Helsefremmende og forebyggende hjemmebesøk til 80-åringer i Trondheim kommune

Trondheim kommune tilbyr helsefremmende og forebyggende hjemmebesøk (HFHB) til alle innbyggere uten omsorgstjenester i kommunen det året de fyller 80 år. Hensikten med denne studien er å få innsikt i hva som karakteriserer de som mottar hjemmebesøk, hvordan de opplever besøket og om besøket har ført til endringer i hverdagen 6 måneder etter. Spørreskjema er brukt for å innhente opplysninger fra seniorene som mottok besøk. Spørreskjemaene er besvart ved hjemmebesøket (T1) og 6 måneder etter (T2). 57 % (n = 322) ønsket hjemmebesøk. 88 % (n = 284) ville delta i studien og besvarte spørreskjema ved T1. Majoriteten å ha god helserelatert livskvalitet og et godt kosthold. Ved T2 rapporterer 70 % samtalen som nyttig, de ble møtt med respekt og ønsket nytt besøk. Seks måneder etter hjemmebesøket rapporterer signifikant flere å ha kjennskap til kommunale helsetjenester og å gjennomføre planlagt fysisk aktivitet 1-2 ganger per uke. Over halvparten av 80-åringene i Trondheim kommune mottar HFHB og de rapporterer å ha relativt god helse. De setter pris på samtalen, har fått økt kunnskap om kommunale helsetjenester og flere har økt sitt fysiske aktivitetsnivå 6 måneder etter

Prediction of function in daily life following multidisciplinary rehabilitation for individuals with chronic musculoskeletal pain; a prospective study

Background: The prevalence of chronic musculoskeletal pain is high, with widespread negative economic, psychological, and social consequences for the individual. It is therefore important to find ways to predict the outcome of rehabilitation programmes in terms of function in daily life. The aims of this study were to investigate the improvements over time from multidisciplinary rehabilitation in terms of pain and function, and analyse the relative impact of individual and psychosocial factors as predictors of function in daily life in individuals with chronic musculoskeletal pain. Methods: A prospective study was conducted among one hundred and forty three (N = 143) musculoskeletal pain patients. Measures of pain, function, and functional health status were obtained at baseline, after 5 weeks of intensive training, at the end of the 57-week rehabilitation programme, and at a 1 year follow-up, using validated self-administrated measures. Linear regression analysis was applied to investigate the relative impact of musculoskeletal pain, individual- , and psychosocial factors in function. Results: The participants studied showed a significant increase in function during the 57 weeks rehabilitation period. There was also a significant increase in function from the end of the rehabilitation period (57th week) to the one year follow-up measures. Pain intensity associated significantly with pain experience over all measurement periods. High levels of pain intensity (β = .42**) and pain experience (β = .37*), and poor psychological capacity (β = -.68*) at baseline, as well as poor physiological capacity (β = -.44**) and high levels of anxiety (β = .48**) and depression (β = .58***) at the end of the rehabilitation program were the most important prognostic factors of variance in functioning over the 4 measurement periods. Conclusion: The data suggest that physical capacity, emotional distress and coping skills should be priority areas in rehabilitation programmes to improve functioning in daily life

A systematic review assessing non-pharmacological conservative treatment studies for people with non-inflammatory multi-joint pain: clinical outcomes and research design considerations

To systematically review the evidence to determine the clinical outcomes and the important methodological quality features of interventional studies on adults with non-inflammatory multi-joint pain (MJP). Systematic search of published and unpublished literature using the databases: AMED, CINAHL, MEDLINE, EMBASE, psycINFO, SPORTDiscus, PEDro, OpenGrey, the EU Clinical Trials Register, World Health Organization International Clinical Trial Registry Platform, ClinicalTrials.gov and the ISRCTN registry (search: inception to 19th October 2017). All papers reporting the clinical outcomes of non-pharmacological interventions for people with non-inflammatory MJP were included. Studies were critically appraised using the Downs and Black Critical Appraisal and the TIDieR reporting checklists. Data were analysed using a Best Evidence Synthesis approach. From 3824 citations, four papers satisfied the eligibility criteria. Three studies reported outcomes from multidisciplinary rehabilitation programmes and one study reported the findings of a spa therapy intervention. All interventions significantly improved pain, function and quality of life in the short-term. There was limited reporting of measures for absenteeism, presenteeism and psychosocial outcomes. The evidence was ‘weak’, and due to a lack of controlled trials, there is limited evidence to ascertain treatment effectiveness. Design consideration for future trials surround improved reporting of participant characteristics, interventions and the standardisation of core outcome measures. There is insufficient high-quality trial data to determine the effectiveness of treatments for non-inflammatory MJP. Given the significant health burden which this condition presents on both individuals and wider society, developing and testing interventions and accurately reporting these, should be a research priority

Sense of coherence and intentions to retire early among Finnish women and men

Peer reviewe

Physical functioning after occupational rehabilitation and returning to work among employees with chronic musculoskeletal pain and comorbid depressive symptoms

