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  • 1.
    Ahlstrand, Inger
    et al.
    ADULT, HHJ, Hälsohögskolan, Högskolan i Jönköping.
    Björk, Mathilda
    Avd. för rehabilitering, HHJ, Hälsohögskolan, Högskolan i Jönköping.
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Börsbo, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Landstingets habilitering i centrala Östergötland.
    Pain and daily activities in Rheumatoid Arthritis2012Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, nr 15, s. 1245-1253Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The aim of this study was to describe experiences of pain and its relationship to daily activities in people with rheumatoid arthritis (RA). Method: Seven semi-structured focus group discussions were conducted with 33 men and women of different ages with RA. Data were analysed with content analysis. Results: Pain affected everyday life and may be a barrier to perform valued activities. Regarding the impact of pain on participation and independence, personal factors and the social environment were found to be important. It could be a struggle to find the right activity balance, since it was easy to be overactive, triggering subsequent elevation of pain levels. However, the participants also described activities as a mediator of pain and a distraction from it. Conclusion: The relationship between pain and daily activities in RA was complex. Pain as an impairment was expressed to be related to activity limitations and participation restrictions, as well as to contextual factors. These findings highlight the clinical importance of paying attention to the complexity of pain and its relation to daily activities and participation.

  • 2.
    Ahlstrand, Inger
    et al.
    Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för rehabilitering.
    Björk, Mathilda
    Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för rehabilitering.
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Reumatologi. Linköpings universitet, Hälsouniversitetet.
    Börsbo, Björn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Falkmer, Torbjörn
    Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för rehabilitering.
    Smärta och dagliga aktiviteter vid Reumatoid artrit ur ett patientperspektiv2011Konferansepaper (Annet vitenskapelig)
    Abstract [sv]

    Bakgrund: Smärta vid Reumatoid artrit (RA) ärett välkänt symtom som orsakar lidande ochaktivitetsbegränsning. Traditionellt mäts smärtainom reumatologin som smärtintensitet på enVisuell Analog Skala (VAS). Kunskapen kring hurpatienter med RA upplever smärta och dess konsekvenser är begränsad. Patientens egenbeskrivning behövs som underlag för behandlingsplanering och för att utveckla nya metoderför att beskriva problematiken.Syfte: Syftet med studien är att beskriva smärtavid RA ur ett patientperspektiv med fokus på hursmärtan påverkar dagliga aktiviteter.Metod: Patienter med diagnostiserad RA i syd-östra Sverige identifierades via Svenska Reumatologiregistret. Urvalet baserades på minst 5 årssjukdomsduration och minst 40 mm smärtintensitet på VAS vid de två senaste besöken på reumatologklinik. Sammanlagt 33 patienter, 7 män och26 kvinnor, deltog i sju fokusgrupper. Gruppernaformades utifrån kön och ålder. Intervjuguideninnehöll frågor som: Hur beskriver patienter medRA sin smärta? Vad påverkar smärtan? Vilkakonsekvenser har smärtan för aktivitetsutförande,aktivitetsbalans och undvikande av aktivitet? Enkvalitativ innehållsanalys görs.Resultat/förväntat resultat: Analyser hittills visar patienternas frustration över att inteklara det man vill eller behöver göra, beroendeav andra, minskade möjligheter till delaktigheti sociala sammanhang. Och närståendes betydelse. Analyserna visar att smärtan är relaterad till Göteborg6-8 april 201134trötthet, stress och sinnesstämning och att arbeteeller andra aktiviteter medverkar till att glömmabort smärtan och uppehålla förmåga. Analysenslutförs under hösten.Konklusion: Denna studie förväntas genererany angelägen kunskap om och förståelse försmärta.

  • 3.
    Anund, Anna
    et al.
    Swedish Road and Transport Research Institute, Linköping, Sweden.
    Dukic, Tania
    Swedish Road and Transport Research Institute, Linköping, Sweden.
    Börsbo, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Curtin University of Technology, Perth, WA, Australia .
    Piloting smart safe school bus: exploration of security gains from implementation of a driver support system, additional technical equipment and intelligent bus stops2010Inngår i: European Transport Research Review, ISSN 1867-0717, E-ISSN 1866-8887, Vol. 2, nr 3, s. 157-163Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose

    Road crash statistics reveal that school children are frequent victims and the most risky situation is when the child is outside the bus. The aim of this pilot study was to explore possible changes in speed, implementation of routines, hazard detection and child security gains from a driver support system integrated with intelligent bus stops and additional technical equipment.

    Methods

    In total, 130 children with transmitters were using two specially equipped busses and bus stops. Speed of oncoming and overtaking cars, implementation of routines, the possibilities to discover potential hazards and experienced stress in the children were analysed by speed measurements, diary notes, questionnaires and focus group interviews.

    Results

    This pilot study exploration showed that the speeds of other road users were reduced at one of two bus stops. The driver support system was frequently used in all its parts and was considered useful by the bus drivers. It also raised the level of routines and allowed the drivers to survey the children. Children reported feeling more secure with the system running and experienced less stress as a consequence of it.

    Conclusion

    This pilot study shows that the evaluated systems may have the ability to reduce speed of other road users, raise the level of routines and make children feel more secure. Further studies are needed that apply a holistic approach on school transportation safety and security.

