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  • 1.
    Alexanderson, Kristina
    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.
    An assessment protocol for gender analysis of medical literature.2000In: Women & health, ISSN 0363-0242, E-ISSN 1541-0331, Vol. 29, p. 81-98Article in journal (Refereed)
  • 2.
    Alexanderson, Kristina
    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.
    Ett läkarintygs kvalitet har ibland lika stor betydelse för patienten som den medicinska behandlingens.2001In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 98, p. 1262-1264Article in journal (Other academic)
  • 3.
    Alexanderson, Kristina
    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.
    Learning about being well - not just about being ill.2000In: Medical Education, ISSN 0308-0110, E-ISSN 1365-2923, Vol. 34, no 5, p. 337-338Article in journal (Other academic)
  • 4.
    Alexanderson, Kristina
    et al.
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Borg, Karin E.
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Hensing, Gunnel K.E.
    Department of Social Medicine, The Sahlgrenska Academy at Göteborg University.
    Sickness absence with low-back, shoulder, or neck diagnoses: An 11-year follow-up regarding gender differences in sickness absence and disability pension2005In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 25, no 2, p. 115-124Article in journal (Refereed)
    Abstract [en]

    Background: There is very little knowledge on the long-term outcomes of sickness absence. The aim was to investigate sickness absence and disability pensions over 11 years in a cohort of young persons initially long-term sick listed with back, neck, or shoulder diagnoses.

    Method: A prospective population-based cohort study of all 213 individuals in the Municipality of Linköping, Sweden, who in 1985 were aged 25-34 and had at least one new sick-leave spell > 28 days with such diagnoses.

    Main results: More women (61%) than men fulfilled the inclusion criteria. In 1996, 22% of the cohort (14% of the men, 26% of the women) had been granted disability pension; 76% of these individuals with musculoskeletal and the rest with psychiatric diagnoses. Partial disability pension was granted to 59% of the women, 17% of the men. Women were more often granted temporary disability pension than men.

    Conclusions: This proved to be a high-risk group for disability pension. There were large and somewhat unexpected gender differences regarding incidence and type of disability pension. It has been debated how soon physicians should be concerned about the risk of long-term disability regarding these diagnoses; at four or eight weeks of sickness absence - our results support the former, at least for women.

  • 5.
    Alexanderson, Kristina
    et al.
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Leijon, Margareta
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Åkerlind, Ingemar
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Rydh, Hillevi
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Bjurulf, Per
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Epidemiology of sickness absence in a Swedish county in 1985, 1986 and 1987: A three year longitudinal study with focus on gender, age and occupation1994In: Scandinavian Journal of Social Medicine, ISSN 0300-8037, Vol. 22, no 1, p. 27-34Article in journal (Refereed)
    Abstract [en]

    In order to get a better epidemiological base for preventive intervention in the county of Östergötland, Sweden, a comprehensive study of sickness absence was done. During the years 1985, 1986 and 1987, all new periods of sick-leave exceeding seven days were registered with demographic variables. This information was related to data about the total population of Östergötland. Each year approx. 45,000 persons had approx. 61,000 sickness spells. These figures were stable over the years while the number of sick-leave days increased. Blue-collar occupations had the highest sick-leave rates and the female sick-leave rate was higher in general and much higher in most male-dominated occupations. The male rate was lower within female-dominated areas, except among secretaries and textile workers. Females in extremely male-dominated groups had the highest rates, while both male and female sick-leave rates were lower in more gender-integrated occupations.

  • 6.
    Alexandersson, Kristina
    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.
    Research on sickness absence in different countries2002In: The European Public Health assosiation Annual Meeting Dresden 29-30 2002,2002, 2002, p. 24-26Conference paper (Refereed)
  • 7.
    Alexandersson, Kristina
    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.
    Why do women have higher sickness absence?2002In: Third International Congress on Women Health & work Stockholm 2-5 June 2002,2002, 2002, p. 174-174Conference paper (Refereed)
  • 8.
    Alexandersson, Kristina
    et al.
    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.
    Järvholm, B
    Umeå Universitet.
    Olofsson, C
    Sjukdom och hälsa ett allmänt perspectiv2002In: Försäkringsmedicin / [ed] Bengt Järvholm & Christer Olofsson, Linköping: Linköpings universitet , 2002, p. 22-27Chapter in book (Other academic)
    Abstract [sv]

    En genomsnittlig svensk läkare är varje år inblandad i försäkringsmedicinska frågeställningar som betingar kostnader i storleksordningen 2–3 miljoner kronor. Trots detta ingår inte försäkringsmedicin som eget kompetensområde i läkarnas grundbildning. Enligt en nyligen gjord enkät saknar mer än hälften av läkarna utbildning i vissa basala kunskaper såsom att skriva ett arbetsskadeintyg. Denna lärobok, skriven av 12 experter inom området, avser primärt att svara mot behovet av grundläggande kunskaper inom försäkringsmedicinens område för läkare under utbildning. En central del i en svensk lärobok i försäkringsmedicin är den allmänna försäkringen som bl.a. ligger till grund för sjukpenning och förtidspension. Privata livförsäkringar har funnits i många år, men ställer allt större krav på läkaren i takt med att nya tester utvecklas, bl.a. genetiska som kan förutsäga risker för förtida sjukdom och död. Andra försäkringar, t.ex. privata sjukförsäkringar, har blivit vanligare och frågor kring dessa belyses i boken. Det finns också andra försäkringar som är viktiga ur försäkringsmedicinsk synpunkt och som berör ansvarsfrågor och skadestånd, t.ex. patientförsäkring och läkemedelsförsäkring, vilka också behandlas. Boken innehåller även en översikt över viktiga juridiska frågor, liksom sekretess. Etiska frågeställningar är mycket vanliga inom försäkringsmedicinen och boken avslutas med ett kapitel om etik. Boken vänder sig i första hand till läkarstuderande men kan även fungera som referens- och uppslagsbok för personer verksamma inom sjukvård, försäkringsbolag och försäkringskassan.

  • 9.
    Alexandersson, Kristina
    et al.
    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.
    Järvholm, B
    Olofsson, C
    Sjukfrånvaro skillnader mellan kvinnor och män2002In: Försäkringsmedicin / [ed] Bengt Järvholm & Christer Olofsson, Linköping: Linköpings universitet , 2002, p. 82-89Chapter in book (Other academic)
    Abstract [sv]

    En genomsnittlig svensk läkare är varje år inblandad i försäkringsmedicinska frågeställningar som betingar kostnader i storleksordningen 2–3 miljoner kronor. Trots detta ingår inte försäkringsmedicin som eget kompetensområde i läkarnas grundbildning. Enligt en nyligen gjord enkät saknar mer än hälften av läkarna utbildning i vissa basala kunskaper såsom att skriva ett arbetsskadeintyg. Denna lärobok, skriven av 12 experter inom området, avser primärt att svara mot behovet av grundläggande kunskaper inom försäkringsmedicinens område för läkare under utbildning. En central del i en svensk lärobok i försäkringsmedicin är den allmänna försäkringen som bl.a. ligger till grund för sjukpenning och förtidspension. Privata livförsäkringar har funnits i många år, men ställer allt större krav på läkaren i takt med att nya tester utvecklas, bl.a. genetiska som kan förutsäga risker för förtida sjukdom och död. Andra försäkringar, t.ex. privata sjukförsäkringar, har blivit vanligare och frågor kring dessa belyses i boken. Det finns också andra försäkringar som är viktiga ur försäkringsmedicinsk synpunkt och som berör ansvarsfrågor och skadestånd, t.ex. patientförsäkring och läkemedelsförsäkring, vilka också behandlas. Boken innehåller även en översikt över viktiga juridiska frågor, liksom sekretess. Etiska frågeställningar är mycket vanliga inom försäkringsmedicinen och boken avslutas med ett kapitel om etik. Boken vänder sig i första hand till läkarstuderande men kan även fungera som referens- och uppslagsbok för personer verksamma inom sjukvård, försäkringsbolag och försäkringskassan.

