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Holopainen, R., Piirainen, A., Karppinen, J., Linton, S. J. & O'Sullivan, P. (2020). An adventurous learning journey: Physiotherapists' conceptions of learning and integrating cognitive functional therapy into clinical practice. Physiotherapy Theory and Practice
Open this publication in new window or tab >>An adventurous learning journey: Physiotherapists' conceptions of learning and integrating cognitive functional therapy into clinical practice
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2020 (English)In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Recent low back pain guidelines recommend a BPS approach to the management of disabling low back pain. However, the most effective way of teaching physiotherapists to implement these approaches remains unknown. The present qualitative study aimed to explore physiotherapists' conceptions of learning and integrating Cognitive Functional Therapy (CFT) into clinical practice in Finnish primary health care.

Methods: We interviewed 22 physiotherapists, who participated in four to six days of CFT workshops. A phenomenographic approach was used to explore the variation in the physiotherapists' conceptions of this process.

Results: Four themes emerged from the data: 1) membership of work community; 2) learning journey; 3) transition to new working methods; and 4) professional role as a physiotherapist. These themes varied in four categories of description: recognizing difference of the new approach, toward integrating the new approach, waking up to explore, commitment to new approach and expanding application of new approach. The critical aspects between the categories that enabled the integration of CFT into clinical practice were ability to overcome resistance and to change views, being shaken and ability to critically reflect on one's work, support from the work community and becoming convinced, creativity, multidisciplinary collaboration and continuous learning.

Conclusion: The participants' responses to the training varied greatly, suggesting that for some, the training was insufficient to support adequate changes in their practice behavior; whereas for others, the training was a life changing experience.

Place, publisher, year, edition, pages
Taylor & Francis, 2020
Keywords
Qualitative, biopsychosocial, cognitive functional therapy, implementation, phenomenography, physiotherapist
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-81457 (URN)10.1080/09593985.2020.1753271 (DOI)000531985900001 ()32338113 (PubMedID)
Note

Funding Agency:

Signe & Ane Gyllenberg foundation

Available from: 2020-05-04 Created: 2020-05-04 Last updated: 2020-05-25Bibliographically approved
Simula, A. S., Ruokolainen, O., Oura, P., Lausmaa, M., Holopainen, R., Paukkunen, M., . . . Karppinen, J. (2020). Association of STarT Back Tool and the short form of the Örebro Musculoskeletal Pain Screening Questionnaire with multidimensional risk factors. Scientific Reports, 10(1), Article ID 290.
Open this publication in new window or tab >>Association of STarT Back Tool and the short form of the Örebro Musculoskeletal Pain Screening Questionnaire with multidimensional risk factors
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2020 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 10, no 1, article id 290Article in journal (Refereed) Published
Abstract [en]

The Short form of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ-short) and the STarT Back Tool (SBT) have been developed to screen for risk factors for future low back pain (LBP) -related disability and work loss respectively. The aim of this study was to investigate the accordance of the two questionnaires and to evaluate the accumulation of risk factors in the risk groups of both screening tools in a large population-based sample. The study population consisted of 3079 participants of the Northern Finland Birth Cohort 1966 who had reported LBP over the previous 12 months and had SBT and ÖMPSQ-short data. We evaluated the association of depressive and anxiety symptoms (Hopkins symptom check list-25, Generalized anxiety disorder 7 questionnaire, and Beck's Depression Inventory 21), psychological features (Fear-Avoidance Beliefs Questionnaire), lifestyle characteristics (BMI, smoking, alcohol abuse, physical inactivity) and social factors (education level) with the SBT and ÖMPSQ-short risk groups. The high-risk groups of both questionnaires were associated (p < 0.001) with depressive and anxiety symptoms and fear-avoidance beliefs. In addition, adverse lifestyle factors accumulated in the higher risk groups, especially from the ÖMPSQ-short. Agreement between the two questionnaires was moderate for men and fair for women.

