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Wennberg, P., Möller, M., Sarenmalm, E. K. & Herlitz, J. (2020). Evaluation of the intensity and management of pain before arrival in hospital among patients with suspected hip fractures. International Emergency Nursing, Article ID 100825.
Open this publication in new window or tab >>Evaluation of the intensity and management of pain before arrival in hospital among patients with suspected hip fractures
2020 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, article id 100825Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Pain management needs to be comprehensively investigated in patients with hip fractures, as it represents a fast-growing challenge to emergency care. The purpose of this study was to describe reported pain in patients with suspected hip fractures in a prehospital setting.

METHODS: In this observational study, 1,426 patients with a suspected hip fracture were included. Dynamic and static pain were assessed on the arrival of the emergency medical services (EMS) and on hospital admission using the Numerical Rating Scale (NRS), if feasible, and the Behaviour Rating Scale (BRS), if not.

RESULTS: On EMS arrival, the median dynamic NRS pain score was eight and 84% of the patients had severe or moderate dynamic pain according to the BRS. On admission to hospital, the median dynamic NRS pain score was reduced to five and 45% of the patients had reduced dynamic pain according to the BRS. Among all patients, the NRS was judged to be feasible and was therefore used in 36%. Furthermore, there was an association between the decrease in pain and the increase in the number of administered medications, as well as the duration of prehospital care.

CONCLUSIONS: Patients with suspected hip fractures suffered substantial pain on EMS arrival. Only half experienced a reduction in pain on hospital admission and only 75% received pain-relieving medication.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Analgesia, Emergency medical services, Hip fracture, Pain, Pain management, Pain measurement
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-79933 (URN)10.1016/j.ienj.2019.100825 (DOI)32029418 (PubMedID)
Available from: 2020-02-20 Created: 2020-02-20 Last updated: 2020-02-20Bibliographically approved
Duberg, A., Jutengren, G., Hagberg, L. & Möller, M. (2020). The effects of a dance intervention on somatic symptoms and emotional distress in adolescent girls: A randomized controlled trial. Journal of international medical research, 48(2), Article ID 300060520902610.
Open this publication in new window or tab >>The effects of a dance intervention on somatic symptoms and emotional distress in adolescent girls: A randomized controlled trial
2020 (English)In: Journal of international medical research, ISSN 0300-0605, E-ISSN 1473-2300, Vol. 48, no 2, article id 300060520902610Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate whether a dance intervention for adolescent girls reduces stressrelated symptoms. Methods: This was a randomized controlled trial of an after-school intervention. Participants were 112 girls aged 13 to 18 years with stress-related somatic symptoms and emotional distress. The intervention comprised twice-weekly dance sessions for 8 months with a focus on enjoyment and socialization. A questionnaire was administered at baseline and after 8, 12 and 20 months. Participants rated the frequency with which they had experienced somatic symptoms and emotional distress during the previous 3 months. Results: After the intervention, there was a significantly greater reduction in somatic symptoms and emotional distress in the dance intervention group than in the control group. The difference in the mean score change on a 5-point scale was 0.26 (95% confidence interval [CI]: 0.04 to 0.47) for somatic symptoms and 0.30 (95% CI: 0.04 to 0.58) for emotional distress. Conclusion: Dance interventions may reduce somatic symptoms and emotional distress in adolescent girls, and may constitute a nonpharmacological complement to school health services. However, continued participation is needed for long-term sustainable results. Additional randomized studies are required to further evaluate the effect of this type of intervention in different settings.

