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Wallman, Thorne
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Publications (10 of 39) Show all publications
Bardel, A., Wallander, M.-A., Wallman, T., Rosengren, A., Johansson, S., Eriksson, H. & Svärdsudd, K. (2019). Age and sex related self-reported symptoms in a general population across 30 years: Patterns of reporting and secular trend. PLoS ONE, 14(2), Article ID e0211532.
Open this publication in new window or tab >>Age and sex related self-reported symptoms in a general population across 30 years: Patterns of reporting and secular trend
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2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 2, article id e0211532Article in journal (Refereed) Published
Abstract [en]

Objective To study age and sex specific prevalence of 30 symptoms in random samples from the general population and to analyze possible secular trends across time. Study population The study was based on data from eight on-going Swedish cohort studies, with baseline investigations performed between 1973 and 2003. Samples were drawn from the general population of the cities of Gothenburg and Eskilstuna, and of Uppsala County. Overall, 20,160 subjects were sampled, 14,470 (71.8%) responded, of whom 12.000 were unique subjects, and 2548 were part of more than one sample. Methods The Complaint score sub-scale of the Gothenburg Quality of Life instrument, listing 30 general symptoms was used. Responders were asked to indicate which symptoms they had experienced during the last three months. Results Women reported on average 7.8 symptoms, and men 5.3 (p<0.0001). Women reported higher prevalence than men for 24 of the 30 symptoms. In multivariate analyses four patterns of prevalence across age were identified in both men and women; increasing prevalence, decreasing, stable and biphasic prevalence. The symptoms in the various pattern groups differed somewhat between men and women. However, symptoms related to strain were prominent among symptoms decreasing with age. Moreover, there were secular trends. Across all symptoms reporting prevalence increased over time in men (p<0.001) as well as in women (p<0.0001). Conclusions Women reported higher total symptom prevalence than men. Symptoms related to health generally increased with age, while symptoms related to stress decreased markedly. Significant secular trends across time regarding symptom prevalence were found.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2019
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-377595 (URN)10.1371/journal.pone.0211532 (DOI)000457744200030 ()30716129 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2019-03-01 Created: 2019-03-01 Last updated: 2019-03-07Bibliographically approved
Husdal, R., Thors Adolfsson, E., Leksell, J., Eliasson, B., Jansson, S., Jerdén, L., . . . Rosenblad, A. (2019). Associations between quality of work features in primary health care and glycaemic control in people with Type 2 diabetes mellitus: A nationwide survey.. Primary Care Diabetes, 13(2), 176-186, Article ID S1751-9918(18)30277-8.
Open this publication in new window or tab >>Associations between quality of work features in primary health care and glycaemic control in people with Type 2 diabetes mellitus: A nationwide survey.
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2019 (English)In: Primary Care Diabetes, ISSN 1751-9918, E-ISSN 1878-0210, Vol. 13, no 2, p. 176-186, article id S1751-9918(18)30277-8Article in journal (Refereed) Published
Abstract [en]

Aims: To describe and analyse the associations between primary health care centres’ (PHCCs’) quality of work (QOW) and individual HbA1c levels in people with Type 2 diabetes mellitus (T2DM).

Methods: This cross-sectional study invited all 1152 Swedish PHCCs to answer a questionnaire addressing QOW conditions. Clinical, socio-economic and comorbidity data for 230,958 people with T2DM were linked to data on QOW conditions for 846 (73.4%) PHCCs.

Results: Of the participants, 56% had controlled (≤52 mmol/mol), 31.9% intermediate (53–69 mmol/mol), and 12.1% uncontrolled (≥70 mmol/mol) HbA1c. An explanatory factor analysis identified seven QOW features. The features having a call-recall system, having individualized treatment plans, PHCCs’ results always on the agenda, and having a follow-up strategy combined with taking responsibility of outcomes/results were associated with lower HbA1c levels in the controlled group (all < 0.05). For people with intermediate or uncontrolled HbA1c, having individualized treatment plans was the only QOW feature that was significantly associated with a lower HbA1c level (< 0.05).

Conclusions: This nationwide study adds important knowledge regarding associations between QOW in real life clinical practice and HbA1c levels. PHCCs’ QOW may mainly only benefit people with controlled HbA1c and more effective QOW strategies are needed to support people with uncontrolled HbA1c.

