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Åkerlind, Ingemar
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Publications (10 of 29) Show all publications
Olsen Faresjö, Å., Grodzinsky, E., Johansson, S., Wallander, M.-A., Timpka, T. & Åkerlind, I. (2007). A population based case control study of work and psychosocial problems in patients with irritable bowel syndrome: women are more seriously affected than men. American Journal of Gastroenterology, 102(2), 371-379
Open this publication in new window or tab >>A population based case control study of work and psychosocial problems in patients with irritable bowel syndrome: women are more seriously affected than men
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2007 (English)In: American Journal of Gastroenterology, ISSN 0002-9270, E-ISSN 1572-0241, Vol. 102, no 2, p. 371-379Article in journal (Refereed) Published
Abstract [en]

Objective: Everyday psychosocial functioning and quality of life are known to be reduced for patients with irritable bowel syndrome (IBS), but few previous studies have analyzed associations with functioning in working life. Accordingly, we examined perceptions of working conditions, functioning in the workplace, quality of life, and psychological complaints among IBS patients compared with age- and sex-matched controls.

Methods: A case–control study design was used based on 347 IBS patients from Swedish general practice who were compared with age- and sex-matched controls (N = 1,041) randomly selected from the general population. A survey was performed including validated questions concerning job strain, quality of life (SF-36 [Short Form 36]), absence because of illness, depression, anxiety, and sleeping habits.

Results: The IBS patients reported considerably more often that their daily performance in working life was affected by their gastrointestinal problems (OR [odds ratio] 7.14, 95% CI 5.45–9.36). Male IBS cases only reported less authority regarding decisions on their working pace (OR 5.44, 95% CI 1.28–23.18), while female IBS patients reported less decision authority regarding planning their work (OR 2.29, 95% CI 1.13–4.64), fewer learning opportunities at work (OR 2.12, 95% CI 1.26–3.57), and more long-term sick leave than their controls (OR 3.70, 95% CI 1.94–7.07). The female IBS cases also reported lower quality of life in all dimensions than their controls.

Conclusion: In particular, female IBS patients reported lower authority over decisions at work and problems in their daily functioning in the workplace. These associations persisted after adjustments for possible confounders such as mood, sleeping problems, and perceived health.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13967 (URN)10.1111/j.1572-0241.2006.01012.x (DOI)
Available from: 2006-09-19 Created: 2006-09-19 Last updated: 2017-12-13
Olsen Faresjö, Å., Grodzinsky, E., Johansson, S., Wallander, M.-A., Timpka, T. & Åkerlind, I. (2007). Psychosocial factors at work and in everyday life are associated with irritable bowel syndrome. European Journal of Epidemiology, 22(7), 473-480
Open this publication in new window or tab >>Psychosocial factors at work and in everyday life are associated with irritable bowel syndrome
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2007 (English)In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 22, no 7, p. 473-480Article in journal (Refereed) Published
Abstract [en]

The etiology of irritable bowel syndrome (IBS) tends to be complex and multi-factorial and there is still a lack of understanding of how different psychosocial factors are associated with the syndrome. Our aim was to examine the occurrence of psychosocial and behavioural factors among patients diagnosed with IBS in primary care. The study had an epidemiological population-based case–control design comparing 347 IBS cases to 1041 age and sex matched controls from the general population. A survey was directed to cases and controls based on validated questions asking for mood status, job strain, family history of IBS, and sleeping habits as well as education, nutritional and exercise habits and medication. In multivariate analyses, independent associations were found between IBS and lack of influence on work planning, a family history of IBS, anxiety, and sleeping disturbances. Important factors associated with IBS diagnosis among females were anxiety as well as family history of IBS and lack of co-determination at work. For males, only lack of influence on working pace and family history of IBS remained independently associated with an IBS diagnosis. The causal associations of the complex risk factor panorama for IBS warrants further study. This study indicates that there should be a special focus on investigating the psychosocial working conditions and their associations to IBS.

Keywords
Case–control study, Irritable bowel syndrome, Family history, Psychosocial factors, Risk factors
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13968 (URN)10.1007/s10654-007-9133-2 (DOI)
Available from: 2006-09-19 Created: 2006-09-19 Last updated: 2017-12-13
Faresjö, Å., Grodzinsky, E., Timpka, T. & Åkerlind, I. (2006). A case-control study of irritable bowel syndrome in primary care - female patients are seriously affected by psychosocial problems in their every day life. In: EUPHA 14th annual conference,2006.
Open this publication in new window or tab >>A case-control study of irritable bowel syndrome in primary care - female patients are seriously affected by psychosocial problems in their every day life
2006 (English)In: EUPHA 14th annual conference,2006, 2006Conference paper, Published paper (Other academic)
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-34935 (URN)24172 (Local ID)24172 (Archive number)24172 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2013-09-05
Bendtsen, P., Johansson, K. & Åkerlind, I. (2006). Feasibility of an email-based electronic screening and brief intervention (e-SBI) to college students in Sweden.. Addictive Behaviours, 31, 777-787
Open this publication in new window or tab >>Feasibility of an email-based electronic screening and brief intervention (e-SBI) to college students in Sweden.
2006 (English)In: Addictive Behaviours, ISSN 0306-4603, E-ISSN 1873-6327, Vol. 31, p. 777-787Article in journal (Refereed) Published
Keywords
Alcohol habits, College students, computerized normative feedback; Sweden
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-34267 (URN)10.1016/j.addbeh.2005.06.002 (DOI)21191 (Local ID)21191 (Archive number)21191 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Johansson, K., Bendtsen, P. & Åkerlind, I. (2005). Advice to patients in Swedish primary care regarding alcohol and other lifestyle habits: how patients report the actions of GPs in relation to their own expectations and satisfaction with the consultation. European Journal of Public Health, 15(6), 615-620
Open this publication in new window or tab >>Advice to patients in Swedish primary care regarding alcohol and other lifestyle habits: how patients report the actions of GPs in relation to their own expectations and satisfaction with the consultation
2005 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 15, no 6, p. 615-620Article in journal (Refereed) Published
Abstract [en]

