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Ljungvall, H., Persson, A., Åsenlöf, P., Heilig, M. & Ekselius, L. (2019). Reliability of the Addiction Severity Index self-report form (ASI-SR): a self-administered questionnaire based on the Addiction Severity Index composite score domains. Nordic Journal of Psychiatry
Open this publication in new window or tab >>Reliability of the Addiction Severity Index self-report form (ASI-SR): a self-administered questionnaire based on the Addiction Severity Index composite score domains
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2019 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objectives:

The Addiction Severity Index (ASI) is a standardized interview used to assess problems associated with substance use. Although widely used, the time required for the interview remains an obstacle to its acceptance in many clinical settings. We examined if a self-administered questionnaire based on the composite score (CS) items, the ASI Self-Report form (ASI-SR), offers a reliable alternative to the ASI in assessing current substance use and related problems.

Methods:

Participants were 59 treatment seeking individuals entering outpatient programs at the Addiction Psychiatric Clinic at Uppsala University Hospital who were assessed with Swedish versions of the ASI and ASI-SR. Agreement between the ASI interview's CS and ASI-SR's CS was evaluated on the individual basis by intraclass correlation analysis (ICC) and on group level with the Wilcoxon signed rank test. Reliability and internal consistency were evaluated using Cronbach's alpha.

Results:

For 6 out of 7 CS domains, the ICC for the ASI interview and ASI-SR were good to excellent. Internal consistency was acceptable for 6 out of 7 CS domains on the ASI interview and for 5 out of 7 CS domains on the ASI-SR.

Conclusions:

The present study suggests that the ASI-SR is a reliable alternative to the ASI interview for assessing current patient functioning and evaluation of problems related to alcohol and drug use.

Keywords
Addiction Severity Index, self-report, questionnaire, reliability, substance use disorders
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-397679 (URN)10.1080/08039488.2019.1666300 (DOI)000494993300001 ()31696752 (PubMedID)
Available from: 2019-11-28 Created: 2019-11-28 Last updated: 2019-11-28Bibliographically approved
Emilson, C., Demmelmaier, I., Bergman, S., Pettersson, S. & Åsenlöf, P. (2018). Concurrent Validity and Stability of Subgroup Assignment to Three Levels of Pain Condition Severity in Patients With Musculoskeletal Pain. Paper presented at Congress of the European-League-Against-Rheumatism (EULAR), JUN 13-16, 2018, Amsterdam, NETHERLANDS. Annals of the Rheumatic Diseases, 77, 1835-1835
Open this publication in new window or tab >>Concurrent Validity and Stability of Subgroup Assignment to Three Levels of Pain Condition Severity in Patients With Musculoskeletal Pain
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2018 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, p. 1835-1835Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-368671 (URN)10.1136/annrheumdis-2018-eular.7207 (DOI)000444351005504 ()
Conference
Congress of the European-League-Against-Rheumatism (EULAR), JUN 13-16, 2018, Amsterdam, NETHERLANDS
Funder
Swedish Rheumatism Association
Available from: 2018-12-06 Created: 2018-12-06 Last updated: 2018-12-06Bibliographically approved
Geenen, R., Overman, C. L., Christensen, R., Åsenlöf, P., Capela, S., Huisinga, K. L., . . . Bergman, S. (2018). EULAR recommendations for the health professional's approach to pain management in inflammatory arthritis and osteoarthritis. Annals of the Rheumatic Diseases, 77(6), 797-807
Open this publication in new window or tab >>EULAR recommendations for the health professional's approach to pain management in inflammatory arthritis and osteoarthritis
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2018 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, no 6, p. 797-807Article, review/survey (Refereed) Published
Abstract [en]

Pain is the predominant symptom for people with inflammatory arthritis (IA) and osteoarthritis (OA) mandating the development of evidence-based recommendations for the health professional's approach to pain management. A multidisciplinary task force including professionals and patient representatives conducted a systematic literature review of systematic reviews to evaluate evidence regarding effects on pain of multiple treatment modalities. Overarching principles and recommendations regarding assessment and pain treatment were specified on the basis of reviewed evidence and expert opinion. From 2914 review studies initially identified, 186 met inclusion criteria. The task force emphasised the importance for the health professional to adopt a patient-centred framework within a biopsychosocial perspective, to have sufficient knowledge of IA and OA pathogenesis, and to be able to differentiate localised and generalised pain. Treatment is guided by scientific evidence and the assessment of patient needs, preferences and priorities; pain characteristics; previous and ongoing pain treatments; inflammation and joint damage; and psychological and other pain-related factors. Pain treatment options typically include education complemented by physical activity and exercise, orthotics, psychological and social interventions, sleep hygiene education, weight management, pharmacological and joint-specific treatment options, or interdisciplinary pain management. Effects on pain were most uniformly positive for physical activity and exercise interventions, and for psychological interventions. Effects on pain for educational interventions, orthotics, weight management and multidisciplinary treatment were shown for particular disease groups. Underpinned by available systematic reviews and meta-analyses, these recommendations enable health professionals to provide knowledgeable pain-management support for people with IA and OA.