Keywords
Diabetes mellitus, National survey, Primary health care, Quality of health care, Type 2
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:uu:diva-373949 (URN)10.1016/j.pcd.2018.11.005 (DOI)000462105300010 ()30545793 (PubMedID)
Available from: 2019-01-17 Created: 2019-01-17 Last updated: 2019-04-17Bibliographically approved
Lännerström, L., Wallman, T., Kaminsky, E. & Holmström, I. K. (2019). Gaining role clarity in working with sick leave questions - Registered Nurses' experiences of an educational intervention. Nursing Open, 6(2), 236-244
Open this publication in new window or tab >>Gaining role clarity in working with sick leave questions - Registered Nurses' experiences of an educational intervention
2019 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 2, p. 236-244Article in journal (Refereed) Published
Abstract [en]

Aim

To describe how a short educational intervention in social insurance medicine was experienced by Registered Nurses and what changes it brought to their work with sick leave questions in telephone nursing.

Design

Qualitative explorative interview study.

Methods

Interviews with 12 purposively sampled Registered Nurses were conducted and analysed using manifest content analysis.

Results

The intervention increased Registered Nurses’ knowledge of the sick leave process and changed their work habits as they now have more of the skills needed to handle sick leave questions. In this way, they gained role clarity in their work with sick leave questions. The new knowledge included rules and regulations, actors’ roles and patients’ experiences. Learning from peers, reflecting and having the opportunity to ask questions were also described as increasing their knowledge. The skills following the participation were described as knowing what to say and do and knowing where to turn for support.

Keywords
cluster randomized controlled study, educational intervention, interviews, sick leave, social insurance medicine, telephone nursing
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-361653 (URN)10.1002/nop2.201 (DOI)000461835600004 ()30918675 (PubMedID)
Available from: 2018-09-26 Created: 2018-09-26 Last updated: 2019-05-07Bibliographically approved
Berglund, E., Anderzén, I., Andersén, Å., Carlsson, L., Gustavsson, C., Wallman, T. & Lytsy, P. (2018). Multidisciplinary Intervention and Acceptance and Commitment Therapy for Return-to-Work and Increased Employability among Patients with Mental Illness and/or Chronic Pain: A Randomized Controlled Trial. International Journal of Environmental Research and Public Health, 15(11), Article ID 2424.
Open this publication in new window or tab >>Multidisciplinary Intervention and Acceptance and Commitment Therapy for Return-to-Work and Increased Employability among Patients with Mental Illness and/or Chronic Pain: A Randomized Controlled Trial
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2018 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, no 11, article id 2424Article in journal (Refereed) Published
Abstract [en]

Background: People on long-term sick leave often have a long-lasting process back to work, where the individuals may be in multiple and recurrent states; i.e., receiving different social security benefits or working, and over time they may shift between these states. The purpose of this study was to evaluate the effects of two vocational rehabilitation programs, compared to a control, on return-to-work (RTW) or increased employability in patients on long-term sick leave due to mental illness and/or chronic pain. Methods: In this randomized controlled study, 427 women and men were allocated to either (1) multidisciplinary team management, i.e., multidisciplinary assessments and individual rehabilitation management, (2) acceptance and commitment therapy (ACT), or (3) control. A positive outcome was defined as RTW or increased employability. The outcome was considered negative if the (part-time) wage was reduced or ceased, or if there was an indication of decreased employability. The outcome was measured one year after entry in the project and analyzed using binary and multinomial logistic regressions. Results: Participants in the multidisciplinary team group reported having RTW odds ratio (OR) 3.31 (95% CI 1.39-7.87) compared to the control group in adjusted models. Participants in the ACT group reported having increased employability OR 3.22 (95% CI 1.13-9.15) compared to the control group in adjusted models. Conclusions: This study of vocational rehabilitation in mainly female patients on long-term sick leave due to mental illness and/or chronic pain suggests that multidisciplinary team assessments and individually adapted rehabilitation interventions increased RTW and employability. Solely receiving the ACT intervention also increased employability.

