified by age and year of diagnosis. Results In total, 17 296 women (mean age 45.1 years) underwent TCRE (n = 8626) or EA (n = 8670). Excluded were 3121 who had a hysterectomy for benign causes during follow up. During a median follow-up time of 7.1 years (interquartile range 3.1-13.3 years) the numbers of EC were 25 (0.3%) after TCRE and 2 (0.02%) after EA, respectively. The observed incidence was significantly lower than expected (population-based estimate) after EA but not after TCRE, giving a standardized incidence ratio of 0.13 (95% confidence interval [CI] 0.03-0.53) after EA and 1.27 (95% CI 0.86-1.88) after TCRE. Median times to EC were 3.0 and 8.3 years after TCRE and EA, respectively. Conclusions There was a significant reduction of EC after EA, suggesting a protective effect, whereas endometrial resection showed an incidence within the expected rate.

Place, publisher, year, edition, pages
WILEY, 2022
Keywords
endometrial ablation; endometrial cancer incidence; endometrial cancer risk; menorrhagia; transcervical endometrial resection
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-185831 (URN)10.1111/aogs.14385 (DOI)000805401100001 ()35624547 (PubMedID)
Note

Funding Agencies|Swedish Cancer Society

Available from: 2022-06-15 Created: 2022-06-15 Last updated: 2023-02-09Bibliographically approved
Wedin, M., Stalberg, K., Marcickiewicz, J., Ahlner, E., Ottander, U., Åkesson, Å., . . . Kjølhede, P. (2021). Risk factors for lymphedema and method of assessment in endometrial cancer: a prospective longitudinal multicenter study. International Journal of Gynecological Cancer, 31(11), 1416-1427
Open this publication in new window or tab >>Risk factors for lymphedema and method of assessment in endometrial cancer: a prospective longitudinal multicenter study
Show others...
2021 (English)In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 31, no 11, p. 1416-1427Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The aim of the study was to determine risk factors for lymphedema of the lower limbs, assessed by four methods, 1 year after surgery for endometrial cancer.

METHODS: A prospective longitudinal multicenter study was conducted in 14 Swedish hospitals. 235 women with endometrial cancer were included; 116 underwent surgery including lymphadenectomy, and 119 had surgery without lymphadenectomy. Lymphedema was assessed preoperatively and 1 year postoperatively objectively by systematic circumferential measurements of the legs, enabling volume estimation addressed as (1) crude volume and (2) body mass index-standardized volume, or (3) clinical grading, and (4) subjectively by patient-reported perception of leg swelling. In volume estimation, lymphedema was defined as a volume increase ≥10%. Risk factors were analyzed using forward stepwise logistic regression models and presented as adjusted odds ratio (aOR) and 95% confidence interval (95% CI).

RESULTS: Risk factors varied substantially, depending on the method of determining lymphedema. Lymphadenectomy was a risk factor for lymphedema when assessed by body mass index-standardized volume (aOR 14.42, 95% CI 3.49 to 59.62), clinical grading (aOR 2.11, 95% CI 1.04 to 4.29), and patient-perceived swelling (aOR 2.51, 95% CI 1.33 to 4.73), but not when evaluated by crude volume. Adjuvant radiotherapy was only a risk factor for lymphedema when assessed by body mass index-standardized volume (aOR 15.02, 95% CI 2.34 to 96.57). Aging was a risk factor for lymphedema when assessed by body mass index-standardized volume (aOR 1.07, 95% CI 1.00 to 1.15) and patient-perceived swelling (aOR 1.06, 95% CI 1.02 to 1.10), but not when assessed by crude volume or clinical grading. Increase in body mass index was a risk factor for lymphedema when estimated by crude volume (aOR 1.92, 95% CI 1.36 to 2.71) and patient-perceived swelling (aOR 1.36, 95% CI 1.11 to 1.66), but not by body mass index-standardized volume or clinical grading. The extent of lymphadenectomy was strongly predictive for the development of lymphedema when assessed by body mass index-standardized volume and patient-perceived swelling, but not by crude volume or clinical grading.