  • 10.
    Alexandersson, Kristina
    et al.
    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.
    Järvholm, B
    Umeå Universitet.
    Olofsson, C
    Vad beror sjukfrånvaro på?2002In: Försäkringsmedicin / [ed] Bengt Järvholm & Christer Olofsson, Linköping: Linköpings universitet , 2002, p. 70-81Chapter in book (Other academic)
    Abstract [sv]

    En genomsnittlig svensk läkare är varje år inblandad i försäkringsmedicinska frågeställningar som betingar kostnader i storleksordningen 2–3 miljoner kronor. Trots detta ingår inte försäkringsmedicin som eget kompetensområde i läkarnas grundbildning. Enligt en nyligen gjord enkät saknar mer än hälften av läkarna utbildning i vissa basala kunskaper såsom att skriva ett arbetsskadeintyg. Denna lärobok, skriven av 12 experter inom området, avser primärt att svara mot behovet av grundläggande kunskaper inom försäkringsmedicinens område för läkare under utbildning. En central del i en svensk lärobok i försäkringsmedicin är den allmänna försäkringen som bl.a. ligger till grund för sjukpenning och förtidspension. Privata livförsäkringar har funnits i många år, men ställer allt större krav på läkaren i takt med att nya tester utvecklas, bl.a. genetiska som kan förutsäga risker för förtida sjukdom och död. Andra försäkringar, t.ex. privata sjukförsäkringar, har blivit vanligare och frågor kring dessa belyses i boken. Det finns också andra försäkringar som är viktiga ur försäkringsmedicinsk synpunkt och som berör ansvarsfrågor och skadestånd, t.ex. patientförsäkring och läkemedelsförsäkring, vilka också behandlas. Boken innehåller även en översikt över viktiga juridiska frågor, liksom sekretess. Etiska frågeställningar är mycket vanliga inom försäkringsmedicinen och boken avslutas med ett kapitel om etik. Boken vänder sig i första hand till läkarstuderande men kan även fungera som referens- och uppslagsbok för personer verksamma inom sjukvård, försäkringsbolag och försäkringskassan.

  • 11.
    Bendtsen, Preben
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Beroendekliniken IHS. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Dependency.
    Hensing, G
    Göteborg.
    Alexanderson, Kristina
    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.
    Self-perceived excessive alcohol consumption among employed women: Association with health and psychosocial factors2003In: Addictive Behaviours, ISSN 0306-4603, E-ISSN 1873-6327, Vol. 28, no 4, p. 777-783Article in journal (Refereed)
    Abstract [en]

    [No abstract available]

  • 12.
    Boman, John
    et al.
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Lindfors, Sara
    Karolinska Institutet, Stockholm.
    Nordqvist, Cecilia
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Nordström, Louise
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Alexanderson, Kristina
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Konstruktiva strategier för att hantera stress bland disputerade specialistläkare vid ett universitetssjukhus2005Report (Other academic)
  • 13.
    Borg, Karin
    et al.
    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.
    Hensing, G
    Göteborg.
    Alexandersson, Kristina
    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.
    Sickness absence with low-back, shoulder, or neck diagnoses- an 11 -year follow up regarding sickness absence and disability pension2002In: Third International Congress on women Health & work , Stockholm 2-5 June 2002,2002, 2002, p. 131-131Conference paper (Refereed)
  • 14.
    Borg, Karin
    et al.
    Linköping University, Department of Department of Health and Society. Linköping University, Faculty of Health Sciences.
    Hensing, Gunnel
    Department of Social Medicine, Sahlgrenska Academy, University of Göteborg, SwedenDepartment of Social Medicine, Sahlgrenska Academy, University of Göteborg, Sweden.
    Alexandersson, Kristina
    Department of Clinical Neuroscience, Karolinska Institutet, Sweden.
    Prediction of future low levels of sickness absence among young persons sick listed with low-back, neck, or shoulder diagnoses2004In: Work : a journal of prevention, assessment & rehabilitation, ISSN 1051-9815, Vol. 23, no 2, p. 159-167Article in journal (Refereed)
    Abstract [en]

    In recent years sickness absence has increased in most Western countries. Risk factors for sickness absence and disability pension have been emphasised in studies, while focus on factors predicting low sickness absence is very rare. This paper is an attempt to apply such a perspective in an 11-year prospective cohort study of young persons n = 213) who in 1985 were sick listed ≥ 28 days with back, neck, or shoulder diagnoses. Having had no sick-leave spells > 14 days in 1992-1996 was used as the outcome measure. Sixty-nine persons (34%) had no such spells, with an unexpected similar proportion of men and women. Data on prior sick leave and demographic variables were analysed using univariate and multiple logistic regression. Factors that predicted low sickness absence were having prior low sickness absence, being a white-collar worker, and being married. We concluded that individuals with a history of low sickness absence have an increased odds for remaining in the work force after a single long sick-leave spell, and might need less attention in rehabilitation compared to persons with a history of high sickness absence. Focusing on low sickness absence led to different results than those discussed in previous studies on risk factors for disability pension.

  • 15.
    Borg, Karin
    et al.
    Linköping University, Department of Department of Health and Society. Linköping University, Faculty of Health Sciences.
    Hensing, Gunnel
    Department of Social Medicine, Sahlgrenska Academy, University of Göteborg.
    Alexandersson, Kristina
    Department of Clinical Neuroscience, Karolinska Institutet .
    Predictive factors for disability pension: An 11-year follow up of young persons on sick leave due to neck, shoulder, or back diagnoses2001In: Scandinavian journal of public health, ISSN 1403-4948, Vol. 29, no 2, p. 104-112Article in journal (Refereed)
  • 16.
    Borg, Karin
    et al.
    Linköping University, Department of Department of Health and Society. Linköping University, Faculty of Health Sciences.
    Hensing, Gunnel
    Department of Social Medicine, Sahlgrenska Academy, University of Göteborg.
    Alexandersson, Kristina
    Department of Clinical Neuroscience, Karolinska Institutet.
    Risk factors for disability pension over 11 years in a cohort of young persons initially sick-listed with low back, neck, or shoulder diagnoses2004In: Scandinavian journal of public health, ISSN 1403-4948, Vol. 32, no 4, p. 272-278Article in journal (Refereed)
    Abstract [en]

    Aim: A study was undertaken to ascertain whether the differences in risk in relation to gender and citizenship observed in a previous study of the same cohort would remain if more recent data on sickness absence were used. Methods: This was an 11-year prospective population-based cohort study. The dataset includes all individuals in a Swedish city who, in 1985, were aged 25 - 34 and had a sick-leave spell≥28 days with neck, shoulder, or back diagnoses (n=213). The data covered the following: for 1985 - 96, disability pension, emigration, and death; for 1982 - 96, sickness absence; for 1985, sex and citizenship. The data were subjected to Cox regression analyses with a time-dependent covariate. Results: Disability pension was granted to 22% (n=46) of the cohort. The relative risk for disability pension increased by 9.3 with each sick-leave spell≥90 days during the two previous years. The risk was higher for women than men, and also higher for foreign citizens than Swedes. Conclusion: Many studies have revealed a gender difference in the risk of being on disability pension, and it was found that this difference was still apparent when sick leave during the follow-up period is taken into account. Thus, the reason for the gender differences ought to be found among other factors than prior levels of sickness absence.