Place, publisher, year, edition, pages
Nature Publishing Group, 2020
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-79312 (URN)10.1038/s41598-019-57105-3 (DOI)31937867 (PubMedID)2-s2.0-85077861061 (Scopus ID)
Available from: 2020-02-21 Created: 2020-02-21 Last updated: 2020-02-21Bibliographically approved
Nicholas, M. K., Costa, D. S., Linton, S. J., Main, C. J., Shaw, W. S., Pearce, G., . . . McGarity, A. (2020). Implementation of Early Intervention Protocol in Australia for 'High Risk' Injured Workers is Associated with Fewer Lost Work Days Over 2 Years Than Usual (Stepped) Care. Journal of occupational rehabilitation, 30(1), 93-104
Open this publication in new window or tab >>Implementation of Early Intervention Protocol in Australia for 'High Risk' Injured Workers is Associated with Fewer Lost Work Days Over 2 Years Than Usual (Stepped) Care
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2020 (English)In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 30, no 1, p. 93-104Article in journal (Refereed) Published
Abstract [en]

Purpose: To evaluate whether a protocol for early intervention addressing the psychosocial risk factors for delayed return to work in workers with soft tissue injuries would achieve better long-term outcomes than usual (stepped) care.

Methods: The study used a controlled, non-randomised prospective design to compare two case management approaches. For the intervention condition, workers screened within 1-3 weeks of injury as being at high risk of delayed returned to work by the Örebro Musculoskeletal Pain Screening Questionnaire-short version (ÖMPSQ-SF) were offered psychological assessment and a comprehensive protocol to address the identified obstacles for return to work. Similarly identified injured workers in the control condition were managed under usual (stepped) care arrangements.

Results: At 2-year follow-up, the mean lost work days for the Intervention group was less than half that of the usual care group, their claim costs were 30% lower, as was the growth trajectory of their costs after 11 months.

Conclusions: The findings supported the hypothesis that brief psychological risk factor screening, combined with a protocol for active collaboration between key stakeholders to address identified psychological and workplace factors for delayed return to work, can achieve better return on investment than usual (stepped) care.

Place, publisher, year, edition, pages
Springer, 2020
Keywords
Early intervention, Psychosocial factors, Screening, Work injury, Workers’ compensation
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-75572 (URN)10.1007/s10926-019-09849-y (DOI)000514998600008 ()31346923 (PubMedID)
Note

Funding Agencies:

NSW Ministry of Health  

EML Insurance  

Icare 

Available from: 2019-08-09 Created: 2019-08-09 Last updated: 2020-03-17Bibliographically approved
Wiklund, T., Gerdle, B., Linton, S. J., Dragioti, E. & Larsson, B. (2020). Insomnia is a risk factor for spreading of chronic pain: A Swedish longitudinal population study (SwePain). European Journal of Pain
Open this publication in new window or tab >>Insomnia is a risk factor for spreading of chronic pain: A Swedish longitudinal population study (SwePain)
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2020 (English)In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Recent evidence suggests that insomnia negatively influences the occurrence of generalized pain. This study examined whether insomnia is a risk factor for the transition from local pain to generalized pain (i.e., spreading of pain).

METHODS: This longitudinal study, with a follow-up of 24 months, included 959 participants (mean age: 55.8 years; SD: 13.9) with local or regional pain at baseline. Participants were grouped by insomnia symptoms as measured by the Insomnia Severity Index. Spreading of pain was measured by body manikins based on the spatial distribution of pain on the body. We defined two outcome categories; one with relatively localized pain (i.e., local pain and moderate regional pain ), and one with relatively generalized pain (i.e., substantial regional pain and widespread pain). Baseline age, sex, education, depressive symptoms, anxiety symptoms, catastrophizing, pain intensity, and spread of pain were also included in the Generalized Linear Model analysis.

RESULTS: The unadjusted model showed that the risk of spreading of pain increased with an increase in insomnia symptoms (no insomnia: 55.4%; subthreshold insomnia: 25.4% moderate insomnia: 16.5% and severe insomnia: 2.7%). The risk increased in a dose-dependent manner; moderate insomnia risk ratio (RR) 2.34 (95% confidence interval [CI]: 1.34 - 4.09) and severe insomnia RR 4.13 (95% CI: 1.56 - 10.92). The results were maintained in the fully adjusted model although moderate regional pain was the strongest predictor RR 6.95 (95% CI: 3.11-15.54).