  • 4.
    Bergström, Maria
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för arbetsterapi. Linköpings universitet, Medicinska fakulteten.
    Ahlstrand, Inger
    Jönköping University, Sweden.
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Jonköping University, Sweden; Curtin University, Australia.
    Börsbo, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Björk, Mathilda
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för arbetsterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Like the worst toothache you've had - How people with rheumatoid arthritis describe and manage pain2017Inngår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 24, nr 6, s. 468-476Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease often associated with disability. Despite new treatments, pain and activity limitations are still present. Objectives: To describe how persons with RA experience and manage pain in their daily life. Methods: Seven semi-structured focus groups (FGs) were conducted and analyzed using content analysis. Results: The analysis revealed four categories: 1) Pain expresses itself in different ways referred to pain as overwhelming, aching or as a feeling of stiffness. 2) Mitigating pain referred to the use of heat, cold, medications and activities as distractions from the pain. 3) Adapting to pain referred to strategies employed as coping mechanisms for the pain, e.g. planning and adjustment of daily activities, and use of assistive devices. 4) Pain in a social context referred to the participants social environment as being both supportive and uncomprehending, the latter causing patients to hide their pain. Conclusions: Pain in RA is experienced in different ways. This emphasizes the multi-professional team to address this spectrum of experiences and to find pain management directed to the individual experience that also include the persons social environment.

  • 5.
    Bromley Milton, Maria
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Börsbo, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. County Hospital Ryhov, Jönköping, Sweden.
    Rovner, Graciela
    University of Gothenburg, Sweden.
    Lundgren-Nilsson, Åsa
    University of Gothenburg, Sweden.
    Stibrant-Sunnerhagen, Katharina
    University of Gothenburg, Sweden.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Is Pain Intensity Really That Important to Assess in Chronic Pain Patients? A Study Based on the Swedish Quality Registry for Pain Rehabilitation (SQRP)2013Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, nr 6Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Incorporating the patient's view on care and treatment has become increasingly important for health care. Patients describe the variety of consequences of their chronic pain conditions as significant pain intensity, depression, and anxiety. We hypothesised that intensities of common symptoms in chronic pain conditions carry important information that can be used to identify clinically relevant subgroups. This study has three aims: 1) to determine the importance of different symptoms with respect to participation and ill-health; 2) to identify subgroups based on data concerning important symptoms; and 3) to determine the secondary consequences for the identified subgroups with respect to participation and health factors.

    Methods and Subjects

    This study is based on a cohort of patients referred to a multidisciplinary pain centre at a university hospital (n = 4645, participation rate 88%) in Sweden. The patients answered a number of questionnaires concerning symptoms, participation, and health aspects as a part of the Swedish Quality Registry for Pain Rehabilitation (SQRP).

    Results

    Common symptoms (such as pain intensity, depression, and anxiety) in patients with chronic pain showed great variability across subjects and 60% of the cohort had normal values with respect to depressive and anxiety symptoms. Pain intensity more than psychological symptoms showed stronger relationships with participation and health. It was possible to identify subgroups based on pain intensity, depression, and anxiety. With respect to participation and health, high depressive symptomatology had greater negative consequences than high anxiety.

    Conclusions

    Common symptoms (such as pain intensity and depressive and anxiety symptoms) in chronic pain conditions carry important information that can be used to identify clinically relevant subgroups.

  • 6.
    Börsbo, Björn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Relationships between Psychological Factors, Disability, Quality of Life and Health in Chronic Pain Disorders2008Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Chronic pain is a very common condition with a prevalence of 40-65% in the community. The high prevalence of chronic pain causes a lot of human suffering but also high societal costs. The development and maintenance of chronic pain constitutes a complex interplay between neurobiological, psychosocial and genetic factors. A biopsychosocial model of chronic pain has been suggested to make a comprehensive context of the understanding of this issue.

    The main aims of this thesis were to analyze the relationships of the different components of the biopsychosocial model of pain and to study the relative importance of pain, stress and different psychological factors on disability and health related quality of life.

    The thesis is based on two groups of patients. One group consists of 275 patients with chronic Whiplash Associated Disorder (WAD) and one group comprise 433 patients with WAD, fibromyalgia (FM) and patients with chronic pain related to Spinal Cord Injury (SCI). The patients were investigated by questionnaires assessing different aspects of pain, depression, anxiety, catastrophizing, self-efficacy, disability and Health Related Quality of Life (HRQL).

    The main results were that psychological factors (especially depression) correlated relatively strongly with perceived HRQL and disability. The degree of depression appeared to have the most important relationship to perceived HRQL. Despite the fact that the patients rated depression just mild or moderate, depression had a great importance for the outcome of HQRL and disability. Pain intensity and duration played, in the cross-sectional perspective, a minor role for perceived HRQL, whereas pain intensity related more to the outcome of perceived disability.

    From a clinical point of view it is important to assess the complex and unique situation of each individual with respect to depression, anxiety, self-efficacy and pain when planning treatment and rehabilitation in order to optimise the outcome of such programmes.

    Delarbeid
    1. Generalized pain is associated with more negative consequences than local or regional pain: A study of chronic whiplash-associated disorders
    Åpne denne publikasjonen i ny fane eller vindu >>Generalized pain is associated with more negative consequences than local or regional pain: A study of chronic whiplash-associated disorders
    2007 (engelsk)Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, nr 3, s. 260-269Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Objective: The main aims of this study were: (i) to determine, for chronic whiplash-associated disorders, whether widespread pain has more severe consequences for other symptoms and different aspects of perceived health than does local/regional pain; (ii) to investigate whether pain, depression, and symptoms not directly related to pain are intercorrelated and to what extent these symptoms correlate with catastrophizing according to the Coping Strategy Questionnaire.