Keywords
rheumatoid arthritis, osteoarthritis, spondyloarthritis, psoriatic arthritis, patient perspective
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-361420 (URN)10.1136/annrheumdis-2017-212662 (DOI)000433228800013 ()29724726 (PubMedID)
Available from: 2018-10-30 Created: 2018-10-30 Last updated: 2018-10-30Bibliographically approved
Igelström, H., Åsenlöf, P., Emtner, M. & Lindberg, E. (2018). Improvement in obstructive sleep apnea after a tailored behavioural sleep medicine intervention targeting healthy eating and physical activity: a randomised controlled trial. Sleep and Breathing, 22(3), 653-661
Open this publication in new window or tab >>Improvement in obstructive sleep apnea after a tailored behavioural sleep medicine intervention targeting healthy eating and physical activity: a randomised controlled trial
2018 (English)In: Sleep and Breathing, ISSN 1520-9512, E-ISSN 1522-1709, Vol. 22, no 3, p. 653-661Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The aim of the present single-centre randomised controlled trial was to assess the effect of a behavioural sleep medicine (BSM) intervention on obstructive sleep apnea (OSA) severity in patients who have been referred for new treatment with continuous positive airway pressure (CPAP).

METHODS: After baseline assessment including ventilatory and anthropometric parameters, and physical activity monitoring, 86 patients who were overweight (BMI ≥ 25) and had moderate-severe OSA with apnea-hypopnea index (AHI) ≥ 15 were randomised into a control group (CG; CPAP and advice about weight loss) or an experimental group (ExpG; CPAP and BSM intervention targeting physical activity and eating behaviour). The BSM intervention comprised 10 individual sessions with a dietician and a physiotherapist and included behaviour change techniques such as goal setting and self-monitoring. After 6 months, a new recording of ventilatory parameters was performed without CPAP.

RESULTS: In ExpG, 40% (n = 14) had improved from severe to moderate or mild OSA or from moderate to mild OSA compared to 16.7% in CG (n = 6, p = 0.02). Further, a lower AHI and amount body fat at baseline were correlated with improvement in severity class. Being in ExpG implied a mean improvement in AHI by 9.7 and an odds ratio of 4.5 for improving in severity classification.

CONCLUSIONS: The results highlight the clinical importance of lifestyle modifications in conjunction with CPAP treatment in patients with OSA.

Keywords
Behaviour modification, Diet, Obstructive sleep apnea, Physical activity
National Category
Respiratory Medicine and Allergy Physiotherapy
Identifiers
urn:nbn:se:uu:diva-339680 (URN)10.1007/s11325-017-1597-z (DOI)000443212100009 ()29222619 (PubMedID)
Funder
Swedish Research CouncilSwedish Heart Lung Foundation
Available from: 2018-01-22 Created: 2018-01-22 Last updated: 2018-11-08Bibliographically approved
Åsenlöf, P., Igelström, H., Sandborgh, M. & Fritz, J. (2018). Integration of Physiotherapy in Behavioral Medicine Intervention Research. International Journal of Behavioral Medicine, 25, S3-S3
Open this publication in new window or tab >>Integration of Physiotherapy in Behavioral Medicine Intervention Research
2018 (English)In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 25, p. S3-S3Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Springer, 2018
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-369061 (URN)000446532700014 ()
Available from: 2018-12-13 Created: 2018-12-13 Last updated: 2018-12-13Bibliographically approved
Berman, A. H., Bodenlos, J., Pekmezi, D., Lian, W. M., Griva, K., Åsenlöf, P., . . . Dekker, J. (2018). Teaching Behavioral Medicine: An Inspirational Workshop. International Journal of Behavioral Medicine, 25, S2-S2
Open this publication in new window or tab >>Teaching Behavioral Medicine: An Inspirational Workshop
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2018 (English)In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 25, p. S2-S2Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Springer, 2018
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-369062 (URN)000446532700009 ()
Available from: 2018-12-13 Created: 2018-12-13 Last updated: 2018-12-13Bibliographically approved
Palm, A., Berne, C., Igelström, H., Åsenlöf, P., Janson, C. & Lindberg, E. (2018). The Impact of Continuous Positive Airway Pressure on Circulating IGF-1 in Patients With Obstructive Sleep Apnea. Journal of Clinical Sleep Medicine (JCSM), 385-391
Open this publication in new window or tab >>The Impact of Continuous Positive Airway Pressure on Circulating IGF-1 in Patients With Obstructive Sleep Apnea
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2018 (English)In: Journal of Clinical Sleep Medicine (JCSM), ISSN 1550-9389, E-ISSN 1550-9397, p. 385-391Article in journal (Refereed) Published
Abstract [en]