Place, publisher, year, edition, pages
Sage Publications, 2020
Keywords
Stress-related problems, adolescent girls, dance intervention, emotional distress, mental health, physical activity, somatic symptoms
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-79944 (URN)10.1177/0300060520902610 (DOI)32019389 (PubMedID)2-s2.0-85079008454 (Scopus ID)
Available from: 2020-02-19 Created: 2020-02-19 Last updated: 2020-02-19Bibliographically approved
Philipson, A., Alaie, I., Ssegonja, R., Möller, M., Hagberg, L. & Jonsson, U. (2019). ASSOCIATION OF ADOLESCENT DEPRESSION WITH EARNINGS IN ADULTHOOD. Value in Health, 22, S685-S685
Open this publication in new window or tab >>ASSOCIATION OF ADOLESCENT DEPRESSION WITH EARNINGS IN ADULTHOOD
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2019 (English)In: Value in Health, ISSN 1098-3015, E-ISSN 1524-4733, Vol. 22, p. S685-S685Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Blackwell Publishing, 2019
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-79133 (URN)000503167002033 ()
Available from: 2020-01-15 Created: 2020-01-15 Last updated: 2020-01-22Bibliographically approved
Ssegonja, R., Alaie, I., Philipsson, A., Hagberg, L., Sampaio, F., Möller, M., . . . Feldman, I. (2019). Depressive disorders in adolescence, recurrence in early adulthood, and healthcare usage in mid-adulthood: A longitudinal cost-of-illness study. Journal of Affective Disorders, 258, 33-41
Open this publication in new window or tab >>Depressive disorders in adolescence, recurrence in early adulthood, and healthcare usage in mid-adulthood: A longitudinal cost-of-illness study
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2019 (English)In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 258, p. 33-41Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Depression in adolescence is associated with increased healthcare consumption in adulthood, but prior research has not recognized the heterogeneity of depressive disorders. This paper investigated the additional healthcare usage and related costs in mid-adulthood for individuals with adolescent depression, and examined the mediating role of subsequent depression in early adulthood.

METHODS: This study was based on the Uppsala Longitudinal Adolescent Depression Study, initiated in Sweden in the early 1990s. Depressive disorders were assessed in adolescence (age 16-17) and early adulthood (age 19-30). Healthcare usage and related costs in mid-adulthood (age 31-40) were estimated using nationwide population-based registries. Participants with specific subtypes of adolescent depression (n = 306) were compared with matched non-depressed peers (n = 213).

RESULTS: Women with persistent depressive disorder (PDD) in adolescence utilized significantly more healthcare resources in mid-adulthood. The association was not limited to psychiatric care, and remained after adjustment for individual and parental characteristics. The total additional annual cost for a single age group of females with a history of PDD at a population level was estimated at 3.10 million USD. Depression recurrence in early adulthood mediated the added costs for psychiatric care, but not for somatic care.

LIMITATIONS: Primary health care data were not available, presumably resulting in an underestimation of the true healthcare consumption. Estimates for males had limited precision due to a relatively small male proportion.

CONCLUSIONS: On a population level, the additional healthcare costs incurred in mid-adulthood in females with a history of adolescent PDD are considerable. Early treatment and prevention should be prioritized.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Adolescence, Adulthood, Depression, Direct costs, Non-psychiatric healthcare, Psychiatric healthcare
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-75560 (URN)10.1016/j.jad.2019.07.077 (DOI)000482176400004 ()31382102 (PubMedID)2-s2.0-85071708904 (Scopus ID)
Funder
Swedish Research Council, 2014-10092Forte, Swedish Research Council for Health, Working Life and WelfareSwedish Research Council FormasVinnova
Available from: 2019-08-09 Created: 2019-08-09 Last updated: 2019-11-15Bibliographically approved
Wennberg, P., Möller, M., Herlitz, J. & Kenne Sarenmalm, E. (2019). Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures: effects on cognition. BMC Geriatrics, 19(1), Article ID 252.
Open this publication in new window or tab >>Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures: effects on cognition
2019 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 19, no 1, article id 252Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Impaired cognition is a major risk factor for perioperative delirium. It is essential to provide good pain control in patients with hip fractures and especially important in patients with severely impaired cognitive status, as they receive less pain medication, have poorer mobility, poorer quality of life and higher mortality than patients with intact cognition. The purpose of this study was to examine the association between preoperative pain management with nerve blocks and cognitive status in patients with hip fractures during the perioperative period.

METHODS: One hundred and twenty-seven patients with hip fractures participating in a double-blind, randomised, controlled trial were included in this study. At hospital admission, a low-dose fascia iliaca compartment block (FICB) was administered as a supplement to regular analgesia. Cognitive status was registered on arrival at hospital before FICB and on the first postoperative day using the Short Portable Mental Status Questionnaire.

