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  • 1.
    Ahlgren, Ewa
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Heart Centre. Linköping University, Faculty of Health Sciences.
    Lundqvist, Anna
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Heart Centre. Linköping University, Faculty of Health Sciences.
    Nordlund, Anders
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Heart Centre. Linköping University, Faculty of Health Sciences.
    Arén, Claes
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Heart Centre. Linköping University, Faculty of Health Sciences.
    Rutberg, Hans
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Heart Centre. Linköping University, Faculty of Health Sciences.
    Neurocognitive impairment and driving performance after coronary artery bypass surgery2003In: European Journal of Cardio-Thoracic Surgery, ISSN 1010-7940, E-ISSN 1873-734X, Vol. 23, no 3, p. 334-340Article in journal (Refereed)
    Abstract [en]

    Objective: Neurocognitive impairment is common after cardiac surgery but few studies have examined the relationship between postoperative neuropsychological test performance and everyday behavior. The influence of postoperative cognitive impairment on car driving has previously not been investigated. The purpose of this study was to evaluate neurocognitive function and driving performance after coronary artery bypass grafting (CABG).

    Methods: Twenty-seven patients who underwent coronary artery bypass grafting with standard cardiopulmonary bypass technique and 20 patients scheduled for percutaneous coronary intervention (PCI) under local anesthesia (control group) were enrolled in this prospective study conducted from April 1999 to September 2000. Complete data were obtained in 23 and 19 patients, respectively. The patients underwent neuropsychological examination with a test battery including 12 tests, a standardized on-road driving test and a test in an advanced driving simulator before and 4–6 weeks after intervention.

    Results: More patients in the coronary artery bypass grafting group (n=11, 48%) than in the percutaneous coronary intervention group (n=2, 10%) showed a cognitive decline after intervention (P=0.01). In the on-road driving test, patients who underwent coronary artery bypass grafting deteriorated after surgery in the cognitive demanding parts like traffic behavior (P=0.01) and attention (P=0.04). Patients who underwent percutaneous intervention deteriorated in maneuvering of the vehicle (P=0.04). No deterioration was detected in the simulator in any of the groups after intervention. Patients with a cognitive decline after intervention also tended to drop in the on-road driving scores to a larger extent than did patients without a cognitive decline.

    Conclusion: This study indicates that cognitive functions important for safe driving may be influenced after cardiac surgery.

  • 2.
    Ahlgren, Ewa
    et al.
    Östergötlands Läns Landsting, Heart Centre.
    Lundqvist, Anna
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Nordlund, Anders
    Linköping University, Department of Department of Health and Society. Linköping University, Faculty of Health Sciences.
    Rutberg, Hans
    Östergötlands Läns Landsting, Heart Centre.
    Driving performance of patients with coronary artery diseaseManuscript (preprint) (Other academic)
    Abstract [en]

    Objectives To compare patients with coronary artery disease and healthy controls with respect to cognitive function and driving performance.

    Design and setting A controlled study conducted between April 1999 and January 2001.

    Subjects Forty-four patients with stable coronary artery disease scheduled for cardiac intervention with coronary artery bypass surgery or percutaneous coronary intervention. Forty volunteers of similar age without symptoms of coronary artery disease served as controls.

    Main outcome measures On-road driving scores in five specific test areas with a rating scale from 1 to 5. Neuropsychological test scores, including 12 tests.

    Results Compared with controls, patients with coronary artery disease had lower scores in all areas of the on-road driving test (p<0.05) and in the neuropsychological tests assessing psychomotor speed, visual and verbal memory, focused attention and simultaneous capacity (p<0.05). The difference between the groups in the on-road driving test appeared to be more pronounced among those above 65 years-of-age. Both patients and controls rated their performance significantly higher than the traffic inspector (p<0.05).

    Conclusions Cognitive function and driving performance may be impaired in patients with coronary artery disease.

  • 3.
    Arneson, Hanna
    et al.
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Liljegren, Mats
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Nordlund, Anders
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Psychiological empowerment at the workplace and self-rated health and burnout: a 2-yeah longitudinal analysis in a sample of Swedish employeesManuscript (preprint) (Other academic)
    Abstract [en]

    PURPOSE: To explore the gender-specific longitudinal association between psychological empowerment at the workplace and self-rated health and burnout in a working population.