    Design: Descriptive cross-sectional study.

    Patients: A total of 275 consecutive chronic pain patients with whiplash-associated disorders who were referred to a university hospital.

    Methods: Background history, Beck Depression Inventory, Coping Strategy Questionnaire, Life Satisfaction Checklist, the SF-36 Health Survey and EuroQol were used to collect data.

    Results: Spreading of pain was associated with negative consequences with respect to pain intensity and prevalence of other symptoms, life satisfaction/quality and general health. The subjects differ with respect to the presence of symptoms not directly related to pain. A minor part of the variation in Back Depression Inventory was explained by direct aspects of pain, indicating that, to some extent, generalization of pain is related to catastrophizing thoughts.

    Conclusion: Widespread pain was associated with negative consequences with respect to pain intensity, prevalence of other symptoms including depressive symptoms, some aspects of coping, life satisfaction and general health.

    Emneord
    Neck, whiplash, generalized pain, neuroplasticity, depression, catastrophizing.
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-15687 (URN)10.2340/16501977-0052 (DOI)
    Tilgjengelig fra: 2008-12-04 Laget: 2008-11-26 Sist oppdatert: 2017-12-14bibliografisk kontrollert
    2. Catastrophizing, depression, and pain: Correlation with and influence on quality of life and health: A study of chronic whiplash-associated disorders
    Åpne denne publikasjonen i ny fane eller vindu >>Catastrophizing, depression, and pain: Correlation with and influence on quality of life and health: A study of chronic whiplash-associated disorders
    2008 (engelsk)Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 40, nr 7, s. 562-569Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Objective: The aims of this study were: (i) to classify subgroups according to the degree of pain intensity, depression, and catastrophizing, and investigate distribution in a group of patients with chronic whiplash-associated disorders; and (ii) to investigate how these subgroups were distributed and inter-related multivariately with respect to consequences such as health and quality of life outcome measures.

    Design: Descriptive cross-sectional study.

    Patients: A total of 275 consecutive chronic pain patients with whiplash-associated disorders who were referred to a university hospital.

    Methods: The following data were obtained by means of self-report questionnaires: pain intensity in neck and shoulders, background history, Beck Depression Inventory, the catastrophizing scale of Coping Strategy Questionnaire, Life Satisfaction Checklist, the SF-36 Health Survey, and the EuroQol.

    Results: Principal component analysis was used to recognize subgroups according to the degree of pain intensity, depression, and catastrophizing. These subgroups have specific characteristics according to perceived health and quality of life, and the degree of depression appears to be the most important influencing factor.

    Conclusion: From a clinical point of view, these findings indicate that it is important to assess patients for intensity of pain, depression, and catastrophizing when planning a rehabilitation programme. Such an evaluation will help individualize therapy and intervention techniques so as to optimize the efficiency of the programme.

    Emneord
    Neck, whiplash, pain, depression, catastrophizing, health, quality of life
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-15688 (URN)10.2340/16501977-0207 (DOI)
    Tilgjengelig fra: 2008-12-04 Laget: 2008-11-26 Sist oppdatert: 2017-12-14bibliografisk kontrollert
    3. The complex interplay between pain intensity, depression, anxiety and catastrophizing with respect to quality of life and disability
    Åpne denne publikasjonen i ny fane eller vindu >>The complex interplay between pain intensity, depression, anxiety and catastrophizing with respect to quality of life and disability
    2009 (engelsk)Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, nr 19, s. 1605-1613Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Purpose: To identify subgroups of chronic pain patients based on the occurrence of depression, anxiety, and catastrophizing and the duration of pain and pain intensity. In addition to this, to investigate the relationship between the subgroups with respect to background variables, diagnosis, pain-related disability, and perceived quality of life.

    Methods: This study used 433 chronic pain patients including 47 patients with spinal cord injury related pain, 150 with chronic whiplash associated disorders, and 236 with fibromyalgia. The participants answered a postal questionnaire that provided background data, pain intensity and duration and psychological and health related items.

    Results: Based on depression, anxiety, catastrophizing, pain intensity and duration, we identified subgroups of chronic pain patients that differed with respect to perceived quality of life, disability and diagnosis. The psychological factors, especially depression, significantly influenced perceived quality of life and disability. Pain intensity and duration play a minor role with respect to quality of life although pain intensity is associated contributes more to perceived disability.

    Conclusions: The results of this study highlight the importance of not looking at chronic pain patients as a homogenous entity. A detailed assessment, including psychological factors with emphasis on depressive symptoms, might be essential for planning and carrying through treatment and rehabilitation.