  • 17.
    Festin, Karin
    et al.
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Alexanderson , Kristina
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    CHANGES IN SICK-LEAVE DIAGNOSES OVER ELEVEN YEARS IN A COHORT OF YOUNG ADULTS INITIALLY SICK-LISTED DUE TO LOW BACK, NECK, OR SHOULDER DIAGNOSES2009In: JOURNAL OF REHABILITATION MEDICINE, ISSN 1650-1977 , Vol. 41, no 6, p. 423-428Article in journal (Refereed)
    Abstract [en]

    Objective: To study future general and diagnoses-specific sickness absence and disability pension among young adults who were initially on long-term sick-leave due to back, neck, or shoulder diagnoses. Design: Eleven-year prospective cohort study. Subjects: All 213 adults in a Swedish municipality who, in 1985, were in the age range 25-34 years and had begun a spell of sick-leave lasting andgt;= 28 days with low back, neck, or shoulder diagnoses. Methods: For the time-period 1985-96, data regarding the dates and diagnoses for all periods of sick-leave, and the dates of disability pension, emigration, and death were obtained. Numbers of days of sick-leave and disability pension were analysed separately for each of the 11 years in relation to the number of days at risk for such benefits. Results: The cohort members were on sick-leave or disability pension for 25% of all days at risk during the 11 years of follow-up. A large difference in the number of sick-leave days between the 220% of subjects who were later granted disability pension and the others was already apparent during the first 2 years. During the entire period, up to 21% of the sick-leave days for women and 24% for men entailed psychiatric diagnoses. Conclusion: This cohort of young adults, initially off sick for 4 weeks due to back, neck, or shoulder diagnoses, also had a high level of sickness absence in the subsequent 11 years with other diagnoses.

  • 18.
    Gjesdal, Sturla
    et al.
    University of Bergen.
    Svedberg, Pia
    Karolinska Institute.
    Hagberg, Jan
    Karolinska Institute.
    Alexanderson , Kristina
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Mortality among disability pensioners in Norway and Sweden 1990-96: Comparative prospective cohort study2009In: SCANDINAVIAN JOURNAL OF PUBLIC HEALTH, ISSN 1403-4948 , Vol. 37, no 2, p. 168-175Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of the study was to assess excess mortality related to disability pension (DP) status and DP diagnoses in Norway and Sweden during 1990-96. Methods: Representative samples of the population aged 30-59 years, without DP at baseline 1 January 1990, 71,293 women and 76,928 men from Norway, and 68,181 women and 71,950 men from Sweden, were followed up during 1990-96. Granting of DP, DP diagnosis, age and gender were explanatory variables in Cox proportional hazards analysis with death from all causes as the outcome variable. Results: Among women, 10.4% in Sweden and 7.1% in Norway obtained DP, as compared to 7.5% and 5.6% of the men. In Sweden, 66% of female and 49% of male DP recipients had musculoskeletal diagnoses, as compared to 40% and 27% in Norway. In Sweden, 3.0% of the women and 6.1% of the men with DP died, as compared to 4.6% and 8.5% in Norway. Hazard ratios (HRs) for women with DP vs. the non-DP group were 3.2 (95% confidence interval (CI) 2.7-3.8) in Sweden, and 4.9 (95% CI = 4.1-5.7) in Norway. Among men with DP, there was no difference in mortality rate between the countries. HRs for men with musculoskeletal diagnoses vs. the non-DP group were 1.5 (95% CI = 1.1-2.0) in Norway and 1.4 (95% CI = 1.1-1.8) in Sweden. In both countries, the mortality rate among female disability pensioners with musculoskeletal diagnoses was not increased. Conclusions: The study confirmed an increased mortality rate among disability pensioners, except for women with musculoskeletal diagnoses. The mortality pattern related to DP diagnoses was similar in the two countries. A high frequency of musculoskeletal DP diagnoses among women with DP in Sweden explained a lower mortality rate as compared to Norway.

  • 19.
    Gustafsson, Klas
    et al.
    Karolinska Institute.
    Backenroth-Ohsako, Gunnel
    Karolinska Institute.
    Rosenhall, Ulf
    Karolinska Institute.
    Ternevall-Kjerulf, Elisabeth
    Karolinska Institute.
    Ulfendahl, Mats
    Karolinska Institute.
    Alexanderson, Kristina
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Future risk for disability pension among people with sickness absence due to otoaudiological diagnoses: a population-based cohort study with a 12-year follow-up2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, no 5, p. 501-507Article in journal (Refereed)
    Abstract [en]

    Hearing difficulties is a growing public health problem and more knowledge of consequences of those difficulties in working life is warranted. Aims: To study the future risk of being granted a disability pension (DP) among people with sickness absence with an otoaudiological diagnoses (OAD) compared to other sickness absentees. Methods: A population-based prospective cohort study of all 40,786 people in a Swedish county who in 1985 were aged 16-64 and had a new sick-leave spell greater than 7 days. Those were followed for 12 years with regard to DP. Hazard ratios (HR) + 95% confidence intervals (CI) of being granted DP was calculated among those with sick leave due to OAD compared to people with sickness absence with other diagnoses. Results: In 1985, 515 people had a new sick-leave spell with an OAD. Twelve years later, 36% of those had been granted DP, compared to 24% of all other sickness absentees. Their HR for DP was 1.42 (95% CI 1.23-1.64) adjusting for gender and age. Compared to men, women with an OAD had a HR of DP of 1.24 (95% CI 0.90-1.71), when adjusted for age. The HR for DP regarding those aged greater than 45 years and sickness absent with OAD was 2.63 (95% CI 1.95-3.55) compared to the sickness absentees with OAD below 45 years of age, adjusted for gender. Conclusions: The risk for future DP was more than 40% higher among those initially on sickness absence due to OAD than among other sickness absentees.