    MATERIAL AND METHOD: The participants were employees working in the public service sector in central Sweden. The baseline survey was carried out in 2001 and the follow-up in 2003. The questionnaire was answered by 715 respondents at both points in time (overall response rate 67%). Measures used were Psychological Empowerment Instrument by Spreitzer, the SF-36, the EQ-5D, and the Copenhagen Burnout Inventory. Gender specific differences in average score for self-rated health and burnout at follow-up were assessed using multiple linear regression adjusted for age, education, study cohort and self-rated health and burnout at baseline. An analysis on interactional effects due to gender was also performed.

    RESULTS: For women, increasing levels of psychological empowerment at work at baseline are associated with less bodily pain, better physical role function and mental health in the multivariate analysis at follow-up two years later. For men, increased psychological empowerment at baseline is significantly associated with better self-rated health as measured by the EQ-5D VAS at follow-up in the multivariatc analysis. Higher levels of psychological empowerment at baseline show a statistically significant association with a lower degree of burnout at follow-up in the univariate analysis for men and women. However, the associations diminished after adjustments in the multivariate analyses. No significant gender x empowerment interaction appeared.

    CONCLUSION: Psychological empowerment in working life was associated with somatic and mental aspects of SRH two years later for women. Men seem to be less affected by psychological empowerment, yet an association with the EQ-5D V AS appeared. Psychological empowerment did not predict burnout two years later for either men or women.

  • 4.
    Arneson, Hanna
    et al.
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Liljegren, Mats
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Nordlund, Anders
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Psychological empowerment and self-rated health and burnout in a sample of Swedish employeesManuscript (preprint) (Other academic)
    Abstract [en]

    PURPOSE: To explore the gender-specific association between psychological empowerment and self-rated health and burnout in a working population.

    MATERIAL AND METHOD: A cross-sectional survey was carried out among 1,243 employees (response rate 81% (n=1007), 65 % females). Psychological empowerment was measured by the Spreitzer questionnaire, developed for a working life context. The questionnaire includes the subscales: meaning, competence, self-determination and impact. Self-rated health was evaluated with EQ-5D and SF-36 and the Copenhagen Burnout Inventory was used to measure burnout.

    RESULTS: Men reported a greater degree of empowerment than women in terms of self-determination and impact. Significant associations (p<0.05) were found between psychological empowerment and self-rated health and burnout. Men and women with higher levels of empowerment reported significantly better health compared to those with lower levels of empowerment. In multivitriate analyses, all four subscales of empowerment were associated with burnout among both men and women. The most pronounced association with self-rated health was seen for the subscale impact. These associations were particularly strong among women.

    CONCLUSION: Psychological empowerment in working life is associated with self-rated health and burnout. Interventions aiming to promote health at work or aiming to prevent burnout may therefore benefit if they comprise empowerment in terms of impact, self-determination, meaning and competence. Also, workplace health promotion that includes empowerment processes should be gender conscious.

  • 5.
    Arneson, Hanna
    et al.
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Liljegren, Mats
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Nordlund, Anders
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Psychological empowerment, social support at the workplace and self-rated health and burnout: a 2-year longitudinal analysis in a sample of Swedish employeesManuscript (preprint) (Other academic)
    Abstract [en]

    PURPOSE: To explore the gender-specific longitudinal association between a combination of psychological empowerment and social support at the workplace and self-rated health and burnout in a working population.

    MATERIAL AND METHOD: The participants were employees working in the public service sector in central Sweden. The baseline survey in two cohorts was carried out in 2001 and the follow-up in 2003. The questionnaire was answered by 715 respondents at both points in time (overall response rate 67%). Measures used were the Psychological Empowerment Instrument by Spreitzer, the social support dimension in the Demand-Control-Support Questionnaire, the SF-36, the EQ-5D, and the Copenhagen Burnout Inventory. Based on empirical medians, psychological empowerment and social support at baseline were combined into four categories. Mlltivariate comparisons adjusted for age, education, study cohort and SRH and burnout at baseline were performed using multiple linear regression analysis. The genderxempowerment and social support interaction effect was assessed in the multiple linear regression analysis. All analyses were performed for men and women separately.