RESULTS: Changes in cognitive status from arrival at hospital to the first postoperative day showed a positive, albeit not significant, trend in favour of the intervention group. The results also showed that patients with no or a moderate cognitive impairment received 50% more prehospital pain medication than patients with a severe cognitive impairment. FICB was well tolerated in patients with hip fractures.

CONCLUSION: Fascia iliaca compartment block given to patients with hip fractures did not affect cognitive status in this study. Patients with a cognitive impairment may receive inadequate pain relief after hip fracture and this discrimination needs to be addressed in further studies.

TRIAL REGISTRATION: EudraCT number 2008-004303-59 date of registration: 2008-10-24.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Cognitive impairment, Cognitive status, Hip fractures, Nerve block, Pain, Pain management, Perioperative care
National Category
Orthopaedics Geriatrics
Identifiers
urn:nbn:se:oru:diva-76426 (URN)10.1186/s12877-019-1266-0 (DOI)000485322000002 ()31510918 (PubMedID)2-s2.0-85072099268 (Scopus ID)
Note

Funding Agencies:

Region Örebro County  

Skaraborg Hospital 

Available from: 2019-09-16 Created: 2019-09-16 Last updated: 2019-11-15Bibliographically approved
Philipsson, A., Sandberg, E., Högström, S., Eriksson, M., Särnblad, S., Ekstav, L., . . . Duberg, A. (2019). ”Just in TIME” - Intervention med dans och yoga för flickor med funktionell magsmärta och IBS. In: : . Paper presented at Barnveckan, Örebro, Sweden, April 1-4, 2019.
Open this publication in new window or tab >>”Just in TIME” - Intervention med dans och yoga för flickor med funktionell magsmärta och IBS
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2019 (Swedish)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [sv]

Bakgrund och syfte

Funktionell magsmärta drabbar många barn i skolåldern, mestadels flickor. Det kan leda till minskad livskvalitet, skolfrånvaro, sämre sömn, försämrade kamratkontakter och ökad vårdkonsumtion. Det vetenskapliga underlaget för interventioner vid långvarig smärta hos barn är begränsat. Dans kan öka rörelseglädje och förbättra kroppskännedom, vilket i sin tur påverkar självtillit och kan öka psykiskt välbefinnande. Yoga kan ge mental avslappning och reducera stressreaktioner. Syftet med studien är att utvärdera effekten av en intervention med dans och yoga på återkommande magsmärta, stress och depressiva symtom samt på funktion i vardagen hos flickor 9-13 år som har funktionell buksmärta och IBS.

Metod

En randomiserad kontrollerad studie genomförs med forskningspersoner som identifieras via diagnosregister samt barnmottagningarna i Västerås och Örebro, samt från primärvården. Interventionen består av dans och yoga med fokus på rörelseglädje, gemenskap och kravlöshet, och utförs som gruppaktivitet två ggr/veckan under 8 månader. Primärt utfall är förändring av magsmärta efter 8 mån. Flickorna följs upp under fem år avseende magsmärta, självskattad hälsa, stress och psykiskt välmående, fysisk aktivitet och skolfunktioner. Vidare studeras kostnad i relation till nytta.

Resultat/(Planerade studier)

Projektet pågår och de första resultaten beräknas publiceras hösten 2019. Projektet utvärderas både kvalitativt, genom intervjuer med flickor och vårdnadshavare, och kvantitativt, genom bland annat analys av smärtdagböcker, upplevd hälsa, stress samt med en hälsoekonomisk analys. Därutöver utvärderas salivkortisol och faeces som objektiva mått. 

Konklusion

Studien förväntas leda till ökad kunskap om icke-farmakologiska insatser för barn samt hur behandlingsinsatser för målgruppen kan breddas med ett kostnadseffektivt alternativ till ”standard care”.