Linda Ernstsen,1 Monica Lillefjell2 1Faculty of Nursing, Sør-Trøndelag University College, Trondheim, Norway; 2Department of Occupational Therapy, Faculty of Health Education and Social Work, Sør-Trøndelag University College, Trondheim, Norway Background: The aim of this investigation was to assess whether measures of physical functioning after multidisciplinary rehabilitation are associated with return to work among individuals with chronic musculoskeletal pain conditions and comorbid depressive symptoms. Methods: Included were 92 employees with chronic musculoskeletal disorders who had participated in a 57-week multidisciplinary rehabilitation program. Their ages ranged from 25–59 years. The Hospital Anxiety and Depression Scale was used to assess depressive symptoms. Different aspects of physical functioning (muscle strength, mobility, endurance capacity, and balance) were measured with single-item visual analog scales, and physical fitness was measured with the validated COOP/WONCA charts. Being on "active work strategies," such as receiving rehabilitation benefit/vocational rehabilitation or being reported partly or completely fit, was defined as "on their way into/in work". Cross-sectional associations were measured using logistic regression models, estimating odds ratio with 95% confidence intervals. Results: There were no differences between the "on their way into/in work" group (n=70) and the "on their way out/out of work" group (n=22) regarding age, sex, or levels of anxiety or pain. Surprisingly, regression analyses showed that those with higher levels of physical functioning had significantly lower odds of returning to work. Conclusion: The findings of an inverse relationship between self-reported physical function and returning to work in this sample illustrate that the return-to-work process among employees with chronic musculoskeletal pain and comorbid depressive symptoms is multifactorial and influenced by factors other than physical functioning at the individual level. Further research, especially longitudinal studies, is needed to assess the occupational trajectories among employees with chronic musculoskeletal pain and comorbid depressive symptoms after participation in a multidisciplinary rehabilitation program. Keywords: chronic musculoskeletal pain, multidisciplinary rehabilitation, physical functioning, depression, return to wor

Helsefremmende og forebyggende hjemmebesøk til 80-åringer i Trondheim kommune

Trondheim kommune tilbyr helsefremmende og forebyggende hjemmebesøk (HFHB) til alle innbyggere uten omsorgstjenester i kommunen det året de fyller 80 år. Hensikten med denne studien er å få innsikt i hva som karakteriserer de som mottar hjemmebesøk, hvordan de opplever besøket og om besøket har ført til endringer i hverdagen 6 måneder etter. Spørreskjema er brukt for å innhente opplysninger fra seniorene som mottok besøk. Spørreskjemaene er besvart ved hjemmebesøket (T1) og 6 måneder etter (T2). 57 % (n = 322) ønsket hjemmebesøk. 88 % (n = 284) ville delta i studien og besvarte spørreskjema ved T1. Majoriteten å ha god helserelatert livskvalitet og et godt kosthold. Ved T2 rapporterer 70 % samtalen som nyttig, de ble møtt med respekt og ønsket nytt besøk. Seks måneder etter hjemmebesøket rapporterer signifikant flere å ha kjennskap til kommunale helsetjenester og å gjennomføre planlagt fysisk aktivitet 1-2 ganger per uke. Over halvparten av 80-åringene i Trondheim kommune mottar HFHB og de rapporterer å ha relativt god helse. De setter pris på samtalen, har fått økt kunnskap om kommunale helsetjenester og flere har økt sitt fysiske aktivitetsnivå 6 måneder etter

Primary care patients' expectations regarding medical appointments and their experiences during a visit: does age matter?

Mariusz Jaworski,1 Marta Rzadkiewicz,1 Miroslawa Adamus,1 Joanna Chylinska,1 Magdalena Lazarewicz,1 Gørill Haugan,2 Monica Lillefjell,3 Geir Arild Espnes,2 Dorota Wlodarczyk1 1Department of Medical Psychology, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland; 2Department of Public Health and Nursing, 3Department of Neuromedicine and Movement Science, NTNU Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway Introduction: There is evidence that meeting patients’ expectations toward health care correlates with involvement in the treatment they receive. The most important patient expectations concern certain types of information: explanation of disease and treatment, health promotion, and improvement in quality of life. Other demands include proper rapport and emotional support. The aim of this paper was to examine different patient groups over the age of 50 years and their expectations toward medical visits, evaluated before a visit and after the visit.Patients and methods: The study group consisted of 4,921 primary health-care patients. The patients received self-administered questionnaires that they filled in before and after the appointment with the doctor. Interviews with patients were conducted individually by specially trained interviewers. The PRACTA Patient Expectations Scale was used to measure the appointment-related expectations of the patients.Results: We observed differences related to age in patients’ expectations before medical visits regarding the following factors: disease explanation, treatment explanation, quality of life, rapport, and emotional support. The same differences were not observed on health promotion. Evaluation of patients’ appointment-related experiences after the visit showed that there were significant differences between the age-groups regarding all types of expectations included in the study. Differences between previsit and postvisit measurements were statistically significant in all age-groups. Patients who received less than they expected from doctors outnumbered those who received what they expected or more in all the groups.Conclusion: Patients’ expectations toward medical visits are conditioned by age. Therefore, doctors should pay more attention to requirements related to age in their effort to identify and satisfy expectations. This is particularly important in light of the discrepancy between previsit expectations and the actual experiences of patients evaluated after the visit. Keywords: primary care, patients expectations, medical appointment, experiences, PRACT