CONCLUSION: Apparent risk factors for lymphedema differed considerably depending on the method used to determine lymphedema. This highlights the need for a 'gold standard' method when addressing lymphedema for determining risk factors.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2021
Keywords
Endometrial neoplasms, SLN and lympadenectomy, Surgery
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-180706 (URN)10.1136/ijgc-2021-002890 (DOI)000715381200004 ()34610970 (PubMedID)
Note

Funding: Swedish Cancer Society (Cancerfonden)Swedish Cancer Society [CAN2013/620]; Medical Research Council of Southeast SwedenUK Research & Innovation (UKRI)Medical Research Council UK (MRC) [FORSS-308611, FORSS-391311, FORSS-662141, FORSS-858611]; Uppsala-Orebro Regional Research Council [LUL-349271]; Scientific Council of the Region Halland; County Council of Ostergotland; Linkoping University

Available from: 2021-11-01 Created: 2021-11-01 Last updated: 2021-11-23Bibliographically approved
Kassymova, G., Sydsjö, G., Borendal Wodlin, N., Nilsson, L. & Kjölhede, P. (2021). The Effect of Follow-Up Contact on Recovery After Benign Hysterectomy: A Randomized, Single-Blinded, Four-Arm, Controlled Multicenter Trial. Journal of Women's Health, 30(6), 872-881
Open this publication in new window or tab >>The Effect of Follow-Up Contact on Recovery After Benign Hysterectomy: A Randomized, Single-Blinded, Four-Arm, Controlled Multicenter Trial
Show others...
2021 (English)In: Journal of Women's Health, ISSN 1540-9996, E-ISSN 1931-843X, Vol. 30, no 6, p. 872-881Article in journal (Refereed) Published
Abstract [en]

Background: The objective of this trial was to analyze the effect of follow-up programs using standard follow-up protocol and structured coaching on recovery after hysterectomy in an enhanced recovery after surgery setting. Materials and Methods: A randomized, four-armed, single-blinded, controlled multicenter trial comprising 487 women was conducted at five hospitals in the southeast region of Sweden. The women were allocated (1:1:1:1) to Group A: no planned follow-up contact; Group B: a single, planned, structured, broadly kept, follow-up telephone contact with the research nurse the day after discharge; Group C: planned, structured, broadly kept follow-up telephone contact with the research nurse the day after discharge and then once weekly for 6 weeks; and Group D: as Group C, but with planned, structured, coaching telephone contact. Recovery was assessed by the health-related quality of life (HRQoL) questionnaires EuroQoL-5 Dimension with three levels (EQ-5D-3L) and Short-Form-Health Survey with 36 items (SF-36) and duration of sick leave. Results: Neither the recovery of HRQoL as measured by the EQ-5D-3L and the SF-36 nor the duration of sick leave (mean 26.8-28.1 days) differed significantly between the four intervention groups. Irrespective of mode of follow-up contact used, the women had recovered to their baseline EQ-5D-3L health index 4 weeks after surgery. The occurrence of unplanned telephone contact was significantly lower (by nearly 30%) in the women who had structured coaching. Conclusion: Follow-up contact, including coaching, did not seem to expedite the postoperative recovery in HRQoL or reduce the sick leave after hysterectomy, but the coaching seemed to reduce unplanned telephone contact with the health care services. ClinicalTrial.gov (NCT01526668).

Place, publisher, year, edition, pages
MARY ANN LIEBERT, INC, 2021
Keywords
coaching; enhanced recovery after surgery; follow-up; hysterectomy; health-related quality of life; recovery
National Category
Other Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-171936 (URN)10.1089/jwh.2020.8752 (DOI)000593314100001 ()33232628 (PubMedID)
Note

Funding Agencies|Medical Research Council of Southeast Sweden [FORSS-155141, FORSS-222211, FORSS-308441, FORSS-387761]; Futurum-the Academy of Health and Care, Region Jonkoping Council [FUTURUM-487481, FUTURUM 579171]; Region Ostergotland Council; Linkoping University