  • 20.
    Hagberg, Jan
    et al.
    Karolinska Institute.
    Vaez, Marjan
    Karolinska Institute.
    Alexanderson, Kristina
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Methods for analysing individual changes in sick-leave diagnoses over time2010In: WORK-A JOURNAL OF PREVENTION ASSESSMENT and REHABILITATION, ISSN 1051-9815, Vol. 36, no 3, p. 283-293Article in journal (Refereed)
    Abstract [en]

    Several methodological challenges arise when attempting to analyse individual data on changes of sick-leave diagnoses over several years. Sick-leave spells for a person can recur, have different sick-leave diagnoses, and both these aspects are dependent of previous episodes, the numbers of repeated periods vary across subjects, and standard statistical methods are not valid for variables on nominal scales, e. g. sick-leave diagnoses. Objective: Our aim was to ascertain whether the number and pattern of changes in sick-leave diagnoses are associated with future disability pension (DP) and to test methods for analysis of repeated measurements on nominal data. Participants: Data from a 12-year prospective cohort study of the 8000 sick-leave periods of the 213 persons aged 25-34 who, in 1985, had a new sick-leave spell andgt;= 28 days with back diagnoses were used. Methods: We used entropies, uncertainty coefficients adjusted for repeated measurements, and transition matrices to examine the changes in sick-leave diagnoses that occurred during follow up. Results: In the 12 years 22% were granted DP and they had changed sick-leave diagnosis less frequently and more often had new sick-leave periods with musculoskeletal diagnoses than the others. The variation in diagnoses and the degree of dependence between consecutive diagnoses were associated with DP. Conclusions: Many tools in statistics are based on linear methods that require numerical variables, but such methods are not valid for repeated measurements on discrete variables on nominal scales, as for sick-leave diagnosis. In such cases, it can be beneficial to use tools that are applied in statistical information theory.

  • 21. Hensing, G
    et al.
    Alexanderson, Kristina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science.
    The association between sex segregation, working conditions, and sickness absence among employed women2004In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 61, no 2Article in journal (Refereed)
    Abstract [en]

    Aims: To analyse the association between sickness absence and sex segregation of occupation and of work site, respectively, and to analyse work environmental factors associated with high sickness absence. Methods: The study group consisted of 1075 women employed as nurses, assistant nurses, medical secretaries, or metal workers who answered a questionnaire comprising 218 questions on women's health and living conditions. Sickness absence was collected from employers' and social insurance registers. Results: Women working in the male dominated occupation had in general higher sickness absence compared to those working in female dominated occupations. However, metal workers at female dominated work sites had 2.98 (95% CI 2.17 to 3.79) sick-leave spells per woman and year compared to 1.70 (95% CI 1.29 to 2.10) among those working with almost only men. In spite of a better physical work environment, female metal workers at a female dominated work site had a higher sickness absence than other women, which probably could be explained by the worse psychosocial work environment. Working with more women also had a positive association to increased frequency of sick-leave spells in a multivariate analysis including several known indicators of increased sick-leave. Conclusions: There was an association between sickness absence and sex segregation, in different directions at the occupational and work site level. The mechanism behind this needs to be more closely understood regarding selection in and out of an occupation and a certain work site.

  • 22.
    Hensing, G
    et al.
    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.
    Alexanderson, Kristina
    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.
    The relation of adult experience of domestic harassment, violence, and sexual abuse to health and sickness absence.2000In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 7Article in journal (Refereed)
  • 23.
    Karlsson, Nadine
    et al.
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Borg, Karin
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Carstensen, John
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Medicine and Health Sciences, Health and Society.
    Hensing, Gunnel
    Department of Social Medicine, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Alexanderson, Kristina
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Risk of disability pension in relation to gender and age in a Swedish county: A 12-year population based, prospective cohort study2006In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 27, no 2, p. 173-179Article in journal (Refereed)
    Abstract [en]

    Residents of the county of Östergötland, Sweden, who were 16-64 years of age in December 1984 and not pensioned (n=229,864), were followed in a prospective, cohort, study of data collected between 1985 and 1996. Using survival methods as the method of analysis, the likelihood of being granted a disability pension was 14% for women, 11% for men, and increased with age. Women less than 54 years of age were at higher risk than men (P<0.001), 69% of disability pensions granted were full-time and 31% were part-time, more women received part-time pensions (P<0.001). Whether the differences observed are due to gender bias in social insurance practices, to disease patterns, to occupational and work-related factors, or to a cohort effect has yet to be determined.

  • 24.
    Karlsson, Nadine
    et al.
    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.
    Carstensen, John
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Department of Health and Society, Tema Health and Society.
    Gjesdal, Sturla
    Personskadeprevention Karolinska Institutet.
    Alexanderson, Kristina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science.
    Mortality in relation to disability pension: findings from a 12-year prospective population-based cohort study in Sweden.2007In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 35, no 4, p. 341-347Article in journal (Refereed)
  • 25.
    Karlsson, Nadine
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science.
    Carstensen, John
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Medicine and Health Sciences, Health and Society.
    Gjesdal, Sturla
    Socialmedicin Bergen Norge.
    Alexanderson, Kristina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science.
    Risk factors for disability pension in a population-based cohort of men and women on long-term sick leave in Sweden2008In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 18, no 3, p. 224-231Article in journal (Refereed)
    Abstract [en]

    Background: Knowledge on predictors of disability pension is very limited. The aim was to assess the importance of sick-leave diagnosis and socio-demographic variables as risk factors for disability pension among individuals on long-term sickness absence and to compare these factors by gender and over time. Methods: A prospective population-based cohort study in Östergötland County, Sweden, included 19 379 individuals who, in 1985-87, were aged 16-60 years and had a new spell of long-term sickness absence lasting <56 days. Follow-up was done in two time frames: 0-5 and 6-10 years after inclusion. The risk of disability pension in relation to sick-leave diagnosis and socio-demographic factors was assessed by Cox proportional hazard regression analysis. Results: In 5 years, after inclusion, 28% of the cohort had been granted disability pension. Those with higher age, low income, previous sick leave, no employment and non-Swedish origin had higher risk of disability pension, while those with young children had lower risk. Considering the inclusion diagnosis, the pattern differed between men and women (P < 0.001). Among men, those with mental disorders had the highest risk and among women those with musculoskeletal disorders. Except for income, the effect of which was reversed over time, the overall pattern of disability pension predictors remained 6-10 years after inclusion but was attenuated. Conclusion: Besides socio-demographic risk factors, the sick-leave diagnoses constitute an important both medium and long-term predictor of disability pension among both men and women on long-term sickness absence. © 2008. The Author(s).

  • 26.
    Kivimaki, M.
    et al.
    Kivimäki, M., Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom, International Institute for Health and Society, Department of Epidemiology and Public Health, University College London Medical School, London, United Kingdom, Finnish Institute of Occupational Health, Helsinki, Finland.
    Ferrie, J.E.
    International Institute for Health and Society, Department of Epidemiology and Public Health, University College London Medical School, London, United Kingdom.
    Hagberg, J.
    Section of Personal Injury Prevention, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Head, J.
    International Institute for Health and Society, Department of Epidemiology and Public Health, University College London Medical School, London, United Kingdom.
    Westerlund, H.
    National Institute for Psychosocial Medicine, Stockholm, Sweden.
    Vahtera, J.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Alexanderson, Kristina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science.
    Diagnosis-specific sick leave as a risk marker for disability pension in a Swedish population2007In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 61, no 10, p. 915-920Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate diagnosis-specific sick leave as a risk marker for subsequent disability pension. Design: A prospective population based cohort study. Exposure to a new medically certified sick leave episode of more than seven days by diagnosis during 1985 was examined in relation to incident cause-specific disability pension through 1996. Participants: The total non-retired population of one Swedish county aged 16 to 49 years, alive and not in receipt of a disability pension at the end of 1985 (176 629 persons, 51% men). Main results: To eliminate confounding by sick leaves that translate into a disability pension, the follow up period for disability pension was started five years after the assessment of sick leave. After adjustment for demographic characteristics, the risk of disability pension from mental disorders was 14.1 times higher (95% confidence interval (CI), 12.1 to 16.4) for those with sick leave for mental disorders than for those with no sick leave. The corresponding hazard ratio for sick leave and disability pension within diagnostic category was 5.7 (95% CI, 5.3 to 6.2) for musculoskeletal diseases and 13.0 (7.7 to 21.8) for gastrointestinal diseases. Irrespective of diagnoses, the hazard ratio for sick leave and disability pension was 3.0 (2.9 to 3.1). Conclusions: Sick leave may provide an important risk marker for identifying groups at high risk of a disability pension, especially for psychiatric diagnoses.