Keywords
return-to-work, vocational rehabilitation, multidisciplinary rehabilitation, chronic pain, mental illness, sick leave
National Category
Occupational Health and Environmental Health Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-372458 (URN)10.3390/ijerph15112424 (DOI)000451640500098 ()30384498 (PubMedID)
Funder
Swedish Social Insurance Agency
Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-01-07Bibliographically approved
Husdal, R., Karlsson, A., Leksell, J., Eliasson, B., Jansson, S., Jerden, L., . . . Thors Adolfsson, E. (2018). Resources and organisation in primary health care are associated with HbA1c level: A nationwide study of 230958 people with Type 2 diabetes mellitus.. Primary Care Diabetes, 12(1), 23-33
Open this publication in new window or tab >>Resources and organisation in primary health care are associated with HbA1c level: A nationwide study of 230958 people with Type 2 diabetes mellitus.
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2018 (English)In: Primary Care Diabetes, ISSN 1751-9918, E-ISSN 1878-0210, Vol. 12, no 1, p. 23-33Article in journal (Refereed) Published
Abstract [en]

AIMS: To examine the association between personnel resources and organisational features of primary health care centres (PHCCs) and individual HbA1c level in people with Type 2 diabetes mellitus (T2DM).

METHODS: People with T2DM attending 846 PHCCs (n=230958) were included in this cross-sectional study based on PHCC-level data from a questionnaire sent to PHCCs in 2013 and individual-level clinical data from 2013 for people with T2DM reported in the Swedish National Diabetes Register, linked to individual-level data on socio-economic status and comorbidities. Data were analysed using a generalized estimating equations linear regression models.

RESULTS: After adjusting for PHCC- and individual-level confounding factors, personnel resources associated with lower individual HbA1c level were mean credits of diabetes-specific education among registered nurses (RNs) (-0.02mmol/mol for each additional credit; P<0.001) and length of regular visits to RNs (-0.19mmol/mol for each additional 15min; P<0.001). Organisational features associated with HbA1c level were having a diabetes team (-0.18mmol/mol; P<0.01) and providing group education (-0.20mmol/mol; P<0.01).

CONCLUSIONS: In this large sample, PHCC personnel resources and organisational features were associated with lower HbA1c level in people with T2DM.

Keywords
HbA(1c), Organisation, Personnel resources, Primary health care system, Type 2 diabetes mellitus
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:uu:diva-332689 (URN)10.1016/j.pcd.2017.09.003 (DOI)000423008800003 ()28964673 (PubMedID)
Available from: 2017-10-31 Created: 2017-10-31 Last updated: 2018-12-21Bibliographically approved
Lännerström, L., Holmström, I. K., Svärdsudd, K. & Wallman, T. (2017). Possible causes of experiencing problems with sick leave questions in telephone nursing. Upsala Journal of Medical Sciences, 122(4), 249-253
Open this publication in new window or tab >>Possible causes of experiencing problems with sick leave questions in telephone nursing
2017 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 122, no 4, p. 249-253Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Registered nurses at primary health care centres in Sweden receive about 20 million telephone calls annually. Questions related to sick leave occur regularly. Previous studies conclude that those calls often are perceived as problematic. The aim of this study was to explore factors associated with problems regarding sick leave questions in telephone nursing.

METHODS: A questionnaire was distributed to all registered nurses (n = 185) working with telephone nursing in 26 Swedish primary health care centres, of whom 114 (61.6%) responded. Based on the results of a Spearman correlation analysis a logistic regression analysis was performed of significant exposure variables on outcome (perceived problems).

RESULTS: Significant exposure variables were: experience of telephone nursing, age, being educated in social insurance medicine, and frequency of telephone calls with sick leave questions. Young age was associated with more problems than old age. Those having education in social insurance medicine reported fewer problems than those who had not, and so did those having few telephone calls with sick leave questions as compared with those who had many.

CONCLUSIONS: Young age, lack of education in insurance medicine, and high frequency of sick leave questions increased the perceived problem level in telephone nursing.