Available from: 2020-12-16 Created: 2020-12-16 Last updated: 2023-08-16
Zach, D., Kannisto, P., Stenström Bohlin, K., Moberg, L. & Kjölhede, P. (2020). Can we extend the indication for sentinel node biopsy in vulvar cancer? A nationwide feasibility study from Sweden. International Journal of Gynecological Cancer, 30(3), 402-405
Open this publication in new window or tab >>Can we extend the indication for sentinel node biopsy in vulvar cancer? A nationwide feasibility study from Sweden
Show others...
2020 (English)In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 30, no 3, p. 402-405Article in journal (Refereed) Published
Abstract [en]

Background: In squamous cell vulvar cancer, sentinel node biopsy is accepted as standard treatment in well-defined patient groups and has reduced surgical morbidity considerably. Currently, due to the lack of evidence, it cannot be offered to patients with tumors of 4 cm diameter or greater or with multifocal tumors, or in local recurrences.

Primary objective: This study is primarily a pilot and feasibility trial, aiming to evaluate if the prerequisites concerning detection rate and negative predictive value are satisfactory before the implementation of a multinational trial.

Study hypothesis: Sentinel node biopsy has an acceptable negative predictive value and detection rate in the study cohort.

Trial design: This study is planned as a prospective, national, multicenter interventional trial. Participating patients will undergo a sentinel node biopsy in addition to an inguinofemoral lymphadenectomy.

Inclusion and exclusion criteria: Inclusion criteria: for women in group 1, a primary tumor ≥4 cm in diameter; in group 2, a multifocal primary tumor; in group 3, a local recurrence without previous inguinofemoral lymphadenectomy or radiation to the groins; in group 4, a local recurrence, with previous inguinofemoral lymphadenectomy and/or radiation to the groins.

Primary endpoint: The primary endpoints are the detection rate and the negative predictive value of the sentinel node procedure.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2020
Keywords
vulvar and vaginal cancer; sentinel lymph node
National Category
Obstetrics, Gynecology and Reproductive Medicine Cancer and Oncology
Identifiers
urn:nbn:se:liu:diva-194716 (URN)10.1136/ijgc-2019-000938 (DOI)000531876000020 ()
Available from: 2023-06-08 Created: 2023-06-08 Last updated: 2023-09-01
Grundström, H., Larsson, B., Arendt-Nielsen, L., Gerdle, B. & Kjölhede, P. (2020). Pain catastrophizing is associated with pain thresholds for heat, cold and pressure in women with chronic pelvic pain. Scandinavian Journal of Pain, 20(3), 635-646
Open this publication in new window or tab >>Pain catastrophizing is associated with pain thresholds for heat, cold and pressure in women with chronic pelvic pain
Show others...
2020 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 20, no 3, p. 635-646Article in journal (Refereed) Published
Abstract [en]

Background and aims: Psychological traits such as pain catastrophizing may play a role in the development of chronic pelvic pain (CPP). Pain catastrophizing is the tendency to amplify negative cognitive and emotional pain processes. The Pain Catastrophizing Scale (PCS) assesses elements of pain catastrophizing divided into three subgroups of factors (rumination, helplessness and magnification). Previous studies have shown associations between CPP and increased pain sensitivity, widespread generalized hyperalgesia, and decreased pain thresholds, but the relation between pain catastrophizing and specific pain thresholds has not yet been widely examined in this patient group. The aims of this study were (a) to determine if catastrophizing is increased in women with CPP compared with pain-free women, (b) to assess the importance of pain catastrophizing, psychological distress variables, and subjective pain sensitivity for pain thresholds of heat, cold and pressure in these two groups, and (c) to determine whether psychological variables or pain thresholds best contribute to the differentiation between CPP and controls. Methods: Thirty-seven women with chronic pelvic pain who underwent diagnostic laparoscopy on the suspicion of endometriosis participated along with 55 healthy and pain-free controls. All underwent quantitative sensory testing on six locations on the body to determine heat (HPT), cold (CPT) and pressure (PPT) pain thresholds. The PCS, the Pain Sensitivity Questionnaire (PSQ), the Hospital Anxiety Depression Scale, (HAUS) demographics and clinical data were collected prospectively. Principal component analysis and orthogonal partial least square regressions were used to assess the associations between PCS scores and pain thresholds. Results: The women with CPP scored significantly higher on PCS than the healthy controls. PCS-helplessness, PCS-rumination and HADS-depression were significantly associated with pain thresholds for the whole group. In the CPP group, PCS-rumination, body mass index and PSQ were significant regressors for HPT and CPT. The PCS and the HADS subscales were strongly intercorrelated in women with CPP and were stronger regressors of group membership than the three pain thresholds. In the group of healthy control women, no relationships were found to be significant. The psychological variables were somewhat stronger significant regressors than pain thresholds (also significant) for group membership. Conclusions: Women with CPP have significantly higher pain catastrophizing scores than women without CPP. The pain catastrophizing rumination factor is significantly associated with pain thresholds of heat and cold in CPP women. PCS and HADS are strongly intercorrelated and PSQ correlates positively with these variables. It seems that the psychological variables are important for group differentiation.