    Emneord
    Chronic pain, catastrophizing, depression, anxiety, quality of life, disability
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-15689 (URN)10.1080/09638280903110079 (DOI)
    Tilgjengelig fra: 2008-12-04 Laget: 2008-11-26 Sist oppdatert: 2017-12-14bibliografisk kontrollert
    4. Impact of the interaction between selfefficacy, symptoms and catastrophizing on disability, quality of life and health in chronic pain patients
    Åpne denne publikasjonen i ny fane eller vindu >>Impact of the interaction between selfefficacy, symptoms and catastrophizing on disability, quality of life and health in chronic pain patients
    2010 (engelsk)Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, nr 17, s. 1387-1396Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    This study investigates the interactions between self-efficacy–including subcomponents–and symptoms (pain, depression, and anxiety), catastrophizing, disability, quality of life, and health in a population of chronic pain patients. The study used 433 chronic pain patients including 47 patients with spinal cord injuryrelated pain, 150 with chronic whiplash-associated disorders, and 236 with fibromyalgia. The participants answered a postal questionnaire that provided background data, pain intensity and duration, and psychological- and health-related items. In the multivariate context, depression, anxiety, catastrophizing, and disability were intercorrelated. Self-efficacy correlated positively with variables of quality of life and general health. These two groups of variables were negatively correlated. The pain variables–duration of pain, pain intensity, and spreading of pain–formed a third group of variables. Self-efficacy function was negatively correlated to these three pain variables. When regressing disability, quality of life, and health, we found that self-efficacy had a positive impact whereas symptoms, catastrophizing, and pain had a negative influence on these aspects. Different patterns of influencing variables were discerned for the three different analyses, and specific patterns of the subscales of self-efficacy corresponded to specific patterns of negative factors for the outcome of disability, quality of life, and health.

    Perspective: This article presents the complex interaction of psychological factors and symptoms and their positive and negative influence on disability, quality of life, and health. The results indicate that it might be important to assess and influence both enhancing and detoriating factors to ensure an effective pain management programme.

    sted, utgiver, år, opplag, sider
    Informa Healthcare, 2010
    Emneord
    Chronic pain, self-efficacy, disability, quality of life, health, depression
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-15690 (URN)10.3109/09638280903419269 (DOI)000280755100001 ()
    Merknad
    Original Publication: Björn Börsbo, Björn Gerdle and Michael Peolsson, Impact of the interaction between selfefficacy, symptoms and catastrophizing on disability, quality of life and health in chronic pain patients, 2010, Disability and rehabilitation, (32), 17, 1387-1396. http://dx.doi.org/10.3109/09638280903419269 Copyright: Informa Healthcare http://informahealthcare.com/ Tilgjengelig fra: 2008-12-04 Laget: 2008-11-26 Sist oppdatert: 2017-12-14bibliografisk kontrollert
  • 7.
    Börsbo, Björn
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Gerdle, Björn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Peolsson, Michael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Impact of the interaction between selfefficacy, symptoms and catastrophizing on disability, quality of life and health in chronic pain patients2010Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, nr 17, s. 1387-1396Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study investigates the interactions between self-efficacy–including subcomponents–and symptoms (pain, depression, and anxiety), catastrophizing, disability, quality of life, and health in a population of chronic pain patients. The study used 433 chronic pain patients including 47 patients with spinal cord injuryrelated pain, 150 with chronic whiplash-associated disorders, and 236 with fibromyalgia. The participants answered a postal questionnaire that provided background data, pain intensity and duration, and psychological- and health-related items. In the multivariate context, depression, anxiety, catastrophizing, and disability were intercorrelated. Self-efficacy correlated positively with variables of quality of life and general health. These two groups of variables were negatively correlated. The pain variables–duration of pain, pain intensity, and spreading of pain–formed a third group of variables. Self-efficacy function was negatively correlated to these three pain variables. When regressing disability, quality of life, and health, we found that self-efficacy had a positive impact whereas symptoms, catastrophizing, and pain had a negative influence on these aspects. Different patterns of influencing variables were discerned for the three different analyses, and specific patterns of the subscales of self-efficacy corresponded to specific patterns of negative factors for the outcome of disability, quality of life, and health.

    Perspective: This article presents the complex interaction of psychological factors and symptoms and their positive and negative influence on disability, quality of life, and health. The results indicate that it might be important to assess and influence both enhancing and detoriating factors to ensure an effective pain management programme.

  • 8.
    Börsbo, Björn
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin.
    Lemming, Dag
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin. Östergötlands Läns Landsting, Medicincentrum, Smärt- och rehabiliteringscentrum.
    Utredning och klinisk undersökning av personer med kronisk smärta2006Inngår i: Rehabiliteringsmedicin - Teori och praktik / [ed] Jörgen Borg, Lund: Studenlitteratur , 2006, 1, s. 91-96Kapittel i bok, del av antologi (Annet vitenskapelig)
    Abstract [sv]

      Kapitel om rehabiliteringsmedicinens utveckling och nuvarande plats i sjukvården samt begrepp och metodik inleder boken. I två delar ges därefter rehabiliteringsmedicinska aspekter på de dominerande sjukdomsgrupperna - komplexa smärttillstånd respektive skador och sjukdomar i nervsystemet. Som avslutning beskrivs bland annat  stressrelaterade tillstånd. Läroboken är avsedd för grundutbildning av läkare, arbetsterapeuter och sjukgymnaster, logopeder samt för läkare under AT-tjänstgöring. Den är också lämplig som introduktion i specialistutbildningen i rehabiliteringsmedicin, geriatrik, neurologi och smärtlindring. Vidareutbildningar av olika vårdyrkesgrupper kan ha nytta av boken och den kan också användas som referenslitteratur av yrkesverksamma med intresse för rehabiliteringsmedicin.