  • 27.
    Kjellman, Görel
    et al.
    Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Öberg, Birgitta
    Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Hensing, Gunnel
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Alexanderson, Kristina
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    A 12-year follow-up of subjects initially sicklisted with neck/shoulder or low back diagnoses2001In: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 6, no 1, p. 52-63Article in journal (Refereed)
    Abstract [en]

    Background and Purpose Neck/shoulder and low back pain are common in the Western world and can cause great personal and economic consequences, but so far there are few long term follow-up studies of the consequences of back pain, especially studies that separate the location of back pain. More knowledge is needed about different patterns of risk factors and prognoses for neck/shoulder and low back pain, respectively, and they should not be treated as similar conditions. The aim of the present study was to investigate possible long-term differences in neck/shoulder and low back symptoms, experienced over a 12-year period, with regard to work status, present health, discomfort and influence on daily activities.

    Method A retrospective cohort study of individuals sicklisted with neck/shoulder or low back diagnoses 12 years ago was undertaken. Included were all 213 people who, in 1985, lived in the municipality of Linköping, Sweden, were aged 25–34 years and who had taken at least one new period of sickleave lasting >28 days with a neck/shoulder or low back diagnosis. In 1996, a questionnaire was mailed to the 204 people who were still resident in Sweden (response rate 73%).

    Results Those initially absent with neck/shoulder diagnoses rated their present state of discomfort as worse than those sicklisted with low back diagnoses. Only 4% of the neck/shoulder group reported no present discomfort compared with 25% of the low back group. Notably, both groups reported the same duration of low back discomfort during the last year, which may indicate a higher risk for symptoms in more than one location for subjects with neck/shoulder problems.

    Conclusions Individuals with sickness absence of more than 28 days with neck/shoulder or low back diagnoses appear to be at high risk of developing long-standing symptoms, significantly more so for those initially having neck/shoulder diagnoses.

  • 28.
    Klanghed Müssener, Ulrika
    et al.
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Alexandersson, Kristina
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Positive encounters with rehabilitation professionals reported by persons with experience of sickness absence2004In: Work: A Journal of Prevention, Assessment & Rehabilitation, ISSN 1051-9815, Vol. 22, no 3, p. 247-254Article in journal (Refereed)
    Abstract [en]

    More knowledge is needed on different factors that can promote return to work among sick-listed persons. One such factor might be by their interactions with the rehabilitation professionals they encounter. The aim of the present study was to identify and analyze statements about positive encounters with rehabilitation staff, reported by persons who had been absent from work with back, neck, or shoulder diagnoses. A descriptive and explorative qualitative approach was used to analyze data from five focus-group interviews. There were few statements on positive encounters, and they were frequently attributed to sheer luck. Experiences of positive encounters were assigned to two major categories: respectful treatment and supportive treatment. Receiving adequate medical examination or treatment was also mentioned as being positive. Further efforts are needed to study and develop methods for investigating interactions with rehabilitation professionals that laypersons experience as positive and that may contribute to empowerment and influence return to work when sickness absent.

  • 29.
    Larsson, Caroline
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Sydsjö, Adam
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Alexanderson, Kristina
    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.
    Sydsjö, Gunilla
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Obstetricians' attitudes and opinions on sickness absence and benefits during pregnancy2006In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 85, no 2, p. 165-170Article in journal (Refereed)
    Abstract [en]

    Background . In Sweden, sick leave is taken more frequently by pregnant women than by nonpregnant women. This led us to ask if the taking of sick leave during pregnancy could possibly be explained by attitudes to sickness absence held among obstetricians working in antenatal care. Methods . All obstetricians ( n =45) engaged in public antenatal care and at work in May 2001 in seven hospitals in South Eastern Sweden were asked to anonymously respond to questions/statements concerning their work, 87% participated. The results were presented as percent (the median value) on a visual analog scale. Results . In 60% of all contacts with pregnant women issues such as working conditions, sickness absence or benefit programs were discussed besides the actual pregnancy. In 46% the obstetricians stated that they could not exactly pinpoint a correct medical diagnosis motivating a sickness certificate asked for by the pregnant woman. As the majority of the obstetricians (74%) often did not like to conform to the pregnant women's wishes, unpleasant situations were not uncommon (56%). A conflict was experienced in the dual role that the obstetrician had as the patient's confidant on the one hand and as a representative or gatekeeper for the social security system on the other. Male and female obstetricians did not differ in their opinions on their handling of pregnant women with regard to taking sick leave but for one issue, back pain. Conclusions . The high degree of work dealing with sickness absence and social benefits at the Antenatal Care Centers seems to have a negative effect on the obstetrician's evaluation of their work environment. The obstetricians' opinion is that pregnant women are sick-listed too frequently, but obstetricians comply as a rule to the women's wishes in order to avoid conflict. © 2006 Taylor & Francis.

  • 30. Larsson, E
    et al.
    Mårtensson, Niklas
    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.
    Alexanderson, Kristina
    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.
    First-aid training and bystander actions at traffic crashes - A population study2003In: Prehospital and disaster medicine : the official journal of the National Association of EMS Physicians and the World Association for Emergency and Disaster Medicine in association with the Acute Care Foundation, ISSN 1049-023X, Vol. 17, p. 134-141Article in journal (Refereed)
  • 31.
    Larsson, E
    et al.
    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.
    Mårtensson, Niklas
    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.
    Alexandersson, Kristina
    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.
    First-aid training and bystander actions taken at traffic crashes a population study2002In: Prehospital and disaster medicine : the official journal of the National Association of EMS Physicians and the World Association for Emergency and Disaster Medicine in association with the Acute Care Foundation, ISSN 1049-023X, Vol. 17Article in journal (Refereed)
  • 32.
    Leijon, Margareta
    et al.
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Hensing, Gunnel
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Alexanderson, Kristina
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Gender trends in sick-listing with musculoskeletal symptoms in a Swedish county during a period of rapid increase in sickness absence1998In: Scandinavian Journal of Social Medicine, ISSN 1403-4948, Vol. 26, no 3, p. 204-213Article in journal (Refereed)
    Abstract [en]

    Sickness absence and disability pension due to musculoskeletal diagnoses has increased in Sweden.

    Study objective — To study gender trends in sickness absence with musculoskeletal diagnoses and its changes in 1985—87.

    Design — A prospective population-based study of all new sick-leave spells exceeding seven days in 1985—87. Sickness absence with "all diagnoses'' was compared to "all musculoskeletal diagnoses'', the latter group was also divided into three sub-groups.

    Setting — The county of Östergötland, Sweden.

    Participants — All sick-leave insured aged 16—65; 107,000 women and 100,000 men.

    Results — More women than men were sick-listed in "all diagnoses'' in 1985. There were corresponding gender differences in sickness absence with musculoskeletal diagnoses except with the diagnosis "low back pain''. Sick-listing with musculoskeletal diagnoses increased for both women and men from 1985 to 1987, but the increase was consistently much higher for women, especially for younger women.

