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  • 1.
    Andersson, H. Ingemar
    et al.
    Kristianstad University, Department of Health Sciences.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Leden, Ido
    Sektion för reumatologi, Medicinkliniken, Centralsjukhuset Kristianstad.
    Scherstén, Bengt
    Avdelningen för Samhällsmedicinska vetenskaper Lund/Dalby, Lunds Universitet.
    Impact of chronic pain on health care seeking, self care, and medication: results from a population-based Swedish study1999In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 53, no 8, p. 503-509Article in journal (Refereed)
    Abstract [en]

    STUDY OBJECTIVE: To explore individual and social factors that could predict health care utilisation and medication among people with chronic pain in an unselected population. DESIGN: A mailed survey with questions about pain and mental symptoms, disability, self care action, visits to health care providers, and medication. SETTING: General populations in two Swedish primary health care (PHC) districts. Medical care was given in a state health system. PARTICIPANTS: A random sample (from the population register) of 15% of the population aged 25-74 (n = 1806). MAIN RESULTS: Among people reporting chronic pain 45.7% (compared with 29.8 of non-chronic pain persons, p < 0.05) consulted a physician and 7.2% (compared with 1.2%, p < 0.05) a physiotherapist during three months. Primary health care was the most frequent care provider. High pain intensity, aging, depression, ethnicity, and socioeconomic level had the greatest impact on physician consultations. Alternative care, used by 5.9%, was associated with high pain intensity and self care. Use of self care was influenced by high pain intensity, regular physical activity, and ethnicity. Alternative care and self care did not imply lower use of conventional health care. Women reporting chronic pain consumed more analgesics and sedatives than corresponding men. Besides female gender, high pain intensity, insomnia, physician consultation, social network, and self care action helped to explain medication with analgesics. Use of herbal remedies and ointments correlated to self care action, visit to an alternative therapist, high pain intensity, and socioeconomic level. CONCLUSIONS: The presence of chronic pain has an impressive impact on primary health care and medication. Various therapeutic actions are common and are partly overlapping. The use of health care among people with chronic pain depends above all on pain perception and intensity of pain but is also affected by ethnicity, age, socioeconomic level, and depressive symptoms. Among people with chronic pain use of analgesics is common in contrast with other types of pain relief (acupuncture, physiotherapy) suitable for treating chronic pain symptoms.

  • 2.
    Andersson, H. Ingemar
    et al.
    Department of Community Medicine, Lund University.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Leden, Ido
    Department of Medicine, Rheumatology section, Central Hospital, Kristianstad.
    Scherstén, Bengt
    Department of Community Medicine, Lund University.
    Musculoskeletal chronic pain in general practice: studies of health care utilisation in comparison with pain prevalence1999In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 17, no 2, p. 87-92Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study the relations between population prevalence of chronic pain and pain-related diagnoses (musculoskeletal and headaches) in primary health care (PHC) and to examine longitudinal variations in these diagnoses. DESIGN: A population-based mailed survey to catch prevalence data and continuous computerised diagnosis registration in PHC. SETTING: General population in a well-defined Swedish PHC district. SUBJECTS: A random sample of 15% of the population aged 25-74, n = 1101. Annual visitors to district physicians at the health centre. MAIN OUTCOME MEASURES: Rates of pain-related diagnoses in PHC in relation to population prevalence of chronic pain. Comparisons of the number of individuals (annual visiting rates) with pain-related diagnoses 1987-1996. RESULTS: Population pain prevalence and pain-related diagnoses in PHC corresponded as regards the magnitude and distribution of chronic pain by age and partly by pain location. Compared to low-back and widespread pain, neck-shoulder pain and headaches were less frequent in PHC in relation to reported prevalence. From 1987 to 1996 we found an increasing number of individuals seeking primary care with pain-related diagnoses. The increase was mainly assigned to the groups of fibrositis/myalgia and headache. CONCLUSION: Pain-related diagnoses in PHC reflect partly the occurrence of self-reported chronic pain symptoms in the population. The observed increase in visits with pain-related diagnoses in the last 10 years is due to an increased number of individuals with soft-tissue rheumatism and headaches. Future studies will have to elucidate whether these findings are due to an increase in morbidity or changes in care-seeking and social conditions.

  • 3.
    Andersson, H. Ingemar
    et al.
    Kristianstad University, Department of Health Sciences.
    Leden, Ido
    Reumatologsektionen, Medicinska kliniken, Centralsjukhuset, Kristianstad.
    SBU-rapport Ont i ryggen - ont i nacken. Ambitiös genomgång av stort problemområde. Medicinsk kommentar2000In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 97, no 44, p. 4952-4954Article in journal (Other academic)
  • 4.
    Lowden, Arne
    et al.
    Stress Research Institute, University of Stockholm.
    Moreno, Claudia
    School of Public Health, University of Sao Paulo, Brazil.
    Holmbäck, Ulf
    Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University.
    Lennernäs, Maria
    Kristianstad University, School of Health and Society.
    Tucker, Philip
    Department of Psychology, Swansea University, Wales, United Kingdom.
    Eating and shift work: effects on habits, metabolism and performance2010In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 36, no 2, p. 150-162Article in journal (Refereed)
    Abstract [en]

    Compared to individuals who work during the day, shift workers are at higher risk of a range of metabolic disorders and diseases (eg, obesity, cardiovascular disease, peptic ulcers, gastrointestinal problems, failure to control blood sugar levels, and metabolic syndrome). At least some of these complaints may be linked to the quality of the diet and irregular timing of eating, however other factors that affect metabolism are likely to play a part, including psychosocial stress, disrupted circadian rhythms, sleep debt, physical inactivity, and insufficient time for rest and revitalization. In this overview, we examine studies on food and nutrition among shift workers [ie, dietary assessment (designs, methods, variables) and the factors that might influence eating habits and metabolic parameters]. The discussion focuses on the quality of existing dietary assessment data, nutritional status parameters (particularly in obesity), the effect of circadian disruptions, and the possible implications for performance at work. We conclude with some dietary guidelines as a basis for managing the nutrition of shift workers.

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