  • 9.
    Börsbo, Björn
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Liedberg, Gunilla M
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Wallin, Mia
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Gerdle, Björn
    Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin.
    Subgroups based on thermal and pressure pain thresholds in women with chronic whiplash display differences in clinical presentation - an explorative study2012Inngår i: Journal of pain research, ISSN 1178-7090, Vol. 5, s. 511-521Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To investigate the presence of subgroups in chronic whiplash-associated disorders (WAD) based on pain thresholds for pressure (PPT), cold (CPT), and heat (HPT) and to compare these subgroups with respect to symptomatology, disability, and health aspects. Methods: Two groups of female subjects – patients with chronic WAD (n = 28) and healthy controls (CON; n = 29) – were investigated. Quantitative sensory testing (QST) for thermal thresholds and algometry for PPT at four sites in the body (over the trapezius and tibialis anterior bilaterally) were determined. Habitual pain intensities, psychological strain, disability, and health aspects were registered using a questionnaire.Results: A cluster analysis based on PPT, CPT, and HPT identified two subgroups of chronic WAD: one sensitive subgroup (s-WAD; n = 21), and one less sensitive subgroup (ls-WAD; n = 6). S-WAD displayed widespread hyperalgesia, whereas ls-WAD had localized hyperalgesia in the neck area, with tendencies to supernormal values in remote areas of the body. Generally, s-WAD had a significantly worse situation than the CON with respect to symptomatology, disability, and health aspects. The ls-WAD group was intermediary between s-WAD and CON in these aspects.Conclusion: Different explanations, eg, severity of the pain condition per se, etiological factors, and pre-trauma differences in pain sensitivity, may exist for the differences in pain thresholds between the two subgroups. Future research should investigate the role of pain thresholds in the chronic stage to determine the efficacy of treatment interventions.

  • 10.
    Börsbo, Björn
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Peolsson, Michael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Gerdle, Björn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Catastrophizing, depression, and pain: Correlation with and influence on quality of life and health: A study of chronic whiplash-associated disorders2008Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 40, nr 7, s. 562-569Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The aims of this study were: (i) to classify subgroups according to the degree of pain intensity, depression, and catastrophizing, and investigate distribution in a group of patients with chronic whiplash-associated disorders; and (ii) to investigate how these subgroups were distributed and inter-related multivariately with respect to consequences such as health and quality of life outcome measures.

    Design: Descriptive cross-sectional study.

    Patients: A total of 275 consecutive chronic pain patients with whiplash-associated disorders who were referred to a university hospital.

    Methods: The following data were obtained by means of self-report questionnaires: pain intensity in neck and shoulders, background history, Beck Depression Inventory, the catastrophizing scale of Coping Strategy Questionnaire, Life Satisfaction Checklist, the SF-36 Health Survey, and the EuroQol.

    Results: Principal component analysis was used to recognize subgroups according to the degree of pain intensity, depression, and catastrophizing. These subgroups have specific characteristics according to perceived health and quality of life, and the degree of depression appears to be the most important influencing factor.

    Conclusion: From a clinical point of view, these findings indicate that it is important to assess patients for intensity of pain, depression, and catastrophizing when planning a rehabilitation programme. Such an evaluation will help individualize therapy and intervention techniques so as to optimize the efficiency of the programme.

  • 11.
    Börsbo, Björn
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Peolsson, Michael
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin.
    Gerdle, Björn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Östergötlands Läns Landsting, Medicincentrum, Smärt- och rehabiliteringscentrum.
    The complex interplay between pain intensity, depression, anxiety and catastrophizing with respect to quality of life and disability2009Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, nr 19, s. 1605-1613Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To identify subgroups of chronic pain patients based on the occurrence of depression, anxiety, and catastrophizing and the duration of pain and pain intensity. In addition to this, to investigate the relationship between the subgroups with respect to background variables, diagnosis, pain-related disability, and perceived quality of life.

    Methods: This study used 433 chronic pain patients including 47 patients with spinal cord injury related pain, 150 with chronic whiplash associated disorders, and 236 with fibromyalgia. The participants answered a postal questionnaire that provided background data, pain intensity and duration and psychological and health related items.

    Results: Based on depression, anxiety, catastrophizing, pain intensity and duration, we identified subgroups of chronic pain patients that differed with respect to perceived quality of life, disability and diagnosis. The psychological factors, especially depression, significantly influenced perceived quality of life and disability. Pain intensity and duration play a minor role with respect to quality of life although pain intensity is associated contributes more to perceived disability.

    Conclusions: The results of this study highlight the importance of not looking at chronic pain patients as a homogenous entity. A detailed assessment, including psychological factors with emphasis on depressive symptoms, might be essential for planning and carrying through treatment and rehabilitation.

  • 12.
    Clementz, Gunilla
    et al.
    Rehab Stn, Sweden .
    Börsbo, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Norrbrink, Cecilia
    Danderyd Hospital, Sweden .
    Burnout in patients with chronic whiplash-associated disorders2012Inngår i: International Journal of Rehabilitation Research, ISSN 0342-5282, E-ISSN 1473-5660, Vol. 35, nr 4, s. 305-310Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study sought to assess burnout and its relation to pain, disability, mood and health-related quality of life in a group of patients with chronic whiplash-associated disorders (WAD). Forty-five patients with chronic WAD (andgt;= 3 months) referred to a multidisciplinary rehabilitation centre were included. A questionnaire covering data on background and lifestyle, the Shirom Melamed Burnout Questionnaire, pain intensity, the Neck Disability Index, the Hospital Anxiety and Depression Scale and the EQ-5D was filled in before the first visit to the clinic. A high proportion of burnout as measured using the Shirom Melamed Burnout Questionnaire was found in the patient group (87%). Burnout correlated moderately with present pain intensity, neck disability, depression and health-related quality of life. The results indicate the possible clinical importance of burnout in relation to chronic WAD and the need for further studies including a larger study population and a longitudinal study design.