Place, publisher, year, edition, pages
Taylor & Francis, 2017
Keywords
Nursing, primary health care, sick leave, sick-listing, sickness certification, social insurance medicine, telephone nursing
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-332688 (URN)10.1080/03009734.2017.1385665 (DOI)000423294800007 ()29045168 (PubMedID)
Available from: 2017-10-31 Created: 2017-10-31 Last updated: 2018-03-15Bibliographically approved
Lännerström, L., von Celsing, A.-S., Holmström, I. & Wallman, T. (2017). Registered nurses' work with sick leave questions by telephone in primary health care. Journal of Clinical Nursing, 26(5/6), 641-647
Open this publication in new window or tab >>Registered nurses' work with sick leave questions by telephone in primary health care
2017 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 5/6, p. 641-647Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES:

To describe registered nurses' work with sick leave questions by telephone.

BACKGROUND:

In Sweden, when a sick person needs to request a sickness certification, it is common to contact the primary healthcare centre. The main access to primary health care is by telephone, with a registered nurse answering the care seeker's questions, triaging and helping care seekers to the right level of care. Registered nurses' work with sick leave questions has not been studied, except for two qualitative interview studies.

DESIGN:

A descriptive cross-sectional study.

METHODS:

A questionnaire with 120 questions was distributed to 185 registered nurses in one county in central Sweden. Descriptive statistics were used for analysis.

RESULTS:

Response rate was 62% (n = 114). Registered nurses (n = 105) in this study talked weekly to persons on, or at risk, for sick leave. A large part (n = 78) felt they had a role in the care of persons on sick leave, consisting of booking appointments as well as acting as a pilot, advisor, caretaker and coordinator. For 74 of 114 registered nurses, it was problematic to handle the phone calls weekly. Measures were 'often' booking appointments with physicians (n = 67) and 'seldom' providing information on social insurance rules ('never' n = 51). The registered nurses expressed a great need for more education.

CONCLUSION:

Registered nurses in this study reported having a role in the care of persons on sick leave when handling sick leave questions by telephone. The telephone calls were problematic to handle, and the registered nurses expressed a great need for education and training in social insurance medicine.

RELEVANCE TO CLINICAL PRACTICE:

There is a need to educate and train registered nurses in social insurance medicine to provide high-quality nursing for patients on or at risk for sick leave.

National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-310973 (URN)10.1111/jocn.13580 (DOI)000398914400007 ()27626185 (PubMedID)
Available from: 2016-12-20 Created: 2016-12-20 Last updated: 2018-09-14Bibliographically approved
Husdal, R., Rosenblad, A., Leksell, J., Eliasson, B., Jansson, S., Jerdén, L., . . . Adolfsson, E. T. (2017). Resource allocation and organisational features in Swedish primary diabetes care: Changes from 2006 to 2013. Primary Care Diabetes, 11(1), 20-28
Open this publication in new window or tab >>Resource allocation and organisational features in Swedish primary diabetes care: Changes from 2006 to 2013
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2017 (English)In: Primary Care Diabetes, ISSN 1751-9918, E-ISSN 1878-0210, Vol. 11, no 1, p. 20-28Article in journal (Refereed) Published
Abstract [en]

AIMS: To compare the resource allocation and organisational features in Swedish primary diabetes care for patients with type 2 diabetes mellitus (T2DM) between 2006 and 2013.

METHODS: Using a repeated cross-sectional study design, questionnaires covering personnel resources and organisational features for patients with T2DM in 2006 and 2013 were sent to all Swedish primary health care centres (PHCCs) during the following year. In total, 684 (74.3%) PHCCs responded in 2006 and 880 (76.4%) in 2013.

RESULTS: Compared with 2006, the median list size had decreased in 2013 (p<0.001), whereas the median number of listed patients with T2DM had increased (p<0.001). Time devoted to patients with T2DM and diabetes-specific education levels for registered nurses (RNs) had increased, and more PHCCs had in-house psychologists (all p<0.001). The use of follow-up systems and medical check-ups had increased (all p<0.05). Individual counselling was more often based on patients' needs, while arrangement of group-based education remained low. Patient participation in setting treatment targets mainly remained low.

CONCLUSIONS: Even though the diabetes-specific educational level among RNs increased, the arrangement of group-based education and patient participation in setting treatment targets remained low. These results are of concern and should be prioritised as key features in the care of patients with T2DM.