CONCLUSION: Our findings show a strong prospective relationship between insomnia symptoms and the transition from relatively localized to generalized pain.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
National Category
Psychology
Identifiers
urn:nbn:se:oru:diva-81767 (URN)10.1002/ejp.1582 (DOI)32386443 (PubMedID)
Available from: 2020-05-12 Created: 2020-05-12 Last updated: 2020-05-12Bibliographically approved
Boersma, K., Flink, I. & Linton, S. J. (2020). Interpersonal problems as a predictor of pain catastrophizing in patients with chronic pain: Editorial comment on: Ryum, T., Börsting Jacobsen, H., Borchgrevink, P.C., Landrö, N.I. & Stiles, T.C.. Scandinavian Journal of Pain
Open this publication in new window or tab >>Interpersonal problems as a predictor of pain catastrophizing in patients with chronic pain: Editorial comment on: Ryum, T., Börsting Jacobsen, H., Borchgrevink, P.C., Landrö, N.I. & Stiles, T.C.
2020 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879Article in journal (Refereed) Accepted
Place, publisher, year, edition, pages
Walter de Gruyter, 2020
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:oru:diva-78835 (URN)
Available from: 2019-12-27 Created: 2019-12-27 Last updated: 2020-01-07Bibliographically approved
Sündermann, O., Flink, I. & Linton, S. J. (2020). My body is not working right: a cognitive behavioral model of body image and chronic pain. Pain
Open this publication in new window or tab >>My body is not working right: a cognitive behavioral model of body image and chronic pain
2020 (English)In: Pain, ISSN 0304-3959, E-ISSN 1872-6623Article in journal (Refereed) Epub ahead of print
Place, publisher, year, edition, pages
Wolters Kluwer, 2020
National Category
Psychology
Identifiers
urn:nbn:se:oru:diva-79937 (URN)10.1097/j.pain.0000000000001822 (DOI)32028333 (PubMedID)
Available from: 2020-02-19 Created: 2020-02-19 Last updated: 2020-02-19Bibliographically approved
Bauducco, S., Flink, I., Boersma, K. & Linton, S. J. (2020). Preventing sleep deficit in adolescents: Long-term effects of a quasi-experimental school-based intervention study. Journal of Sleep Research (1), Article ID e12940.
Open this publication in new window or tab >>Preventing sleep deficit in adolescents: Long-term effects of a quasi-experimental school-based intervention study
2020 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, no 1, article id e12940Article in journal (Refereed) Published
Abstract [en]

Adolescents are at risk of sleep deficit, which has serious consequences for their daytime functioning. However, school-based interventions to improve sleep have shown limited success. This might be due to the content of the programmes (e.g., not targeting central factors such as daytime stress and technology use) or because changes have not been captured due to a lack of long-term follow-ups. Hence, the aim of this study was to evaluate the long-term effects of a school-based sleep education curriculum including time-management training. The study used a quasi-experimental design. Participants were 3,622 adolescents (mean age 13.7, 48% girls); 286 were in the intervention group and 3,336 were followed as a natural control group. Data were collected before the intervention and at a 1-year follow-up. We divided participants into three groups according to baseline sleep duration (calculated from self-reported bed- and wake times, minus sleep onset latency): insufficient (<7 hr), borderline (7-8 hr) and adequate (>8 hr). Adolescents in the intervention group were ~2 times less likely to report insufficient sleep at follow-up as compared to controls. Sleep knowledge improved significantly in the intervention group but there were no changes in emotional sleep hygiene (e.g., bedtime worry) and perceived stress. Surprisingly, technology use increased and behavioural sleep hygiene worsened in the intervention group. Although the mechanisms of change need further investigation, the results of this study point to potential long-term benefits of school-based sleep programmes.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2020
Keywords
Information and communication technology, prevention, sleep health, youths
National Category
Applied Psychology
Identifiers
urn:nbn:se:oru:diva-77882 (URN)10.1111/jsr.12940 (DOI)000494302700001 ()31691408 (PubMedID)2-s2.0-85074845721 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2012-65Vinnova, 2012-65Swedish Research Council Formas, 2012-65
Available from: 2019-11-14 Created: 2019-11-14 Last updated: 2020-02-14Bibliographically approved
Linton, S. J. & Kienbacher, T. (2020). Psychological Subgrouping to Assess the Risk for the Development or Maintenance of Chronic Musculoskeletal Pain: Is This the Way Forward?. The Clinical Journal of Pain, 36(3), 172-177
Open this publication in new window or tab >>Psychological Subgrouping to Assess the Risk for the Development or Maintenance of Chronic Musculoskeletal Pain: Is This the Way Forward?
2020 (English)In: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 36, no 3, p. 172-177Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Because musculoskeletal pain problems are so prevalent, new methods of evaluating and treating patients are needed to increase effectiveness. Subgrouping is a method wherein patients are classified into defined groups on the basis of psychosocial factors with the expectation of more specific and tailored treatments can be prescribed for them. For those seeking care for a new episode, the risk of developing chronic pain-related disability is assessed, whereas, for those with existing pain, the risk for the maintenance of the chronic pain problem is evaluated.