    RESULTS: For women, a combination of high psychological empowerment and high social support at the workplace, in comparison with a combination of low psychological empowerment and low social support, is strongly associated with better SRH (bodily pain, general health, vitality, social functioning, emotional role, mental health, the EQ-5D VAS, and EQ-5D index) and lower levels of work-related burnout at the 2-year follow-up after adjusting for demographics and baseline SRH and burnout. For men, there are univariate associations with burnout and some associations with SRH. After adjustments for demographics and baseline SRH and burnout, psychological empowerment and social support is associated with SRH as measured by the EQ-5D VAS for men. The gender x empowerment and social support interaction analyses confirm gender differences regarding bodily pain, social function, and work-related burnout.

    CONCLUSION: A combination of psychological empowerment and social support in working life strongly affects SRH and work-related burnout two years later for women, but only in part for men.

  • 6.
    Barajas, Josefin
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Nordlund, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Ekberg, Kerstin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Employee-Perceived Leadership Behaviour and Effort-Reward Imbalance & Overcomittment2006In: 28th International Congress on Occupational Health,2006, 2006, p. 105-105Conference paper (Other academic)
    Abstract [en]

      

  • 7.
    Bernfort, Lars
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Center for Medical Technology Assessment.
    Persson, Jan
    Linköping University, The Institute of Technology. Linköping University, Department of Department of Health and Society, Center for Medical Technology Assessment.
    Ekberg, Kerstin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Öberg, Birgitta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Östergötlands Läns Landsting, Centre for Public Health Sciences, Centre for Public Health Sciences.
    Nordlund, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Economic evaluation in a cluster randomized controlled study of work place intervention in south-east Sweden2006In: International workshop Economic Evaluations of Occupational Health Interventions,2006, 2006Conference paper (Refereed)
  • 8. Cucchiara, B
    et al.
    Kasner, SE
    Wolk, DA
    Lyden, PD
    Knappertz, VA
    Ashwood, T
    Odergren, T
    Nordlund, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Lack of hemispheric dominance for consciousness in acute ischaemic stroke2003In: Journal of Neurology, Neurosurgery and Psychiatry, ISSN 0022-3050, E-ISSN 1468-330X, Vol. 74, no 7, p. 889-892Article in journal (Refereed)
    Abstract [en]

    Background: Previous reports have suggested left hemispheric dominance for maintaining consciousness, although there is controversy over this claim. Objective: To compare early impairment of level of consciousness between patients with right and left hemispheric stroke. Methods: Data from 564 patients with ischaemic stroke enrolled in the placebo arm of a trial of a putative neuroprotectant were analysed. All patients had major hemispheric stroke with cortical dysfunction, visual field deficit, and limb weakness, with symptom onset within 12 hours of enrolment. Patients were prospectively evaluated on a predefined scale (1-6, 1 = fully awake, higher scores representing greater impairment) to measure level of consciousness at multiple time points over the initial 24 hours after presentation. The National Institutes of Health (NIH) stroke scale score at presentation and infarct volume at 30 days were determined. Results: Some degree of impairment in level of consciousness was observed in 409 of the 564 patients (73%). Median maximum sedation score was 2 for both right and left hemispheric stroke (p = 0.91). Mean sedation score over 24 hours was 1.5 for both right and left stroke (p = 0.75). There was no difference between level of consciousness scores in right and left stroke at any individual time point during the 24 hour monitoring period. No association between side and impairment in level of consciousness was seen after adjustment for stroke severity and infarct volume. Conclusions: In contrast to previous reports, there was no evidence for hemispheric dominance for consciousness in the setting of a major hemispheric stroke.

  • 9. Cucchiara, BL
    et al.
    Kasner, SE
    Messe, SR
    Lyden, PD
    Knappertz, VA
    Ashwood, T
    Odergren, T
    Nordlund, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Adjusting for the NIH stroke scale bias toward left hemisphere stroke.2004In: 29th International Stroke Conference,2004, 2004Conference paper (Other academic)
  • 10. Cucchiara, BL
    et al.
    Kasner, SE
    Wolk, DA
    Lyden, PD
    Knappertz, VA
    Ashwood, T
    Odergren, T
    Nordlund, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation .
    Early impairment in consciousness predicts mortality after hemispheric ischemic stroke2004In: Critical Care Medicine, ISSN 0090-3493, E-ISSN 1530-0293, Vol. 32, no 1, p. 241-245Article in journal (Refereed)
    Abstract [en]