National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:uu:diva-304779 (URN)10.1016/j.pcd.2016.08.002 (DOI)000392679200003 ()27578488 (PubMedID)
Available from: 2016-10-10 Created: 2016-10-10 Last updated: 2019-01-25Bibliographically approved
Peterson, G., Nilsson, D., Peterson, S., Dedering, Å., Trygg, J., Wallman, T. & Peolsson, A. (2016). Changes in dorsal neck muscle function in individuals with chronic whiplash-associated disorders: a real-time ultrasound case-control study. Ultrasound in Medicine and Biology, 42(5), 1090-1102
Open this publication in new window or tab >>Changes in dorsal neck muscle function in individuals with chronic whiplash-associated disorders: a real-time ultrasound case-control study
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2016 (English)In: Ultrasound in Medicine and Biology, ISSN 0301-5629, E-ISSN 1879-291X, Vol. 42, no 5, p. 1090-1102Article in journal (Refereed) Published
Abstract [en]

Impaired neck muscle function leads to disability in individuals with chronic whiplash-associated disorder (WAD), but diagnostic tools are lacking. In this study, deformations and deformation rates were investigated in five dorsal neck muscles during 10 arm elevations by ultrasonography with speckle tracking analyses. Forty individuals with chronic WAD (28 women and 12 men, mean age = 37 y) and 40 healthy controls matched for age and sex were included. The WAD group had higher deformation rates in the multifidus muscle during the first (p < 0.04) and 10th (only women, p < 0.01) arm elevations compared with the control group. Linear relationships between the neck muscles for deformation rate (controls: R-2 = 0.24-0.82, WAD: R-2 = 0.05-0.74) and deformation of the deepest muscles (controls: R-2 = 0.61-0.32, WAD: R-2 = 0.15-0.01) were stronger for women in the control group versus women with WAD, indicating there is altered interplay between dorsal neck muscles in chronic WAD.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-270190 (URN)10.1016/j.ultrasmedbio.2015.12.022 (DOI)000373385300008 ()26921149 (PubMedID)
Funder
Swedish Research Council
Available from: 2015-12-22 Created: 2015-12-22 Last updated: 2017-12-01Bibliographically approved
Peterson, G., Dedering, A., Andersson, E., Nilsson, D., Trygg, J., Peolsson, M., . . . Peolsson, A. (2015). Altered ventral neck muscle deformation for individuals with whiplash associated disorder compared to healthy controls: A case-control ultrasound study. Manual Therapy, 20(2), 319-327
Open this publication in new window or tab >>Altered ventral neck muscle deformation for individuals with whiplash associated disorder compared to healthy controls: A case-control ultrasound study
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2015 (English)In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 20, no 2, p. 319-327Article in journal (Refereed) Published
Abstract [en]

Previous studies have shown altered neck muscle function in individuals with chronic whiplash associated disorder (WAD). However, we lack real-time investigations with non-invasive methods that can distinguish between the different ventral neck muscle layers. This study investigated deformations and deformation rates in the sternocleidomastoid (SCM), longus capitis (Lcap), and longus colli (Lco) muscles with real-time ultrasonography. Twenty-six individuals with WAD were compared with 26 controls, matched for age and sex. Ultrasound imaging of the SCM, Lcap, and Lco were recorded during 10 repetitive arm elevations. The first and tenth arm elevations were post-process analyzed with speckle tracking. There were few significant differences in the deformations or deformation rates in the SCM, Lcap, and Lco between the WAD and control group. In controls, deformations and deformation rates showed linear positive relationships between SCM/Lcap, SCM/Lco, and Lcap/Lco which increased from the first arm elevation (R(2) = 0.14-0.70); to the tenth arm elevation (R(2) = 0.51-0.71). The WAD group showed similar or weaker linear relationship (R(2) < 0.19) during the tenth compared to the first (R(2) < 0.44) arm elevation except for deformations in Lcap/Lco (R(2) = 0.13-0.57). This result indicated that deformations and deformation rates in one muscle were correlated by similar deformations and deformation rates in other neck muscles in the control group, but this interplay between muscles was not found in the WAD group.

National Category
General Practice
Identifiers
urn:nbn:se:uu:diva-238485 (URN)10.1016/j.math.2014.10.006 (DOI)000352769200013 ()25454684 (PubMedID)
Available from: 2014-12-12 Created: 2014-12-12 Last updated: 2018-01-11Bibliographically approved
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