Place, publisher, year, edition, pages
WALTER DE GRUYTER GMBH, 2020
Keywords
chronic pelvic pain; catastrophizing; PCS; pain thresholds
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-174010 (URN)10.1515/sjpain-2020-0015 (DOI)000551937700020 ()32383692 (PubMedID)
Note

Funding Agencies|Medical Research Council of Southeast SwedenUK Research & Innovation (UKRI)Medical Research Council UK (MRC); Swedish Research CouncilSwedish Research CouncilEuropean Commission; County council of Ostergotland; Linkoping University; IMI Paincare

Available from: 2021-03-16 Created: 2021-03-16 Last updated: 2021-03-16
Wedin, M., Fredrikson, M., Ahlner, E., Falk, A., Sandstrom, A., Lindahl, G., . . . Kjölhede, P. (2020). Validation of the Lymphoedema Quality of Life Questionnaire (LYMQOL) in Swedish cancer patients. Acta Oncologica, 59(3), 365-371
Open this publication in new window or tab >>Validation of the Lymphoedema Quality of Life Questionnaire (LYMQOL) in Swedish cancer patients
Show others...
2020 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 59, no 3, p. 365-371Article in journal (Refereed) Published
Abstract [en]

Background: The aim of this study was to validate a translated Swedish version of the lymphoedema-specific quality of life questionnaire (LYMQOL) in a cohort of Swedish cancer patients with secondary lymphoedema of the limbs after cancer treatment.

Material and methods: We recruited 102 patients with lymphoedema of the arms or legs after cancer treatment who were visiting lymphoedema therapists at the departments of oncology at the university hospitals in Linköping and Umeå. The LYMQOL questionnaires were translated forward and backward from English to Swedish. Content and face validity were evaluated. The construct validity was assessed by comparing the LYMQOL with the Short Form Health Survey (SF-36) and the perceived degree of lymphoedema of the limbs, respectively. Reliability was determined through test-retest. The internal consistency was assessed by determining Cronbach’s alpha and by factor analysis.

Results: The content and face validity assessments showed that LYMQOL was an easy, clear and not too long questionnaire to use for patients with lymphoedema. Construct validity was high in both versions when compared with the SF-36. The association between the degrees of perceived lymphoedema and the LYMQOL was only significant in the domains Function and Body Image in the arm version, whereas all domains in the leg version were significant. The reliability was good for the arm version (intra-class-correlation coefficients 0.53–0.87) and very good for the leg version (intra-class-correlation coefficients 0.78–0.90). The internal consistency was acceptable to excellent, with Cronbach’s alpha values between 0.79–0.93 (arm-version) and 0.87–0.94 (leg-version). The factor analysis confirmed the usefulness of the four domains in the LYMQOL versions.

Conclusions: This study confirmed the validity of the Swedish version of LYMQOL and demonstrated that LYMQOL may be a simple and useful tool for use in clinical practice and scientific contexts for evaluating QoL in patients with lymphoedema of the limbs.

Place, publisher, year, edition, pages
Taylor & Francis, 2020
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:liu:diva-162920 (URN)10.1080/0284186X.2019.1701199 (DOI)000503636500001 ()31852317 (PubMedID)2-s2.0-85076903224 (Scopus ID)
Note

Funding Agencies|Swedish Cancer SocietySwedish Cancer Society [CAN 2013/620]; Linkoping University; County Council of Ostergotland

Available from: 2020-01-02 Created: 2020-01-02 Last updated: 2021-05-07Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-5702-4116

Search in DiVA

Show all publications