  • 33.
    Leijon, Margareta
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Hensing, Gunnel
    Linköping University, Faculty of Health Sciences.
    Alexanderson, Kristina
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Sickness absence due to musculoskeletal diagnoses: association with occupational gender segregation2004In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 32, no 2, p. 94-101Article in journal (Refereed)
    Abstract [en]

    Background: Musculoskeletal disorders represent a considerable public health problem and the most common diagnoses behind sickness absence and disability pensions. However, little is known about how sickness absence with these diagnoses varies with the strong gender segregation of the labour market.

    Aims: A study was undertaken to investigate the association between musculoskeletal-related sickness absence and occupational gender segregation.

    Methods: The study was population based, and included all new sick-leave spells exceeding seven days due to musculoskeletal diagnoses, comprising neck/ shoulder pain, low back pain, and osteoarthritis in Östergötland county, Sweden, which has 393,000 inhabitants (5% of the national population). The participants were all sick-leave insured employed persons in Östergötland (n=182,663) in 1985.

    Results: Cumulative incidence of musculoskeletal-related sickness absence (>7 days) was higher for women (7.5%, 95% confidence interval [C.I.] 7.3-7.7) than for men, (5.8%, C.I. 5.6-5.9), and the same was true for the mean number of sick-leave days (women 81, C.I. 78-83; men 65, C.I. 63-68). Grouping occupations according to degree of numerical gender segregation revealed the highest incidence and duration of sickness absence for women in male-dominated occupations. For both genders, the lowest cumulative incidence and duration occurred in gender-integrated occupations.

    Conclusions: Our results indicate a strong association between occupational gender segregation and musculoskeletal-related sickness absence. Further studies are needed to elucidate gender segregation of the labour market in relation to health and rehabilitation measures.

  • 34.
    Lindfors, Sara
    et al.
    Karolinska Institutet.
    Eintrei, Christina
    Linköping University, Department of Medicine and Health Sciences, Anesthesiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthesiology and Surgical Centre, Department of Intensive Care UHL.
    Alexanderson, Kristina
    Karolinska Institutet.
    Stress factors affecting academic physicians at a university hospital.2009In: Work (Reading, Mass.), ISSN 1875-9270, Vol. 34, no 3, p. 305-13Article in journal (Refereed)
    Abstract [en]

    Research is limited regarding occupational stress in academic physicians; professionals whose work situation includes the three areas of clinical practice, research, and teaching. The aim of this study was to gain knowledge of factors experienced as stressful by academic physicians employed by a university hospital. A questionnaire assessing the frequency and intensity of 36 potentially stressful factors was sent to all 157 academic physicians who were employed at the Linköping University Hospital, Sweden. The response rate was 77%. Both a high frequency and intensity of stress was experienced by 66% of the academic physicians in relation to "time pressure" and by almost 50% in connection with both "find time for research" and having "conflict of interest between different work assignments". Moreover, physicians in the higher age group and those who had attained a higher academic position experienced less stress. The female participants experienced more stress than the males due to gender-related problems and to variables associated with relationships at work. More knowledge is needed to determine the consequences of this finding and to identify coping strategies used for handling such stress.

  • 35.
    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.
    Alexanderson, Kristina
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Begreppen Hälsa och Hälsofrämjande - en litteraturstudie.2001Book (Other academic)
    Abstract [sv]

    Begreppen hälsa och hälsofrämjande används alltmer i olika måldokument på lokal, nationell och internationell nivå. Det är dock sällan som begreppen definieras. Detta har inneburit en stor osäkerhet kring vad som egentligen avses med dessa begrepp och denna osäkerhet har ibland skapat irritation över vad som uppfattats som ”flummigt” och vagt kring hälsa.Denna bok är en litteraturgenomgång av olika teorier om och definitioner av hälsa och hälsofrämjande. Teorier och definitioner förklaras och klassificeras utifrån termer som holistisk, biostatistisk, teleologisk, strategi, handling o.s.v. Vi belyser frågor som: Är hälsa motsatsen till sjukdom? Är hälsa något annat än frånvaro av sjukdom? Går den att förklara med termer som handlingsförmåga, välbefinnande eller mening? Finns det någon skillnad mellan hälsofrämjande och prevention? Vad kan olika hälsosyner ha för inverkan på mötet med patienter, klienter etc.Målgruppen omfattar blivande och praktiserande läkare, sköterskor, folkhälsovetare, arbetsterapeuter, socionomer och andra yrkesgrupper som professionellt arbetar med hälsa och hälsofrämjande.

  • 36. Messing, K
    et al.
    Punett, L
    Alexanderson, Kristina
    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.
    Pyle, J
    Zahm, S
    Wegman, D
    Stock, S
    Grosbois, S
    Be the fairest of them all: Challenges and recommendations for the treatment of gender in occupational health research2003In: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 43, no 6, p. 618-629Article in journal (Refereed)
    Abstract [en]

    Background Both women's and men's occupational health problems merit scientific attention. Researchers need to consider the effect of gender on how occupational health issues are experienced, expressed, defined, and addressed. More serious consideration of gender-related factors will help identify risk factors for both women and men. Methods The authors, who come from a number of disciplines (ergonomics, epidemiology, public health, social medicine, community psychology, economics, sociology) pooled their critiques in order to arrive at the most common and significant problems faced by occupational health researchers who wish to consider gender appropriately. Results This paper describes some ways that gender can be and has been handled in studies of occupational health, as well as some of the consequences. The paper also suggests specific research practices that avoid errors. Obstacles to gender-sensitive practices are considered. Conclusions Although gender-sensitive practices may be difficult to operationalize in some cases, they enrich the scientific quality of research and should lead to better data and ultimately to well-targeted prevention programs. ⌐ 2003 Wiley-Liss, Inc.

  • 37.
    Müssener, Ulrika
    et al.
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Festin, Karin
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Upmark, Marianne
    Karolinska Institutet.
    Alexanderson, Kristina
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Positive experiences of encounters with healthcare and social insurance professionals among people on long-term sick leave2008In: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine, ISSN 1651-2081, Vol. 40, no 10, p. 805-811Article in journal (Refereed)
    Abstract [en]

    Objective: To analyse different aspects of positive experiences of people on long-term sick leave with regard to their interactions with healthcare and social insurance professionals.

    Methods: A random population-based questionnaire survey among 10,042 long-term sick-listed people in Sweden. Statements related to positive encounters with the professionals were analysed. Factor analysis and logistic regression was used to identify possible associations with gender, age, marital status, country of birth, level of education, part- or full-time sickness absence, self-rated health, depression during the past year, and reasons for sick leave.

    Results: Ninety-two percent of respondents had experienced positive encounters with healthcare and 73% had experienced positive encounters with social insurance. The mean rating was higher for healthcare. The respondents agreed most with the items "treated me with respect", "listened to me", and "was nice to me". Three aspects of interactions were identified: competence, personal attention, and confidence and trust. Women, people born in Sweden, and individuals with good self-rated health experienced the inter-actions as most positive.

    Conclusion: The majority of the respondents on long-term sickness absence have had positive interactions with healthcare and social insurance. More research is required to determine the impact that such experiences might have on return to work, and how such interactions might be promoted.