Study Objectives: Obstructive sleep apnea (OSA) is a disease with metabolic and cardiovascular consequences and is associated with decreased serum concentrations of insulin-like growth factor-1 (IGF-1). The aim of this study was to investigate whether continuous positive airway pressure (CPAP) will increase serum IGF-1 concentration in patients with OSA. Methods: Patients with moderate to severe OSA were recruited from a sleep clinic and serum IGF-1 was measured before initiation of CPAP and at follow-up after 4.8 +/- 2.5 months. Patients adherent to CPAP treatment (usage >= 4 h/night) were compared with those considered to be nonadherent (usage < 4 h/night). Results: Complete data were obtained from 69 patients (86% male, age 56 +/- 12 years, respiratory event index 43 +/- 21 events/h, Epworth Sleepiness Scale score 12 +/- 5). In those adherent to CPAP (n = 42), there was an increase in serum IGF-1 concentration with 21.1 (95% confidence interval [CI]: 13.1 to 29.2) mu g/L compared to 4.7 (95% CI: -4.1 to 13.5) mu g/L in the nonadherent group (n = 27) (P =.0083). In a linear multivariate model adjusting for sex, age, body mass index, respiratory event index, and mean oxygen saturation during the night recording, the change in serum IGF-1 concentration was significantly associated with adherence to CPAP treatment (adjusted beta coefficient: 21.8, 95% CI: 10.2 to 33.4) and inversely associated with change in body mass index (adjusted beta coefficient: -7.1, 95% CI: -11.3 to -3.0) and change in hemoglobin A1c (adjusted beta coefficient: -1.8, 95% CI: - 33 to -0.3). Conclusions: CPAP usage >= 4 h/night is associated with increased serum IGF-1 concentration in male patients with OSA.

Keywords
adherence, continuous positive airway pressure, IGF-1, obstructive sleep apnea
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-343619 (URN)10.5664/jcsm.6982 (DOI)000427477700011 ()29458693 (PubMedID)
Funder
Swedish Research Council
Available from: 2018-02-28 Created: 2018-02-28 Last updated: 2018-09-25
Emilson, C., Demmelmaier, I., Bergman, S., Lindberg, P., Denison, E. & Åsenlöf, P. (2017). A 10-year follow-up of tailored behavioural medicine treatment and exercise-based physiotherapy in persistent musculoskeletal pain. Clinical Rehabilitation, 31(2), 186-196
Open this publication in new window or tab >>A 10-year follow-up of tailored behavioural medicine treatment and exercise-based physiotherapy in persistent musculoskeletal pain
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2017 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, no 2, p. 186-196Article in journal (Refereed) Published
Abstract [en]

Objective: To study the long-term outcomes of two interventions targeting patients with sub-acute and persistent pain in a primary care physiotherapy setting.

Design: A 10-year follow-up of a two-armed randomised controlled trial, initially including 97 participants.

Interventions: Tailored behavioural medicine treatment, applied in a physiotherapy context (experimental condition), and exercise-based physiotherapy (control condition). Main measures: Pain-related disability was the primary outcome. The maximum pain intensity, pain control, fear of movement, sickness-related absence (register data) and perceived benefit and confidence in coping with future pain problems were the secondary outcomes.

Results: Forty-three (44%) participants responded to the follow-up survey, 20 in the tailored behavioural medicine treatment group and 23 in the exercise-based physiotherapy group. The groups did not differ in terms of the change in the scores for the primary outcome (p=0.17) of pain-related disability between the experimental group (median: 2.5, Q1-Q3: -2.5-14.25), and the control group (median: 0, Q1-Q3: -5-6). Further, there were also no significant differences found for the secondary outcomes except for sickness-related absence, where the exercise-based physiotherapy group had more days of sickness-related absence three months before treatment (p= 0.02), and at the 10-year follow-up (p=0.03).