Keywords
Buksmärta, dans, yoga
National Category
Health Sciences Pediatrics
Research subject
Pediatrics
Identifiers
urn:nbn:se:oru:diva-73177 (URN)
Conference
Barnveckan, Örebro, Sweden, April 1-4, 2019
Available from: 2019-03-18 Created: 2019-03-18 Last updated: 2019-04-17Bibliographically approved
Wennberg, P., Norlin, R., Herlitz, J., Sarenmalm, E. K. & Möller, M. (2019). Pre-operative pain management with nerve block in patients with hip fractures: a randomized, controlled trial. International Journal of Orthopaedic and Trauma Nursing, 33, 35-43
Open this publication in new window or tab >>Pre-operative pain management with nerve block in patients with hip fractures: a randomized, controlled trial
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2019 (English)In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 33, p. 35-43Article in journal (Refereed) Published
Abstract [en]

Introduction: Pain management in patients with hip fractures is a major challenge for emergency care. The objective of this study was to evaluate whether the supplementation of pre-operative analgesia with low-dose fascia iliaca compartment block (FICB) compared with placebo would improve pain relief in patients with hip fractures.

Methods: A double-blind, randomized, controlled trial was conducted on 127 patients. At hospital admission, a low-dose FICB was administered to patients with hip fractures as a supplement to regular pre-operative analgesia. Patients with and without cognitive impairment were included. The instruments used were a visual analogue scale (VAS), a numerical rating scale and a tool for behavior related pain assessment. The primary endpoint was the change in reported pain on movement from hospital admission to two hours after FICB.

Results: The intervention group showed improved pain management by mean VAS score for pain on movement compared with the control group (p = 0.002).

Conclusions: Our results support the use of low-dose FICB as a pain-relieving adjuvant to other analgesics when administered to patients with a hip fracture.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Hip fractures, Pain, Nerve block, Pain management, Fascia iliaca compartment block, Analgesia
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-74410 (URN)10.1016/j.ijotn.2018.11.003 (DOI)000467622900006 ()30876869 (PubMedID)2-s2.0-85065780869 (Scopus ID)
Note

Funding Agency:

Skaraborg Hospital - Örebro County Council

Available from: 2019-05-28 Created: 2019-05-28 Last updated: 2019-09-25Bibliographically approved
Höglund, E., Schröder, A., Möller, M., Andersson-Hagiwara, M. & Ohlsson Nevo, E. (2019). The ambulance nurse experiences of non-conveying patients. Journal of Clinical Nursing, 28(1-2), 235-244
Open this publication in new window or tab >>The ambulance nurse experiences of non-conveying patients
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2019 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, no 1-2, p. 235-244Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES: To explore ambulance nurses' (ANs) experiences of non-conveying patients to alternate levels of care.

BACKGROUND: Increases in ambulance utilisation and in the number of patients seeking ambulance care who do not require medical supervision or treatment during transport have led to increased nonconveyance (NC) and referral to other levels of care.

DESIGN: A qualitative interview study was conducted using an inductive research approach.

METHODS: The study was conducted in a region in the middle of Sweden during 2016-2017. Twenty nurses were recruited from the ambulance departments in the region. A conventional content analysis was used to analyse the interviews. The study followed the COREQ checklist.

RESULTS: The ANs experienced NC as a complex and difficult task that carried a large amount of responsibility. They wanted to be professional, spend time with the patient and find the best solution for him or her. These needs conflicted with the ANs' desire to be available for assignments with a higher priority. The ANs could feel frustrated when they perceived that ambulance resources were being misused and when it was difficult to follow the NC guidelines.

CONCLUSION: If ANs are expected to nonconvey patients seeking ambulance care, they need a formal mandate, knowledge and access to primary health care.

RELEVANCE TO CLINICAL PRACTICE: This study provides new knowledge regarding the work situation of ANs in relation to NC. These findings can guide future research and can be used by policymakers and ambulance organisations to highlight areas that need to evolve to improve patient care.