Background: Lifestyle advice given by general practitioners (GPs) may be a cost-effective means of health promotion; however, it is not fully put into routine practice. The aim of this study was to explore to what extent GPs' patients expect and receive advice concerning alcohol, tobacco, exercise and diet in relation to sociodemographic characteristics, type of visit and patient satisfaction.

Methods: A postal questionnaire was sent to a representative sample (n = 9750) of patients who had consulted GPs in a county in Sweden. The response rate was 69% (n = 6734).

Results: Exercise was the most (16%) and alcohol the least (5%) common type of advice. The patients received advice more often than they expected in all areas except alcohol. The patients reported the highest rate of unfulfilled advice expectation and the lowest rate of unexpected advice in the case of alcohol. Male gender, poorer self-rated health and scheduled appointment were independent predictors of all types of advice. Continuity of GP contact was only favourable for exercise and diet advice. The patients who received advice were more satisfied with their visit to the doctor.

Conclusions: A tertiary preventive perspective guides GPs' practice of giving advice. Male patients with advanced illnesses are given priority. Women and patients with long-term risk habits are more neglected. The GPs tend to misjudge the expectations and needs of their patients and are too restrained in their counselling practice. Alcohol is the most disregarded area of advice in proportion to the patients' expectations and needs.

Keywords
alcohol drinking, counselling, health behaviour, patient satisfaction, primary health care
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-29717 (URN)10.1093/eurpub/cki046 (DOI)15111 (Local ID)15111 (Archive number)15111 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13Bibliographically approved
Johansson, K., Bendtsen, P. & Åkerlind, I. (2005). Factors influencing GPs' decisions regarding screening for high alcohol consumption: a focus group study in Swedish primary care. Public Health, 119(9), 781-788
Open this publication in new window or tab >>Factors influencing GPs' decisions regarding screening for high alcohol consumption: a focus group study in Swedish primary care
2005 (English)In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 119, no 9, p. 781-788Article in journal (Refereed) Published
Abstract [en]

Objective The aim of this study was to explore factors that influence general practitioners' (GPs') decisions regarding screening for high alcohol consumption.

Methods GPs working at three primary healthcare centres in Sweden participated in focus group interviews. The interviews were recorded and transcribed verbatim, and a deductive framework approach was used for the analysis.

Results The majority of the participating GPs did not believe in asking all patients about their alcohol consumption. Reported factors that influenced how many and which patients were questioned about alcohol consumption were time, age of the patient, consultation setting, patient–physician relationship, what symptoms the patient presented with, and knowledge of measures if patients appear to have a high alcohol consumption. Thus, alcohol screening and intervention were not performed in all patient groups as was originally intended, but were performed in limited groups of patients such as those with alcohol-related symptoms.

Conclusions Although the number of participants in this study was small and the conclusions cannot be generalized, the results provide some valuable insights into why GPs are hesitant to engage in screening for high alcohol consumption. Since prevention of alcohol-related health problems is an important public health issue, many different screening and intervention strategies have to be formulated and evaluated in order to reach patients with both hazardous and harmful alcohol consumption within the healthcare system. Screening all consecutive patients for a limited period or screening patient groups known to include a fairly high frequency of high alcohol consumers are two ways of limiting the time requirements and increasing role legitimacy. Still, there is a need for a broader public health strategy involving many players in the community in alcohol preventive measures, especially in more primary preventive approaches.