  • 38. Nordqvist, C
    et al.
    Holmqvist, C
    Cedersund, E
    Alexanderson, Kristina
    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.
    Att arbeta med ryggont: en pilotstudie med fokusgrupper.1999In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 76, p. 347-356Article in journal (Other (popular science, discussion, etc.))
  • 39.
    Nordqvist, Cecilia
    et al.
    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.
    Alexanderson, Kristina
    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.
    Holmqvist, C
    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.
    Arbetsgivarens betydelse vid sjukskrivning - om att återgå i arbete.2000In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 5, p. 429-437Article in journal (Other (popular science, discussion, etc.))
  • 40.
    Nordqvist, Cecilia
    et al.
    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.
    Cedersund, Elisabet
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Holmqvist, C
    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.
    Alexanderson, Kristina
    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.
    Att komma igen. Om att återgå i arbete efter sjukskrivning för rygg-, nack- eller skulderbesvär, en pilotstudie med fokusgrupper.2000In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 4, p. 347-356Article in journal (Other (popular science, discussion, etc.))
  • 41.
    Nordqvist, Cecilia
    et al.
    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.
    Holmqvist, Christina
    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.
    Alexanderson, Kristina
    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.
    Views of laypersons on the role employers play in return to work when sick-listed2003In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 13, no 1, p. 11-20Article in journal (Refereed)
    Abstract [en]

    Sickness absenteeism is an increasing public health problem, but few studies have examined the views of laypersons regarding factors that promote return to work. The present investigation concerns the opinions of such individuals on the role employers play in this context. Data from five focus-group interviews of laypersons with experience of long-term sickness absence were subjected to grounded theory analysis. When asked about factors that hinder or promote return to work, the laypersons spontaneously emphasized the importance of the employer. Specifically, they stressed the need for a structured back-to-work program at each workplace, which should include contacting absent employees and informing fellow workers of possible changes in task assignments upon return of the absent person. Reported hindering factors included lack of such information, leading to envy and harassment. Respondents also asserted the importance of work supervisors in creating a positive emotional atmosphere.

  • 42. Ringsberg, Karin
    et al.
    Alexandersson, Kristina
    Borg, Karin
    Linköping University, Department of Department of Health and Society.
    Hensing, Gunnel
    The health-line: a method for collecting data on self-rated health over time: a pilot study2001In: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 29, no 3, p. 233-239Article in journal (Refereed)
    Abstract [en]

    Background: There is a need for an instrument to record a life-course perspective of self-rated health.

    Aim: To test the ''health-line'', a simple, comprehensive method of collecting data on self-rated health over time.

    Method: In 1996, a questionnaire was mailed to people who in 1985 were aged between 25 and 34 years old and had a sick-leave spell >28 days with ''back diagnoses''. They were asked to rate their global health graphically with a ''health-line'' for the years 1985-95. Official data on sick leave and disability pension were obtained for the same period. In all, 37 out of 52 men and 60 out of 83 women answered; that is, they drew a health-line.

    Result: A statistically significant negative correlation between the mean number of absence days due to ill health and the health-line data was found for every year (r = -0.35 to -0.53; p < 0.001 ) and for the whole period 1985-95 (r = -0.546; p < 0.001) respectively.

    Conclusion: The method worked well and is well worth further development and testing.

  • 43. Savikko, A
    et al.
    Hensing, G
    Alexanderson, Kristina
    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.
    Do mental health problems increase sickness absence due to other diseases?2001In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 36, p. 310-316Article in journal (Refereed)
  • 44.
    Svensson, Tommy
    et al.
    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.
    Karlsson, A
    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.
    Alexanderson, Kristina
    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.
    Nordqvist, Cecilia
    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.
    Shame-inducing encounters. Negative emotional aspects of sickness-absentees' interactions with rehabilitation professionals2003In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 13, no 3, p. 183-195Article in journal (Refereed)
    Abstract [en]

    There is little knowledge on how sickness absentees experience encounters with rehabilitation professionals. This paper explores and describes negative emotions ("shame " in a broad sense) experienced by individuals on sick leave in their interactions with rehabilitation professionals. We performed a qualitative analysis of data from five focus-group interviews. The participants had experience of sickness absence with back diagnoses and discussed factors that facilitate or impede return to work. Reports of demeaning experiences in encounters with rehabilitation workers were frequent and could be divided into two major categories: 1) subjects perceived the behavior of rehabilitation professionals as distanced in a negative way, and felt that they were treated in an indifferent and nonchalant manner or fairly routinely, 2) subjects felt that they were disqualified, which included being discredited or belittled. This explorative study indicates the need for further, more directed investigations of emotional aspects of interactions between sickness absentees and rehabilitation professionals.

  • 45.
    Sydsjö, Adam
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Alexanderson, Kristina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science.
    Dastserri, M.
    Sydsjö, Gunilla
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Gender differences in sick leave related to back pain diagnoses: Influence of pregnancy2003In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 28, no 4, p. 385-389Article in journal (Refereed)
    Abstract [en]

    Study Design. A cross-sectional population-based study was conducted. Objective. To investigate the influence of pregnancy on any gender differences in sickness absence related to back pain diagnoses in the group 16 to 44 years of age. Summary of Background Data. Back pain diagnoses are a major reason for sickness absence, especially among pregnant women. There is, however, little knowledge on the extent to which back pain during pregnancy may account for any differences in sickness absence when compared with men and nonpregnant women. Methods. Data on sick leave periods certified by a physician were combined from two research databases: one including all insured persons (n = 50,167) and one including pregnant women (n = 1342) for the duration of 1 year. Results. When pregnant women were subtracted from "all women," nonpregnant women had the same cumulative incidence of sickness absence related to back pain diagnoses as men. Among "all women" sick-listed with back pain diagnoses, 37% were pregnant, a finding not evident from official statistics. Sickness absence increased with age among nonpregnant women and men, but decreased among pregnant women. Conclusions. The proportion of sickness absence related to back pain diagnoses did not differ between nonpregnant women and men ages 16 to 44 years. The importance of back pain diagnosis as a reason for sickness absence may thus be overrated among nonpregnant women.

  • 46.
    Sydsjö, Adam
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Sydsjö, Gunilla
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Alexanderson, Kristina
    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.
    Influence of pregnancy-related diagnoses on sick-leave data in women aged 16-442001In: Journal of Womens Health & Gender-Based Medicine, ISSN 1524-6094, E-ISSN 2168-7722, Vol. 10, no 7, p. 707-714Article in journal (Refereed)
    Abstract [en]

    Data on sickness absence frequently are used as a measure of morbidity and its social consequences in the employed population. The effects of sickness absence, as well as any possible differences in diagnoses among pregnant women as compared the sick leave data among the total population of women in fertile age have so far not been studied. The aim of this study was to investigate the relative contribution of pregnant women to the level of sickness absence, in general and in different diagnostic groups, as well as the extent to which sick-listed pregnant women can be identified through diagnoses on sickness certificates. In a cross-sectional study of all sick leave insured women aged 16-44 years (n=24,481) in Link÷ping, Sweden (117,000 inhabitants), data from two population-based research registers were used, one of sickness absence for the whole population, one of sickness absence among pregnant women in the same population and year. Pregnant women (5%) had a significantly higher cumulative incidence of sickness absence (0.64) compared with all women (0.18) and accounted for 20% of the women listed as absent because of sickness. The duration of the sickness absence was also significantly longer among pregnant women, 44.8 days compared with 9.7 days among all women. Practically all diagnoses among pregnant women were related to pregnancy or back pain (93%). When using diagnoses on the sickness certificates, only 46% of all sick-listed pregnant women could be identified, suggesting methodological difficulties in studies on sickness absence. Studies on sickness absence among women of fertile age should also contain information on the proportion of sick-listed pregnant women, as a small proportion of pregnant women may have a deep impact on the results and conclusions among all women.