    Objective: Early predictors of poor outcome after acute ischemic stroke may be useful in selecting patients for potentially beneficial but high-risk interventions. Design. Cohort study of patients given placebo in a randomized clinical trial. Setting. Multicenter trial at 139 U.S. and 14 Canadian hospitals. Patients. A cohort of 564 placebo-treated patients with major anterior circulation ischemic stroke enrolled in the Clomethiazole in Acute Stroke Study-Ischemic Stroke (CLASS-I) trial. Patients did not have significant impairment in consciousness at baseline and were enrolled within 12 hrs of symptom onset. Interventions: Prospective data collection of a number of clinical variables including use of a 6-point level of consciousness scale (1 = awake, 6 = no reaction to pain) to measure patients' level of consciousness at enrollment and 12 additional times during the first 24 hrs after enrollment. The ability of level of consciousness score and additional clinical data to predict 30-day mortality was assessed. Measurements and Main Results., At 1 month, 114 of 564 patients (20%) had died. In univariate analysis, factors significantly associated with mortality included older age, white race, higher National Institutes of Health Stroke Scale score, higher serum glucose, atrial fibrillation, and any impairment in level of consciousness (p < .05). After controlling for these factors, increasing level of consciousness score at 3 hrs after enrollment and at all but one subsequent time point was significantly associated with increased mortality (odds ratio, 1.8 per point, 95% confidence interval, 1.2-2.6, p = .003 at 3-hr time point). Maximum level of consciousness score during the initial 24 hrs of monitoring also predicted mortality (odds ratio, 1.9 per point, 95% confidence interval, 1.4-2.5, p < .001). Conclusion: The development of a decreased level of consciousness within the initial hours after stroke onset, as evaluated by a simple six-point scale, is a powerful independent predictor of mortality after major anterior circulation ischemic stroke.

  • 11.
    Ekberg, Kerstin
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Nordlund, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Organisational Development under Stressful Working Conditions2006In: 28th International Congress on Occupational Health,2006, 2006, p. 153-153Conference paper (Other academic)
    Abstract [en]

       

  • 12.
    Ekberg, Kerstin
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Strindlund, Lena
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Nordlund, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Effort-Reward Imbalance and Overcomittment among Sick-listed Health Care Workers with Mental Adjustment Problems2006In: 28th International Congress on Occupational Health,2006, 2006, p. 56-56Conference paper (Other academic)
  • 13.
    Henriksson, Martin
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society.
    Nordlund, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Janzon, Magnus
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Swahn, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    A comparison of EQ-5D and SF-6D utilities2003In: iHEA 2003, San Francisco. Muntlig posterpresentation,2003, 2003Conference paper (Refereed)
  • 14.
    Liljegren, Mats
    et al.
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation . Linköping University, Faculty of Health Sciences.
    Nordlund, Anders
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation . Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation . Linköping University, Faculty of Health Sciences.
    Personality and Social Sciences: Psychometric evaluation and further validation of the Hagedoorn et al. modified EVLN measure2008In: Scandinavian Journal of Psychology, ISSN 0036-5564, Vol. 49, no 2, p. 169-177Article in journal (Refereed)
    Abstract [en]

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

  • 15.
    Liljegren, Mats
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Nordlund, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Ekberg, Kerstin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    The Associations between Perceived Organizational Justice and Self-Rated Health and Burnout.2005In: International Conference on Psychosocial Factors at Work,2005, 2005Conference paper (Other academic)
  • 16.
    Medin, Jennie
    et al.
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    Nordlund, Anders
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Eklund, Jörgen
    Linköping University, Department of Mechanical Engineering, Industrial Ergonomics. Linköping University, Department of Behavioural Sciences, Centre for Studies of Humans, Technology and Organization. Linköping University, The Institute of Technology.
    Organisational change, job strain and increased risk of stroke?: a pilot study2008In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 31, no 4, p. 443-449Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 17.
    Medin, Jennie
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Nordlund, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Ekberg, Kerstin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Increasing Stroke Incidence in Sweden Between 1989 and 2000 Among Persons Aged 30 to 65 Years: Evidence From the Swedish Hosptial Discharge Register.2003In: 12th Nordic Meeting on Cerebrovascular Diseases,2003, 2003Conference paper (Other academic)
  • 18.
    Medin, Jennie
    et al.
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Nordlund, Anders
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Increasing stroke incidence in Sweden between 1989 and 2000 among persons aged 30 to 65 years: evidence from the Swedish Hospital Discharge Register2004In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 35, no 5, p. 1047-1051Article in journal (Refereed)
    Abstract [en]

    Background and Purpose— Stroke mortality is decreasing in Sweden, as is the case in other Western European countries. However, both decreases and increases have been reported in Sweden for persons younger than age 65 years. The aim of this study was to compare the incidence of stroke in Sweden between the periods 1989 and 1991 and 1998 and 2000 in persons aged 30 to 65 years.