Keywords
Alcohol, screening, primary health care, dissemtion, GPs attitudes
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-29718 (URN)10.1016/j.puhe.2004.12.006 (DOI)15112 (Local ID)15112 (Archive number)15112 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13Bibliographically approved
Johansson, K., Åkerlind, I. & Bendtsen, P. (2005). Under what circumstances are nurses willing to engage in brief alcohol interventions?: a qualitative study from primary care in Swedena. Addictive Behaviours, 30(5), 1049-1053
Open this publication in new window or tab >>Under what circumstances are nurses willing to engage in brief alcohol interventions?: a qualitative study from primary care in Swedena
2005 (English)In: Addictive Behaviours, ISSN 0306-4603, E-ISSN 1873-6327, Vol. 30, no 5, p. 1049-1053Article in journal (Refereed) Published
Abstract [en]

To improve alcohol prevention in primary health care, it has been suggested that primary care nurses are an under-utilised resource. The aim of this study was to identify under what circumstances primary care nurses in Sweden are willing to engage in alcohol prevention. All nurses at three primary health care centres in Östergötland, Sweden were invited to participate in focus group interviews; 26 nurses participated. The nurses considered primary health care to be just one among other sectors within the community with responsibility for alcohol prevention. The role of health care in alcohol prevention was perceived to be important but mainly secondary preventive. The nurses felt justified screening all patients' alcohol habits only when they could refer to an obligation or a time-limited project. Otherwise, they mainly wanted to engage in screening patients with alcohol-related symptoms or diagnoses and other risk groups. Reasons for refraining from alcohol screening and intervention included lack of self-efficacy, time consumption and fear of harming their relationship with the patient. New strategies for alcohol prevention in primary care are discussed.

Keywords
Primary care, nurses, alcohol prevention, dissemination strategies, focus groups
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-29733 (URN)10.1016/j.addbeh.2004.09.008 (DOI)15132 (Local ID)15132 (Archive number)15132 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13Bibliographically approved
Johansson, K., Bendtsen, P. & Åkerlind, I. (2004). Kartläggning av alkoholvanor bland patienter på vårdcentral i relation till besöksorsak. In: Svenska läkarsällskapets riksstämma,2004 (pp. 46-46). Katrineholm: Sörmlands grafiska Quebecor AB
Open this publication in new window or tab >>Kartläggning av alkoholvanor bland patienter på vårdcentral i relation till besöksorsak
2004 (Swedish)In: Svenska läkarsällskapets riksstämma,2004, Katrineholm: Sörmlands grafiska Quebecor AB , 2004, p. 46-46Conference paper, Published paper (Other academic)
Place, publisher, year, edition, pages
Katrineholm: Sörmlands grafiska Quebecor AB, 2004
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-22506 (URN)1761 (Local ID)1761 (Archive number)1761 (OAI)
Available from: 2009-10-07 Created: 2009-10-07
Engström, S., Nilsson, P.-O. & Åkerlind, I. (2003). Att öka patientens egenkontroll av sjukdom och hälsa. Ett försök med konsultationshandledning med video i tvärprofessionella grupper på vårdcentral. Allmänmedicin, 24, 104-108
Open this publication in new window or tab >>Att öka patientens egenkontroll av sjukdom och hälsa. Ett försök med konsultationshandledning med video i tvärprofessionella grupper på vårdcentral
2003 (Swedish)In: Allmänmedicin, ISSN 0281-3513, Vol. 24, p. 104-108Article in journal (Other academic) Published
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-28316 (URN)13448 (Local ID)13448 (Archive number)13448 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2011-01-13
Nilsson, S., Scheike, M., Engblom, D., Karlsson, L.-G., Mölstad, S., Åkerlind, I., . . . Nylander, E. (2003). Chest pain and ischaemic heart disease in primary care. British Journal of General Practice, 53(490), 378-382
Open this publication in new window or tab >>Chest pain and ischaemic heart disease in primary care
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2003 (English)In: British Journal of General Practice, ISSN 0960-1643, Vol. 53, no 490, p. 378-382Article in journal (Refereed) Published
Abstract [en]

Background: Chest pain is the main symptom of first presentation with ischaemic heart disease (IHD). Little is known about the incidence of IHD among patients consulting the general practitioner (GP) for chest pain.

Aims: To estimate the occurrence of IHD among patients consulting for chest pain, to study the results of the bicycle exercise test, and to estimate the incidence of IHD in the population.

Design of study: Prospective descriptive study.

Setting: Three primary health centres in south-eastern Sweden

Method: All patients without a current IHD diagnosis, aged 20 to 79 years, and consulting for a new episode of chest pain, were included consecutively. The outcome was classified as IHD, possible IHD or not IHD, according to the results of a postal questionnaire, an exercise test or hospital care. Data from the hospital registry on patients with a diagnosis of IHD were analysed retrospectively.

Results: Out of 38 075 GP consultations, 577 (1.5%) were for chest pain. IHD was diagnosed in 41 (8%) of the chest pain patients, in 41 (83%) the diagnosis was excluded, and in 50 (9%) the diagnosis was judged as being uncertain. Even though the diagnostic criteria were strict, the exercise tests led to a diagnostic conclusion in 77% of the cases, most frequently a normal test result. Combining data from primary and hospital care, the yearly incidence of IHD was 6.5 diagnosed per 1000 inhabitants (aged 20 to 79 years old).

Conclusion: The incidence of a new episode of chest pain bringing the patient to the GP was low. Eight per cent of the patients received an IHD diagnosis, and in 9% further investigation or clinical assessment is needed.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13082 (URN)
Available from: 2008-03-25 Created: 2008-03-25 Last updated: 2009-08-20
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