Discussion: The beneficial effects favouring tailored behavioural medicine treatment that observed post-treatment and at the two-year follow-up were not maintained 10 years after treatment.

Keywords
Chronic pain, behavioural medicine, primary care, physical exercise, long-term compliance
National Category
Physiotherapy
Identifiers
urn:nbn:se:uu:diva-281461 (URN)10.1177/0269215516639356 (DOI)000394758500005 ()27009057 (PubMedID)
Funder
Swedish Rheumatism Association
Available from: 2016-03-24 Created: 2016-03-24 Last updated: 2017-08-22Bibliographically approved
Berntsen, S., Aaronson, N. K., Buffart, L., Börjeson, S., Demmelmaier, I., Hellbom, M., . . . Nordin, K. (2017). Design of a randomized controlled trial of physical training and cancer (Phys-Can) - the impact of exercise intensity on cancer related fatigue, quality of life and disease outcome. BMC Cancer, 17(1), Article ID 218.
Open this publication in new window or tab >>Design of a randomized controlled trial of physical training and cancer (Phys-Can) - the impact of exercise intensity on cancer related fatigue, quality of life and disease outcome
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2017 (English)In: BMC Cancer, ISSN 1471-2407, E-ISSN 1471-2407, Vol. 17, no 1, article id 218Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Cancer-related fatigue is a common problem in persons with cancer, influencing health-related quality of life and causing a considerable challenge to society. Current evidence supports the beneficial effects of physical exercise in reducing fatigue, but the results across studies are not consistent, especially in terms of exercise intensity. It is also unclear whether use of behaviour change techniques can further increase exercise adherence and maintain physical activity behaviour. This study will investigate whether exercise intensity affects fatigue and health related quality of life in persons undergoing adjuvant cancer treatment. In addition, to examine effects of exercise intensity on mood disturbance, adherence to oncological treatment, adverse effects from treatment, activities of daily living after treatment completion and return to work, and behaviour change techniques effect on exercise adherence. We will also investigate whether exercise intensity influences inflammatory markers and cytokines, and whether gene expressions following training serve as mediators for the effects of exercise on fatigue and health related quality of life.

METHODS/DESIGN: Six hundred newly diagnosed persons with breast, colorectal or prostate cancer undergoing adjuvant therapy will be randomized in a 2 × 2 factorial design to following conditions; A) individually tailored low-to-moderate intensity exercise with or without behaviour change techniques or B) individually tailored high intensity exercise with or without behaviour change techniques. The training consists of both resistance and endurance exercise sessions under the guidance of trained coaches. The primary outcomes, fatigue and health related quality of life, are measured by self-reports. Secondary outcomes include fitness, mood disturbance, adherence to the cancer treatment, adverse effects, return to activities of daily living after completed treatment, return to work as well as inflammatory markers, cytokines and gene expression.

DISCUSSION: The study will contribute to our understanding of the value of exercise and exercise intensity in reducing fatigue and improving health related quality of life and, potentially, clinical outcomes. The value of behaviour change techniques in terms of adherence to and maintenance of physical exercise behaviour in persons with cancer will be evaluated.

TRIAL REGISTRATION: NCT02473003 , October, 2014.

Keywords
Behaviour change techniques, Biological mechanism, Cancer, Fatigue, Physical exercise, Quality of life, Randomized controlled trial
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-319059 (URN)10.1186/s12885-017-3197-5 (DOI)000397448100002 ()28347291 (PubMedID)
Funder
Swedish Cancer Society, CAN 2012/621 CAN 2012/631 CAN 2015/414Swedish Research Council, K2014-99X
Available from: 2017-03-31 Created: 2017-03-31 Last updated: 2017-11-29Bibliographically approved
Dodd-Reynolds, C. J., Åsenlöf, P. & Hellström, K. (2017). Editorial: Special issue - physical activity and health. Physical Therapy Reviews, 22(3-4), 101-102
Open this publication in new window or tab >>Editorial: Special issue - physical activity and health
2017 (English)In: Physical Therapy Reviews, ISSN 1083-3196, E-ISSN 1743-288X, Vol. 22, no 3-4, p. 101-102Article in journal, Editorial material (Other academic) Published
National Category
Physiotherapy
Identifiers
urn:nbn:se:uu:diva-346805 (URN)10.1080/10833196.2017.1335823 (DOI)000414044200001 ()
Available from: 2018-03-22 Created: 2018-03-22 Last updated: 2018-03-22Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-7999-6087

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