AIM: The purpose of this narrative review is to examine how patients are classified into subgroups with regard to methods of evaluation and to ascertain whether subgrouping actually facilitates treatment.

RESULTS: For the development of disability, screening tools, for example, the Örebro Musculoskeletal Pain Screening Questionnaire, accurately stratify patients into groups (eg, high, medium, low risk) that predict future pain-related work disability. In addition, several studies show that treatments that directly key in on risk groups enjoy enhanced outcomes compared with treatment as usual. For the maintenance of chronic musculoskeletal pain problems, there are several instruments that classify patients into specific groups or profiles, for example, on the basis of the avoidance and endurance model or the International Classification of Functioning, Disability and Health (ICF) assessment. Although some evidence shows that these classifications are related to treatment outcome, we found no study that directly tested a system for providing treatment matched to the subgrouping for maintenance.

CONCLUSIONS: We conclude that it is possible to reliably subgroup patients with musculoskeletal problems. Likewise, treatments that address the risk factors in the screening procedure may enhance outcomes compared with treatment as usual. More work is needed, however, to better understand the mechanism, so that assessment methods can be improved, and treatment specific to subgroups can be developed and evaluated.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2020
Keywords
chronic musculoskeletal pain, psychological subgroups, risk of chronic pain, psychological screening
National Category
General Practice Neurology
Identifiers
urn:nbn:se:oru:diva-80323 (URN)10.1097/AJP.0000000000000787 (DOI)000516596000004 ()31833912 (PubMedID)2-s2.0-85076958555 (Scopus ID)
Available from: 2020-03-02 Created: 2020-03-02 Last updated: 2020-03-20Bibliographically approved
Mazzer, K., Boersma, K. & Linton, S. J. (2019). A longitudinal view of rumination, poor sleep and psychological distress in adolescents. Journal of Affective Disorders, 245, 686-696
Open this publication in new window or tab >>A longitudinal view of rumination, poor sleep and psychological distress in adolescents
2019 (English)In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 245, p. 686-696Article in journal (Refereed) Published
Abstract [en]

Background: Given the high prevalence and negative impact of psychological problems during adolescence, examining transdiagnostic factors that may have scope to positively influence a variety of psychological problems is imperative. The main purpose of this study was to investigate the longitudinal relationship between rumination and psychological distress and whether sleep mediated this relationship over a 2 year period.

Methods: Participants were 1620 high school students in the 7th and 8th grade at baseline from 17 public schools in three middle Sweden communities. Students completed questionnaires at school during the spring of 2014, 2015 and 2016. Rumination and psychological distress were self-reported, and sleep duration was calculated from reported bed-times, wake-times and sleep onset latencies.

Results: Sleep duration declined with age, whereas rumination and psychological distress increased. Rumination was predictive of future psychological distress and distress at a given time was predictive of concurrent rumination. Sleep duration did not consistently mediate the reciprocal relationships between rumination and psychological distress over time.

Limitations: Stronger longitudinal associations may have been obtained by using smaller measurement intervals or further delineation of outcome constructs.

Conclusions: Reducing rumination, rather than targeting sleep patterns, may work towards preventing the development of a number of psychological problems and is a strategy anticipated to function across disorders to improve young people's mental wellbeing.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Rumination, Adolescence, Sleep, Distress, Longitudinal
National Category
Neurology Psychiatry
Identifiers
urn:nbn:se:oru:diva-72423 (URN)10.1016/j.jad.2018.11.053 (DOI)000456697100084 ()30447567 (PubMedID)2-s2.0-85056473453 (Scopus ID)
Funder
Swedish Research Council Formas
Available from: 2019-02-14 Created: 2019-02-14 Last updated: 2019-02-14Bibliographically approved
Boersma, K., Flink, I. & Linton, S. J. (2019). Considering the interpersonal context of pain catastrophizing. Scandinavian Journal of Pain, 20(1), 9-10
Open this publication in new window or tab >>Considering the interpersonal context of pain catastrophizing
2019 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 20, no 1, p. 9-10Article in journal, Editorial material (Refereed) Published
Place, publisher, year, edition, pages
Walter de Gruyter, 2019
National Category
Physiology
Identifiers
urn:nbn:se:oru:diva-78556 (URN)10.1515/sjpain-2019-2020 (DOI)000504845500003 ()31785197 (PubMedID)
Available from: 2019-12-13 Created: 2019-12-13 Last updated: 2020-01-10Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-5359-0452

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