  • 13.
    Hellgren, Lovisa
    et al.
    Clinical Department of Rehabilitation Medicine, County Hospital Ryhov, Jönköping, Sweden.
    Samuelsson, Kersti
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken.
    Lundqvist, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken.
    Börsbo, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Clinical Department of Rehabilitation Medicine, County Hospital Ryhov, Jönköping, Sweden.
    Computerized Training of Working Memoryfor Patients with Acquired Brain Injury2015Inngår i: Open Journal of Therapy and Rehabilitation, ISSN 2332-1822, Vol. 3, s. 46-55Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Patients with acquired brain injury often experience impaired working memory(WM), a condition that can make everyday life activities and work difficult. Objectives: This studyinvestigates the effects of computerized WM training on WM skills, cognitive tests, activity performanceand estimated health and whether the effects of computerized WM training can be attributedto sex or time since injury. Methods: Forty-eight patients with acquired brain injury underwentcomputerized WM training. Patients were tested by a neuropsychologist and interviewedby an occupational therapist just prior and 20 weeks after completion of training. Results: Patientswho participated in computerized WM training significantly improved their WM skills shown inWM index, their neuropsychological test scores, and their self-estimated health scores. They alsosignificantly improved their performance of individually defined WM-related everyday activitiesand their satisfaction with the performance of these activities. There was a significant differencein terms of WM index, WM-related daily activity performance, and satisfaction with respect to timesince injury. Conclusion: Computerized WM training can improve cognitive and everyday performancefor patients with acquired brain injury. Patients can improve their cognitive functions along time after suffering a brain injury or disease. This effect is greater if WM training is used earlyin the rehabilitation.

  • 14.
    Larsson, B.
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Björk, J.
    Skåne University Hospital, Sweden .
    Börsbo, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    A systematic review of risk factors associated with transitioning from regional musculoskeletal pain to chronic widespread pain2012Inngår i: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 16, nr 8, s. 1084-1093Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Chronic widespread pain has limited treatment options and is associated with pronounced negative individual and socioeconomic consequences. Patients with local or regional pain may be at a risk for developing chronic widespread pain. Knowledge of such risk factors can help prevent chronic widespread pain. This study systematically reviews the literature that examines risk factors associated with developing chronic widespread after developing chronic regional pain. We conducted a three-step database search in Medline. Four articles from the authors files formed a core set of articles that were used to validate the search strategy. We conducted a systematic quality assessment of the included studies. Based on risk estimations reported in six prospective population-based studies and one retrospective study on pain, this study identified five risk factors: female sex, higher age, family history of pain, depressed mode and pain sites at baseline. As only a few studies were recovered, the impact of these factors is unclear. Spreading of pain from local or regional pain to widespread pain occurs in a large proportion of the general population. Few studies have addressed similar risk factors and the few risk factors associated with the transition from chronic regional pain to chronic widespread pain are inconsistent. Studies that focus on this transition have included few subjects and few possible risk factors. Future studies should explore more possible risk factors.

  • 15.
    Lemming, Dag
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Börsbo, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet.
    Sjörs, Anna
    Linköpings universitet, Institutionen för medicin och hälsa. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Single-point but not tonic cuff pressure pain sensitivity is associated with level of physical fitness: a study of non-athletic healthy subjects2015Dataset
    Abstract [en]

    Exercise is often used for pain rehabilitation but the link between physical activity level and pain sensitivity is still not fully understood. Pressure pain sensitivity to cuff algometry and conditioned pain modulation (CPM) were evaluated in highly active men (n=22), normally active men (n=26), highly active women (n=27) and normally active women (n=23) based on the Godin Leisure-Time Exercise Questionnaire. Cuff pressure pain sensitivity was assessed at the arm and lower leg. The subjects scored the pain intensity on an electronic Visual Analogue Scale (VAS) during ten minutes with 25 kPa constant cuff pressure and two minutes with zero pressure. The maximal VAS score and area under the VAS-curve were extracted. Pressure pain thresholds (PPT) were recorded by manual pressure algometry on the ipsilateral tibialis anterior muscle before, during and after the tonic arm stimulation.

    Tonic cuff stimulation of the arm and leg resulted in higher VAS peak scores in women compared with men (p<0.04). In all groups the PPTs were reduced during and after the cuff stimulation compared with baseline (p=0.001). PPT were higher in men compared with women (p=0.03) and higher in highly physical active compared with normal active (p=0.048). 

    Besides the well-known gender difference in pressure pain sensitivity this study demonstrates  that a high physical fitness degree in non-athletic subjects is associated with increased pressure pain thresholds but does not affect cuff pressure pain sensitivity in healthy people.