    Methods— All first-ever stroke patients aged 30 to 65 years in the Swedish Hospital Discharge Register between 1989 and 2000 were included.

    Results— The age-standardized, 3-year average incidence increased by 19%, from 98.9 to 118.0 per 100 000 among men, and by 33%, from 48.4 to 64.4 among women, between 1989 and 1991 and 1998 and 2000. The largest increase was seen among those younger than 60 years. On a county level, the change in age-standardized stroke incidence varied from small decreases (−3%) to large increases (82%).

    Conclusion— Stroke incidence increased in Sweden for both men and women between 1989 and 2000. The increase was larger among women. This calls for action when it comes to studying risk factors and planning for prevention and health promotion and indicates the need for gender-specific studies.

  • 19.
    Medin, Jennie
    et al.
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Nordlund, Anders
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Sick leave, disability pension and health-care-seeking behaviour prior to stroke, among people aged 30–65: a case–control study2007In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 21, no 5, p. 457-463Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 20.
    Medin, Jennie
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Nordlund, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Eklund, Jörgen
    Linköping University, The Institute of Technology. Linköping University, Department of Mechanical Engineering, Industrial Ergonomics.
    Ekberg, Kerstin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Axelsson, Olav
    Linköping University, Department of Molecular and Clinical Medicine.
    Organisational change, job strain, effort reward and increased risk of stroke: a case control study.2005In: Second ICOH International Conference on Psychosocial factors at Work.,2005, 2005Conference paper (Refereed)
  • 21.
    Nordlund, Anders
    Linköping University, Faculty of Arts and Sciences. Linköping University, The Tema Institute.
    Cancer bland kvinnor i Sverige - speciellt tobakens betydelse1998Report (Other academic)
  • 22.
    Nordlund, Anders
    Linköping University, The Tema Institute. Linköping University, Faculty of Arts and Sciences.
    Smoking and cancer among Swedish women1998Doctoral thesis, monograph (Other academic)
    Abstract [en]

    Cancer has been the second most frequent cause of death in Sweden and in other developed countries for most of the 20th century, and today accounts for about 25 per cent of all mortality. While the trend in overall cancer mortality has been increasing among men, the picture is less clear regarding women. In addition, most of the knowledge about the relationship between tobacco smoking - one of the most important among potentially preventable causes of human cancer - and cancer has been generated in studies involving men only. Recently some studies have suggested that female smokers are more susceptible than male smokers to the carcinogenic effects of tobacco smoke. In the present series of investigations, various aspects of cancer among Swedish women were studied and compared with those of Swedish men. This was achieved through the use of official statistics regarding cancer incidence, cancer mortality and smoking prevalence together with data from a large, population-based questionnaire on smoking habits in Sweden from 1963.

    Among men, overall cancer mortality increased between 1931 and 1992, while among women there was a slight decrease. Owing to uncertainties regarding the impact of improvements in diagnostic accuracy the results must be interpreted with some caution. Smoking prevalence was at a high level for men born around the turn of the century, remained high, but started to decrease for men born towards the middle of the century. Among women born around 1900 smoking prevalence was low, but increased steadily for those born later. Lung cancer mortality trends closely followed the pattern of smoking prevalence, with stable rates among men and successively increasing rates among women.

    Regarding the risk of getting different types of cancer among women, current smokers ran a higher risk than never regular smokers of getting cancer of the lung, upper aerodigestive sites, pancreas, bladder, cervix, organs of the urinary tract other than kidney and bladder, and all cancers combined. No substantial difference in dose-response gradient regarding smoking-related cancers other than lung cancer was found between male and female smokers. Furthermore, any differences in lung cancer dose-response gradient between male and female smokers are probably small.