Place, publisher, year, edition, pages
Blackwell Science Ltd., 2019
Keywords
ambulance nursing, care pathways, clinical decision-making, content analysis, experiences, health services research, nurse, qualitative study, refusal of care, self-care
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-71216 (URN)10.1111/jocn.14626 (DOI)000453228000022 ()30016570 (PubMedID)2-s2.0-85052619602 (Scopus ID)
Note

Funding Agency:

Research Committee in the county council of Örebro OLL-590171  OLL-670821  OLL-767261

Available from: 2019-01-08 Created: 2019-01-08 Last updated: 2019-01-08Bibliographically approved
Alaie, I., Philipsson, A., Ssegonja, R., Hagberg, L., Feldman, I., Sampaio, F., . . . Jonsson, U. (2019). Uppsala Longitudinal Adolescent Depression Study (ULADS). BMJ Open, 9(3), Article ID e024939.
Open this publication in new window or tab >>Uppsala Longitudinal Adolescent Depression Study (ULADS)
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2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 3, article id e024939Article in journal (Refereed) Published
Abstract [en]

Purpose: To present the Uppsala Longitudinal Adolescent Depression Study, initiated in Uppsala, Sweden, in the early 1990s. The initial aim of this epidemiological investigation was to study the prevalence, characteristics and correlates of adolescent depression, and has subsequently expanded to include a broad range of social, economic and health-related long-term outcomes and cost-of-illness analyses.

Participants: The source population was first-year students (aged 16-17) in upper-secondary schools in Uppsala during 1991-1992, of which 2300 (93%) were screened for depression. Adolescents with positive screening and sex/age-matched peers were invited to a comprehensive assessment. A total of 631 adolescents (78% females) completed this assessment, and 409 subsequently completed a 15year follow-up assessment. At both occasions, extensive information was collected on mental disorders, personality and psychosocial situation. Detailed social, economic and health-related data from 1993 onwards have recently been obtained from the Swedish national registries for 576 of the original participants and an age-matched reference population (N=200 000).

Findings to date: The adolescent lifetime prevalence of a major depressive episode was estimated to be 11.4%. Recurrence in young adulthood was reported by the majority, with a particularly poor prognosis for those with a persistent depressive disorder or multiple somatic symptoms. Adolescent depression was also associated with an increased risk of other adversities in adulthood, including additional mental health conditions, low educational attainment and problems related to intimate relationships.

Future plans: Longitudinal studies of adolescent depression are rare and must be responsibly managed and utilised. We therefore intend to follow the cohort continuously by means of registries. Currently, the participants are approaching mid-adulthood. At this stage, we are focusing on the overall long-term burden of adolescent depression. For this purpose, the research group has incorporated expertise in health economics. We would also welcome extended collaboration with researchers managing similar datasets.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
National Category
General Practice Psychiatry
Identifiers
urn:nbn:se:oru:diva-75243 (URN)10.1136/bmjopen-2018-024939 (DOI)000471144900167 ()30826765 (PubMedID)2-s2.0-85062413050 (Scopus ID)
Funder
Swedish Research Council, 2014-10092Forte, Swedish Research Council for Health, Working Life and Welfare
Note

Funding Agencies:

Uppsala-Orebro Regional Research Council  RFR-738411  RFR-652841 

Uppsala County Council's Funds for Clinical Research  LUL-713161 

Medical Training and Research Agreement Funds (ALF) from Uppsala University Hospital 

Märta and Nicke Nasvell Foundation  

Clas Groschinsky Memorial Fund  

Söderström-Königska Foundation  

Foundation in Memory of Professor Bror Gadelius 

Available from: 2019-07-25 Created: 2019-07-25 Last updated: 2019-07-25Bibliographically approved
Höglund, E., Schröder, A., Möller, M., Hagiwara, M. & Ohlsson Nevo, E. (2018). Ambulance nurses experiences of non-conveying patients to another level of care. In: : . Paper presented at Forskningens och utvecklingens dag 2018, Örebro, Sweden, 12 April, 2018.
Open this publication in new window or tab >>Ambulance nurses experiences of non-conveying patients to another level of care
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2018 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Medical and Health Sciences Nursing
Identifiers
urn:nbn:se:oru:diva-77568 (URN)
Conference
Forskningens och utvecklingens dag 2018, Örebro, Sweden, 12 April, 2018
Available from: 2019-10-24 Created: 2019-10-24 Last updated: 2019-10-24Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-2411-1795

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