  • 16.
    Lemming, Dag
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Börsbo, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Sjörs, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Lind, Eva-Britt
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Arendt-Nielsen, Lars
    Laboratory for Experimental Pain Research and Center for Neuroplasticity and Pain, Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
    Graven-Nielsen, Thomas
    Center for Neuroplasticity and Pain, Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Cuff Pressure Pain Detection Is Associated with Both Sex and Physical Activity Level in Nonathletic Healthy Subjects2017Inngår i: Pain medicine (Malden, Mass.), ISSN 1526-2375, E-ISSN 1526-4637, Vol. 18, nr 8, s. 1573-1581Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose. The aim of this study was to evaluate pressure pain sensitivity on leg and arm in 98 healthy persons (50 women) using cuff algometry. Furthermore, associations with sex and physical activity level were investigated.

    Method. Normal physical activity level was defined as Godin Leisure-Time Exercise Questionnaire (GLTEQ) score ≤ 45 and high activity level as GLTEQ > 45. A pneumatic double-chamber cuff was placed around the arm or leg where a single chamber was inflated. The cuff inflation rate (1 kPa/s) was constant, and pain intensity was registered continuously on a 10 cm electronic visual analogue scale (VAS). The pain detection threshold (PDT) was defined as when the pressure was perceived as painful, and pain tolerance (PTT) was when the subject terminated the cuff inflation. For PTT, the corresponding VAS score was recorded (VAS-PTT). The protocol was repeated with two chambers inflated.

    Result. Only single cuff results are given. For women compared with men, the PDT was lower when assessed in the arm (P = 0.002), PTTs were lower in the arm and leg (P < 0.001), and the VAS-PTT was higher in the arm and leg (P < 0.033). Highly active participants compared with less active had higher PDT (P = 0.027) in the leg. Women showed facilitated spatial summation (P < 0.014) in the arm and leg and a steeper VAS slope (i.e., the slope of the VAS pressure curve between PDT and PPT) in the arm and leg (P < 0.003).

    Conclusion. This study indicates that reduced pressure pain sensitivity is associated both with male sex and physical activity level.

  • 17.
    Lemming, Dag
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Börsbo, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet.
    Sjörs, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet.
    Lind, Eva-Britt
    Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Arendt-Nielsen, Lars
    Center for Sensory-Motor Interaction (SMI), Laboratory for Experimental Pain Research, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
    Graven-Nielsen, Thomas
    Center for Sensory-Motor Interaction (SMI), Laboratory for Experimental Pain Research, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Single-point but not tonic cuff pressure pain sensitivity is associated with level of physical fitness: a study of non-athletic healthy subjects2015Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 5, artikkel-id e0125432Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Exercise is often used for pain rehabilitation but the link between physical activity level and pain sensitivity is still not fully understood. Pressure pain sensitivity to cuff algometry and conditioned pain modulation (CPM) were evaluated in highly active men (n=22), normally active men (n=26), highly active women (n=27) and normally active women (n=23) based on the Godin Leisure-Time Exercise Questionnaire. Cuff pressure pain sensitivity was assessed at the arm and lower leg. The subjects scored the pain intensity on an electronic Visual Analogue Scale (VAS) during ten minutes with 25 kPa constant cuff pressure and two minutes with zero pressure. The maximal VAS score and area under the VAS-curve were extracted. Pressure pain thresholds (PPT) were recorded by manual pressure algometry on the ipsilateral tibialis anterior muscle before, during and after the tonic arm stimulation.

    Tonic cuff stimulation of the arm and leg resulted in higher VAS peak scores in women compared with men (p<0.04). In all groups the PPTs were reduced during and after the cuff stimulation compared with baseline (p=0.001). PPT were higher in men compared with women (p=0.03) and higher in highly physical active compared with normal active (p=0.048). 

    Besides the well-known gender difference in pressure pain sensitivity this study demonstrates  that a high physical fitness degree in non-athletic subjects is associated with increased pressure pain thresholds but does not affect cuff pressure pain sensitivity in healthy people.

  • 18.
    Liedberg, Gunilla
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    Björk, Mathilda
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Rehabenheten. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin.
    Börsbo, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Self-reported nonrestorative sleep in fibromyalgia - relationship to impairments of body functions, personal function factors, and quality of life2015Inngår i: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 8, s. 499-505Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The purpose of this study was: 1) to determine variables that might characterize good or bad sleep; and 2) to describe the relationship between sleep, impairment of body functions, personal function factors, and quality of life based on quality of sleep in women with fibromyalgia (FM). Methods: This cross-sectional descriptive study included 224 consecutive patients diagnosed at a specialist center. These patients were mailed a questionnaire concerning sleep, body functions, personal factors, and health-related quality of life. In total, 145 completed questionnaires were collected. Results: Using sleep variables (sleep quality, waking up unrefreshed, and tiredness when getting up), we identified two subgroups - the good sleep subgroup and the bad sleep subgroup - of women with FM. These subgroups exhibited significantly different characteristics concerning pain intensity, psychological variables (depressed mood, anxiety, catastrophizing, and self-efficacy), impairments of body functions, and generic and health-related quality of life. The good sleep subgroup reported a significantly better situation, including higher employment/study rate. The bad sleep subgroup reported a greater use of sleep medication. Five variables determined inclusion into either a good sleep or a bad sleep subgroup: pain in the evening, self-efficacy, anxiety, and according to the Short Form health survey role emotional and physical functioning. Conclusion: This study found that it was possible to identify two subgroups of women with FM based on quality of sleep variables. The two subgroups differed significantly with respect to pain, psychological factors, impairments of body functions, and perceived quality of life, where the subgroup with bad sleep had a worse situation.