    Finally, there were only small differences in overall cancer risk and risk of smoking-related cancers between different socio-economic groups in Sweden were the case. Farmers were the notable exception, running a lower risk of getting in particularly smoking-related cancers as compared to blue-collar workers. However, adjusting for smoking habits in 1963, led to decreased differences, and farmers did no longer displayed lower risk.

  • 23.
    Nordlund, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Tobaksrökning och hälsa i Sverige under 1900-talet.2005In: Svenska folkets hälsa i historiskt perspektiv / [ed] Jan Sundin, Christer Hogstedt,Jakob Lindberg, Henrik Moberg, Stockholm: Statens folkhälsoinstitut , 2005, p. 305-361Chapter in book (Other academic)
    Abstract [sv]

    Sverige har i ett internationellt perspektiv en lång tradition av att bedriva´det som nu kallas folkhälsopolitik. Den mångfald av insatser som genomförts har påverkat både hälsan och medellivslängden, vilken fördubblats sedan mitten av 1700-talet. Denna utveckling går dock inte enbart, eller ens främst, att tillskriva folkhälsopolitiska insatser. Förändringar i befolkningens hälsa, sjuklighet och dödlighet måste ses i relation till samhällets struktur i olika skeden och samhällsutvecklingen i bred mening.

  • 24.
    Nordlund, Anders
    Linköping University, Faculty of Arts and Sciences. Linköping University, The Tema Institute.
    Trends in smoking habits and lung cancer in Sweden1998In: European Journal of Cancer Prevention, ISSN 0959-8278, E-ISSN 1473-5709, Vol. 7, no 2, p. 109-116Article in journal (Refereed)
  • 25.
    Nordlund, Anders
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation .
    Ekberg, Kerstin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation .
    Self reported musculoskeletal symptoms in the neck/shoulders and/or arms and general health (SF-36): eight year follow up of a case-control study2004In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 61, no 3Article in journal (Refereed)
    Abstract [en]

    Aims: To explore and compare the prevalence after eight years of self reported musculoskeletal symptoms and general health (SF-36) for groups with initially different degrees of severity of symptoms in the neck/shoulders and/or arms. Methods: A case-control study was performed in 1989 comprising 129 clinically examined cases and 655 survey controls. The study population was followed up in 1997 with a postal survey. The controls, none of which were clinically examined at baseline (1989), were divided into groups according to degree of severity of self reported symptoms in the neck/shoulders and/or arms at baseline: no symptoms, light symptoms, and severe symptoms. Cases were clinically diagnosed with a musculoskeletal disorder of the neck/shoulders and/or arms at baseline. Results: At the 1997 follow up, there was a trend of increasing prevalence of musculoskeletal symptoms, as well as decreasing health status as rated in the SF-36 over the three severity groups among controls. Only small differences were seen between the cases and the controls reporting severe musculoskeletal symptoms or the neck/shoulders and/or arms. Conclusion: The degree of questionnaire based self reported musculoskeletal symptoms of the neck/shoulders and/or arms clearly indicate different degrees of future health problems (both in terms of self reported musculoskeletal problems and health in general as captured by the SF-36). Therefore, there is a need for improved intervention and health promotion strategies. Such effort should be implemented before musculoskeletal symptoms have developed to clinical cases, particularly in the realm of the workplace.

  • 26.
    Nordlund, Anders
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Ekberg, Kerstin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Kristenson, Margareta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Östergötlands Läns Landsting, Centre for Public Health Sciences, Centre for Public Health Sciences.
    Group: med:, Linquest
    Ståhlbom, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Östergötlands Läns Landsting, Pain and Occupational Centre, Occupational and Environmental Medicine Centre.
    Tondel, Martin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Östergötlands Läns Landsting, Pain and Occupational Centre, Occupational and Environmental Medicine Centre.
    EQ-5D in a general population survey - A description of the most commonly reported EQ-5D health states using the SF-362005In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 14, no 4, p. 1099-1109Article in journal (Refereed)
    Abstract [en]

    The importance of studying health-related quality of life in the general population has increasingly been emphasized. From a public health perspective, this benefits the identification of population inequalities in health status. One of the currently most popular instruments is the EQ-5D. Evaluations of the EQ-5D generally focus on the overall preference-based index. As this index has a built-in value, exploration of the information from the underlying health states is also important. In this study, the ten most commonly reported EQ-5D health states are described using the SF-36. Data collected in 1999 by questionnaires mailed to a random sample aged 20-74 in south-eastern Sweden were used (n = 9489). Almost 43% reported the best possible EQ-5D health state and 78% were accounted for by three EQ-5D health states. The EQ-5D health state classification was largely reflected by the SF-36, with the EQ-5D items mobility, usual activities, pain/discomfort and anxiety/depression tapping most clearly on the SF-36 scales physical functioning, role limitations due to physical health problems, bodily pain, and mental health, respectively. However, within the same level of EQ-5D (i.e., moderate problems) there was a rather large variation of SF-36 scale scores, particularly regarding the EQ-5D item pain/discomfort and the SF-36 scale BP. © Springer 2005.