  • 47.
    Söderberg, Elsy
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Alexanderson, Kristina
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Sickness certificates as a basis for decisions regarding entitlement to sickness insurance benefits2005In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 33, no 4, p. 314-320Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    The sickness certificate is a major instrument for establishing contact and conveying information between two authorities that have a substantial impact on the life situation and work situation of the patients, as well as on the economic costs of the society.

    AIM:

    A study was undertaken to assess the quality of physicians' sickness certificates as a basis for social insurance officers' decisions regarding entitlement to sickness benefits.

    METHOD:

    Information on all 2,449 sickness certificates for sick-leave periods exceeding 28 days' sick leave period received at the social insurance offices in one Swedish county during one week in 2002 was coded and analysed.

    RESULTS:

    Information provided in the certificates was often not sufficient to allow social insurance officers to determine eligibility for sickness benefits. Qualitative analyses of certificates from general practitioners (GPs) revealed that 21% contained ambiguous statements about the medical disorder, 30% were unclear regarding the assessment of functional capacity, and 22% required additional information on both those aspects. Sickness certificates issued by GPs and physicians under specialist training, as compared with other categories of physicians, more often provided essential data, for example concerning the patient's occupational tasks and type of employment.

    CONCLUSIONS:

    Physicians often fail to contribute required information concerning functional capacity and other important aspects when issuing sickness certificates. This limits the use of these documents as a basis for decisions regarding sickness insurance benefits. The practical consequences of incomplete certificates might be delayed payment of benefits and delayed initiation of return to work measures.

  • 48.
    Söderberg, Elsy
    et al.
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Alexanderson, Kristina
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Sickness certification practices of physicians: a review of the literature2003In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 31, no 6, p. 460-474Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In most Western countries the responsibilities of physicians include assessing work ability and issuing certificates for sickness absence and disability pension. These tasks often have a substantial impact on the lives of patients and constitute a financial burden on employers, insurance companies, and communities.

    AIM: The aim was to review scientific studies on sickness certification practices of physicians published in English, Danish, Norwegian, or Swedish.

    METHOD: Analyses were carried out of studies searched for through literature databases, reference lists, and personal contacts.

    RESULTS: Twenty-six publications fulfilled the inclusion criteria. Most of these were published in the last decade. The studies focused on physicians, and occasionally on physicians and patients, but never on interaction between them. Data had generally been collected using questionnaires, some including case vignettes. There was a large variation in how long different physicians sickness-certified similar patients. Three comprehensive categories of studies were identified dealing with the following: (1). how physicians certify sickness; (2). factors that might affect the certification process; (i.e. elements related to the patient, to the physician, or to restrictions in insurance legislation); and (3). studies concerning attitudes. No studies were found that took into account the work conditions of the hospital or health-care organization in which the physician works.

    CONCLUSIONS: The research problems were seldom medical in nature but were instead carried out within the realm of behavioural science and should preferably be conducted using theories from behavioural, social, and public health scientific theories. Furthermore, factors such as gender, ethnicity, and power should be taken into consideration in studies on this complex phenomenon.

  • 49.
    Söderberg, Elsy
    et al.
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Vimarlund, Vivian
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Alexanderson, Kristina
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Experiences of professionals participating in inter-organisational cooperation aimed at promoting clients' return to workManuscript (preprint) (Other academic)
    Abstract [en]

    Background: Over the past decade, sickness absence has increased in Sweden and other Western European countries, with regard to both the number of people claiming sickness benefits and the length of the sick-leave spells. In Sweden, the activities initiated to promote RTW are performed in parallel by four different public organisations: the health services, the social services, the employment and the social insurance authorities. The present study focused on cooperation between professionals affiliated to the employment and social insurance authorities.

    Aim: To gain deeper understanding on the experiences of professionals involved in cooperative projects aimed at promoting RTW among unemployed sickness benefit recipients.

    Method: Qualitative analyses were performed of transcribed data from interviews of professionals participating in cooperative projects.

    Result: The analyses identified four impmtant areas of the experiences of such cooperation. First, the daily collaboration on the same cases enabled development of good relationships and cooperative competence, which improved the contact with clients. Second, the cooperative projects made it possible to include only clients perceived motivated for RTW measures. Third, the closer and more frequent interaction with clients proved to be constmctive in that it facilitated recognition and mobilisation of the strengths and abilities of the clients in the RTW process. Fotnih, the differences in rules and regulations between the social insurance and the unemployment insurance standards was often mentioned, and were perceived to induce problems, for example, on how to assess the work capacity of clients.

    Conclusion: The direct cooperation between the professionals from two different authorities was found to improve the application of RTW measures. The assessments of work capacity represent both important and complex tasks that professionals must perfonn without having access to either scientific knowledge or consensus agreement on which to base their decisions. Finally, it is important to gain further knowledge on how to create, develop, and maintain the 'cooperative competence' developed in the projects.

  • 50.
    Vaez, Marjan
    et al.
    Karolinska Institute.
    Hagberg, Jan
    Karolinska Institute.
    Alexanderson, Kristina
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    The panorama of future sick-leave diagnoses among young adults initially long-term sickness absent due to neck, shoulder, or back diagnoses. An 11-year prospective cohort study2009In: BMC MUSCULOSKELETAL DISORDERS, ISSN 1471-2474, Vol. 10, no 84Article in journal (Refereed)
    Abstract [en]

    Background: Little is known about future sick-leave diagnoses among individuals on long-term sickness absence. The aim of this study was to describe the panorama of sick-leave diagnoses over time among young adults initially sick-listed for andgt;= 28 days due to back, neck, or shoulder diagnoses Methods: An 11-year prospective population-based cohort study including all 213 individuals in a Swedish municipality who, in 1985, were aged 25-34 years and had a new sick-leave spell andgt;= 28 days due to neck, shoulder, or back diagnoses. Results: Over the 11-year period, the young adults in this cohort had 176,825 sick-leave days in 7,878 sick-leave periods (in 4,610 sick-leave spells) due to disorders in 17 of the 18 ICD-8 diagnostic categories (International Classification of Diseases, Revision 8). Musculoskeletal or mental diagnoses accounted for most of the sick-leave days, whereas most of the sick-leave periods were due to musculoskeletal, respiratory, or infectious disorders, or to unclassified symptoms. Most cohort members had had four to eight different sick-leave diagnoses over the 11 years, although some had had up to 11 diagnoses. Only two individuals (1%) had been sickness absent solely due to musculoskeletal diagnoses. Conclusion: Although the young adults initially were sick listed with back, neck, or shoulder diagnoses, their sickness absence during the follow up were due to a wide variety of other medical diagnoses. It might be that the ill-health content of sickness absence due to back pain is greater than usually assumed. More research on prognoses of sick-leave diagnoses among long-term sick listed is warranted.

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