  • 19.
    Peolsson, Michael
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Börsbo, Björn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Gerdle, Björn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Smärt- och rehabiliteringscentrum.
    Generalized pain is associated with more negative consequences than local or regional pain: A study of chronic whiplash-associated disorders2007Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, nr 3, s. 260-269Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The main aims of this study were: (i) to determine, for chronic whiplash-associated disorders, whether widespread pain has more severe consequences for other symptoms and different aspects of perceived health than does local/regional pain; (ii) to investigate whether pain, depression, and symptoms not directly related to pain are intercorrelated and to what extent these symptoms correlate with catastrophizing according to the Coping Strategy Questionnaire.

    Design: Descriptive cross-sectional study.

    Patients: A total of 275 consecutive chronic pain patients with whiplash-associated disorders who were referred to a university hospital.

    Methods: Background history, Beck Depression Inventory, Coping Strategy Questionnaire, Life Satisfaction Checklist, the SF-36 Health Survey and EuroQol were used to collect data.

    Results: Spreading of pain was associated with negative consequences with respect to pain intensity and prevalence of other symptoms, life satisfaction/quality and general health. The subjects differ with respect to the presence of symptoms not directly related to pain. A minor part of the variation in Back Depression Inventory was explained by direct aspects of pain, indicating that, to some extent, generalization of pain is related to catastrophizing thoughts.

    Conclusion: Widespread pain was associated with negative consequences with respect to pain intensity, prevalence of other symptoms including depressive symptoms, some aspects of coping, life satisfaction and general health.

  • 20.
    Rovner, Graciela S.
    et al.
    University of Gothenburg, Sweden; Danderyd Hospital, Sweden; Karolinska Institute, Sweden.
    Sunnerhagen, Katharina S.
    University of Gothenburg, Sweden.
    Björkdahl, Ann
    University of Gothenburg, Sweden; Ersta Skondal University of Coll, Sweden.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Börsbo, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. County Hospital Ryhov, Sweden.
    Johansson, Fredrik
    Danderyd Hospital, Sweden.
    Gillanders, David
    University of Edinburgh, Scotland.
    Chronic pain and sex-differences; women accept and move, while men feel blue2017Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, nr 4, artikkel-id e0175737Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose The aim of this study is to explore differences between male and female patients entering a rehabilitation program at a pain clinic in order to gain a greater understanding of different approaches to be used in rehabilitation. Method 1371 patients referred to a specialty pain rehabilitation clinic, completed sociodemographic and pain related questionnaires. They rated their pain acceptance (CPAQ-8), their kinesiophobia (TSK), the impact of pain in their life (MPI), anxiety and depression levels (HAD) and quality of life scales: the SF-36, LiSat-11, and the EQ-5D. Because of the large sample size of the study, the significance level was set at the p amp;lt;= .01. Results Analysis by t-test showed that when both sexes experience the same pain severity, women report significantly higher activity level, pain acceptance and social support while men report higher kinesiophobia, mood disturbances and lower activity level. Conclusion Pain acceptance (CPAQ-8) and kinesiophobia (TSK) showed the clearest differences between men and women. Pain acceptance and kinesiophobia are behaviorally defined and have the potential to be changed.

  • 21.
    Rovner, Graciela S
    et al.
    Sahlgrenska Academy, Gothenburg University, Sweden.
    Årestedt, Kristofer
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum. Linnaeus University, Kalmar, Sweden.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Börsbo, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. County Hospital Ryhov, Jönköping, Sweden.
    McCracken, Lance M
    Institute of Psychiatry, King’s College London, UK.
    Psychometric properties of the 8-item Chronic Pain Acceptance Questionnaire (CPAQ-8) in a Swedish Chronic pain cohort2014Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, nr 1, s. 73-80Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Acceptance and Commitment Therapy for chronic pain has good empirical support. Pain acceptance is most often assessed with the Chronic Pain Acceptance Questionnaire (CPAQ). Recently a shorter 8-item version, the CPAQ-8, was developed. Objectives: To further validate the CPAQ-8 in a Swedish context and to test its sensitivity to treatment effects, an as-yet unknown property of the instrument. Methods: A total of 891 patients completed the CPAQ, along with scales for anxiety and depression (Hospital Anxiety and Depression scale), kinesiophobia (Tampa Scale for Kinesiophobia) and quality of life (Short Form-36). Confirmatory factor analyses were performed to examine the factor structure. Convergent validity was tested with Pearson's correlations. Changes over time were evaluated with paired t-test. Results: The confirmatory factor analyses showed that the CPAQ 2-factor model had a better fit compared with the 1-factor model, both for the 8- and 20-item versions. All CPAQ-8 scales demonstrated good internal consistency (alpha ≥ 0.80). They also correlated significantly with related constructs, supporting convergent validity. The CPAQ-8 explained a large share of the total variance in CPAQ-20 and was also able to track rehabilitation changes (large effect size, d = 0.89). Conclusion: CPAQ-8 demonstrated good psychometric properties and sensitivity to rehabilitation changes. Further research that considers other cultural contexts may lead enhance the applications of this instrument.

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