  • 27.
    Nordlund, Lars Anders
    et al.
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences.
    Carstensen, John
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences.
    Pershagen, Göran
    Karolinska institutet, Stockholm.
    Are male and female smokers at equal risk of smoking-related cancer: evidence from a Swedish prospective study1999In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 27, no 1, p. 56-62Article in journal (Refereed)
    Abstract [en]

    This study examines sex differences in the relative risks of lung cancer and other smoking-related cancers (i.e. cancers of the upper respiratory tract, oesophagus, pancreas, bladder, and renal pelvis). Data on smoking habits in 1963 from a random sample of 56,000 men and women were linked with information on new cases of cancer for 1964-89. Compared with people who have never smoked, the relative risks of lung cancer at different levels of pack-years completed in 1963 (>5, 6-15, 16-25 and 25 + pack-years) were 1.6, 4.4, 14.2, and 17.9 for men, and 2.1, 6.3, 10.3, and 16.5 for women. The corresponding relative risks of other smoking-related cancers were 1.8, 3.0 5.4, and 6.4 for men, and 2.0, 3.1, 5.0, and 6.5 for women. These results suggest that men and women have similar relative risks of smoking-related cancers at different levels of smoking.

  • 28.
    Nordlund, Lars Anders
    et al.
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences.
    Carstensen, John
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences.
    Pershagen, Göran
    Karolinska institutet, Stockholm.
    Cancer incidence in female smokers: a 26-year follow-up1997In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 73, no 5, p. 625-628Article in journal (Refereed)
    Abstract [en]

    A random sample of 26,000 Swedish women who were asked about their smoking habits in the early 1960s have now been followed for 26 years with respect to cancer incidence. Most findings regarding tobacco smoking and cancer from studies of men were confirmed also among the women. Elevated relative risk for current smokers compared with women who never smoked regularly were seen for cancers of the lung, upper aerodigestive sites, pancreas, bladder, cervix and all cancers combined, as well as a notably high relative risk for cancers of organs of the urinary tract other than kidney and bladder. Relative risk increased with dose, measured as grams of tobacco smoked per day, for cancers of the upper aerodigestive sites, lung, cervix, bladder, organs of the urinary tract other than kidney and bladder and all cancers combined. For cancers of the lung, bladder and cervix, there was an inverse relationship with age when starting to smoke tobacco. The reported inverse relationship between smoking and endometrial cancer could not be corroborated, nor was there any significant relationship between smoking and colorectal or breast cancer.

  • 29.
    Orwelius, Lotti
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Bergkvist, Max
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Nordlund, Anders
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Simonsson, Eva
    Department of Anaesthesia and Intensive Care, Ryhov Hospital, Jönköping, Sweden.
    Nordlund, Peter
    Department of Anaesthesia and Intensive Care, Ryhov Hospital, Jönköping, Sweden.
    Bäckman, Carl
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.
    Sjöberg, Folke
    Linköping University, Department of Clinical and Experimental Medicine, Burn Center. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Surgery.
    Physical effects of trauma and the psychological consequences of preexisting diseases account for a significant portion of the health-related quality of life patterns of former trauma patients2012In: Journal of Trauma and Acute Care Surgery, ISSN 2163-0755, E-ISSN 2163-0763, Vol. 72, no 2, p. 504-512Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 30.
    Orwelius, Lotti
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Nordlund, Anders
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Edéll-Gustafsson, Ulla
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Simonsson, Eva
    Department of Anaesthesia and Intensive Care, Ryhov Hospital, Jonkoping, Sweden.
    Nordlund, Peter
    Department of Anaesthesia and Intensive Care, Ryhov Hospital, Jonkoping, Sweden.
    Kristenson, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Bendtsen, Preben
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Sjöberg, Folke
    Linköping University, Department of Clinical and Experimental Medicine, Burn Unit . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Role of preexisting disease in patients' perceptions of health-related quality of life after intensive care.2005In: Critical Care Medicine, ISSN 0090-3493, E-ISSN 1530-0293, Vol. 33, no 7, p. 1557-1564Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To find out how patients perceive their health-related quality of life after they have been treated in an intensive care unit and whether preexisting disease influenced their perception.

