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Swedish women with coeliac disease in remission use more health care services than other women: a controlled study
Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland. Linköping University, Department of Medical and Health Sciences, Nursing Science.
Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the East of Östergötland, Department of Internal Medicine VHN.
2011 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 46, no 1, 13-19 p.Article in journal (Refereed) Published
Abstract [en]

Objective. To examine whether the perceived poor outcome of dietary treatment makes Swedish women with coeliac disease (CD) prone to use more health care services than other women. Material and methods. The health care consumption over 36 consecutive months was examined for 137 Swedish women aged 20-80 years with CD in remission after living on a gluten-free diet for a median of 4 years (range 1-8 years). Comparisons were made with the health care consumption of 411 women in the general population matched for age and residence. Results. The results show that women with CD use health care services annually a median of 5.0 times (range 0-76) that is more than female controls 3.6 (0-311) (p andlt; 0.05) mainly in primary care and for complaints related to mental and behavioral disorders (ICD F), diseases of the digestive system (ICD K) and diseases of the musculoskeletal system and connective tissue (ICD M). Conclusions. Women with CD used health care services in keeping with studies indicating reduced health-related quality of life of people with this condition. The results provide evidence that women with CD in remission suffer from co-morbidities that may signal a need for a multidisciplinary follow-up of subjects with CD in Sweden.

Place, publisher, year, edition, pages
Informa Healthcare , 2011. Vol. 46, no 1, 13-19 p.
Keyword [en]
Adults, coeliac disease, gluten-free diet, health care consumption, Sweden
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-65712DOI: 10.3109/00365521.2010.516448ISI: 000286124300003OAI: oai:DiVA.org:liu-65712DiVA: diva2:398520
Available from: 2011-02-18 Created: 2011-02-18 Last updated: 2017-12-11Bibliographically approved
In thesis
1. Living with coeliac disease beyond the diagnosis
Open this publication in new window or tab >>Living with coeliac disease beyond the diagnosis
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction: Studies show that women living in Sweden treated for coeliac disease have lower subjective health than other women. After showing signs of remission, adults who have coeliac disease and follow a gluten-free diet, are expected to handle the treatment without any further planned follow-up by health care.

Aim: The overall aim of this thesis was to study aspects of living with coeliac disease in adults in the years beyond the diagnosis.

Methods: Quantitative methods were used in Studies I, II and III. A qualitative content analysis was performed in Study IV.

Results: The results show that women with coeliac disease have a lower level of well-being than men with coeliac disease. The women who have coeliac disease reported a high rate of gastrointestinal symptoms, although they followed a gluten-free diet, and they visited health care services more frequently than women who did not have coeliac disease. A low rate of gastrointestinal symptoms, a positive self-image and few comorbidity emerged as factors that positively affected well-being. Worries also seemed to be a companion of women diagnosed with coeliac disease in adulthood, typically evident when socializing with others.

Conclusion: This thesis may provide evidence questioning the validity of declaring all women with coeliac disease showing a normalized intestinal mucosa to be in remission, and thus leaving them to self-management.

Clinical implications: Health care professionals need to be aware of that the transition to a gluten-free life may vary for individuals. It does not seem enough to follow a gluten-free diet to reach a state of good well-being for all women. A major task for health care providers is therefore to support women with CD in reaching better subjective treatment outcomes. The results may also contribute to that health care system develops routines in order to optimise the care and treatment of these patients.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2011. 85 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1278
Keyword
Chronic illness, Coeliac disease, Comorbidity, Gastrointestinal complaints, Health care use, Self-image, Well-being
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-71898 (URN)978-91-7393-019-2 (ISBN)
Public defence
2011-12-08, Aulan K1, Kåkenhus, Campus Norrköping, Linköpings universitet, Norrköping, 13:00 (English)
Opponent
Supervisors
Available from: 2011-11-09 Created: 2011-11-09 Last updated: 2011-12-12Bibliographically approved

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Roos, SusanneWilhelmsson, SusanHallert, Claes

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Health, Activity, CareFaculty of Health SciencesUnit of Research and Development in Local Health Care, County of ÖstergötlandNursing ScienceDepartment of Internal Medicine VHN
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Scandinavian Journal of Gastroenterology
Medical and Health Sciences

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