    DESIGN:: Follow-up, quantitative, dual-site study.

    SETTING: Combined medical and surgical intensive care units of one university and one general hospital in Sweden.

    PATIENTS: Among the 1,938 patients admitted, 562 were considered eligible (>24 hrs in the intensive care unit, and age >18 yrs). The effect of preexisting disease was assessed by use of a large reference group, a random sample (n = 10,000) of the main intake area of the hospitals.

    INTERVENTIONS: None.

    MEASUREMENTS AND MAIN RESULTS: During 2000-2002, data were collected from the intensive care unit register and from a questionnaire mailed to the patients 6 months after their discharge from hospital. Subjects in the reference group were sent postal questionnaires during 1999. Of the patients in the intensive care unit group, 74% had preexisting diseases compared with 51% in the reference group. Six months after discharge, health-related quality of life was significantly lower among patients than in the reference group. When comparisons were restricted to the previously healthy people in both groups, the observed differences were about halved, and when we compared the patients in the intensive care unit who had preexisting diseases with subjects in the reference group who had similar diseases, we found little difference in perceived health-related quality of life. In some dimensions of health-related quality of life, we found no differences between patients in the intensive care unit and the subjects in the reference population.

    CONCLUSIONS: Preexisting diseases significantly affect the extent of the decline of health-related quality of life after critical care, and this effect may have been underestimated in the past. As most patients who are admitted to an intensive care unit have at least one preexisting disease, it is important to account for these effects when examining outcome.

  • 31.
    Orwelius, Lotti
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Nordlund, Anders
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Nordlund, Peter
    Department of Anaesthesia and Intensive Care, Intensiv Care Unit, Ryhov Hospital, 551 85 Jönköping, Sweden.
    Edéll-Gustafsson, Ulla
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Sjöberg, Folke
    Linköping University, Department of Clinical and Experimental Medicine, Burn Center. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Prevalence of sleep disturbances and long-term reduced health-related quality of life after critical care: a prospective multicenter cohort study2008In: Critical care (London, England), ISSN 1466-609X, Vol. 12, no 4, p. R97-Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 32.
    Orwelius, Lotti
    et al.
    Linköping University, Department of Medical and Health Sciences, Anesthesiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Anaesthesiology and Surgery UHL.
    Nordlund, Anders
    TFS Trial Form Support AB, Lund.
    Nordlund, Peter
    Department of Anaesthesia and Intensive Care, Ryhov Hospital, Jönköping, Sweden.
    Simonsson, Eva
    Department of Anaesthesia and Intensive Care, Ryhov Hospital, Jönköping, Sweden.
    Bäckman, Carl
    Department of Anaesthesia and Intensive Care, Vrinnevi Hospital, Norrköping, Sweden.
    Samuelsson, Anders
    Linköping University, Department of Medical and Health Sciences, Anesthesiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Intensive Care UHL.
    Sjöberg, Folke
    Linköping University, Department of Clinical and Experimental Medicine, Burn Center. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Plastic Surgery, Hand surgery UHL. Östergötlands Läns Landsting, Sinnescentrum, Department of Anaesthesiology and Surgery UHL.
    Pre-existing disease: the most important factor for health related quality of life long-term after critical illness: a prospective, longitudinal, multicentre trial2010In: Critical Care, ISSN 1364-8535, E-ISSN 1466-609X, Vol. 14, no 2Article in journal (Refereed)
    Abstract [en]

    Introduction

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

    Methods

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

    Results

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

    Conclusions

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

     

  • 33.
    Ydreborg, Berit
    et al.
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation . Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation . Linköping University, Faculty of Health Sciences.
    Nordlund, Anders
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation . Linköping University, Faculty of Health Sciences.
    Health, quality of life, social network and use of public health: A comparison between those granted and those not granted disability pension2006In: Disability and Rehabilitation, ISSN 0963-8288, Vol. 28, no 1, p. 25-32Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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