H. Ingemar Andersson

The course of non-malignant chronic pain: a 12-year follow-up of a cohort from the general population.

The high prevalence of chronic pain (duration >3 months) reported from different populations indicates a public health problem. Knowledge of the long‐term course of chronic non‐malignant pain is incomplete and scarce.

Widespread musculoskeletal chronic pain associated with smoking : an epidemiological study in a general rural population

Data on smoking and pain symptoms from a random sample (n = 1806) of a general population were used to evaluate the association between chronic pain at various locations and smoking. In both genders current smoking was associated with reports of increased pain in low back, neck and with multiple locations. In a multiple logistic regression analysis current smoking was associated with an increase in widespread chronic musculoskeletal pain (OR 1.60, CI 1.04-2.46, in relation to non-smokers) and chronic low back pain (OR 1.58, CI 1.13-2.20, in relation to non-smokers). A dose-response relationship was found between the daily cigarette consumption and the prevalence of chronic low back pain. Smoking is associated not only with low back pain but also with chronic widespread musculoskeletal pain. No conclusive decrease in pain prevalence was found after quitting smoking. Further studies are necessary to elucidate an aetiologic relationship between smoking and chronic pain.

Increased mortality among individuals with chronic widespread pain relates to lifestyle factors: A prospective population-based study

Purpose. Widespread chronic pain has been related to disability and loss of quality of life, but in a few epidemiological studies also to increased mortality. The aim of this study was to further investigate the relationship between chronic pain, lifestyle factors and all cause mortality. Methods. A random sample of an adult (age 25–74) Swedish population (n = 1609) responded to a comprehensive questionnaire on pain, other symptoms, lifestyle, work and socioeconomic factors in 1988. Mortality data for this cohort between 1988 and 2002 were analysed. Survival analysis (Kaplan–Meier) and Cox proportional regression were used to study initially reported factors influencing survival. Results. Individuals with widespread chronic pain showed an increased mortality risk (hazard ratio, HR = 1.95, CI: 1.26–3.03) compared to the group without chronic pain. Death due to cardiovascular disease accounted for the increased mortality. Adjustment for lifestyle factors eliminated the excess risk. Conclusions. Increased mortality among individuals with widespread chronic pain is related to factors like smoking, sleep disturbances and low physical activity. The result emphasises the importance of including lifestyle factors in a cognitive-behavioural rehabilitation process. It remains to be shown whether health promotion activities aimed at lifestyle could change mortality among individuals with chronic pain.

Development and quality analysis of the Salutogenic Health Indicator Scale (SHIS)

Background: Current health measurement instruments tend to measure aspects of ill-health rather than health in general. There is a need for a salutogenic perspective when describing health and developing a health measurement instrument. The aim of this article is to present the development process and quality assessment of a salutogenic health indicator scale. Methods: A description of health, emanating from the concept of health, positive health and well-being, was used as a basis for the construction of the scale. The scale is a semantic differential consisting of 12 indicator items covering nine heath-related dimensions. A principal component analysis was performed, and three health indicator indexes were constructed. Correlation with self-rated health questions was investigated, weighted kappa values were calculated, and Cronbachs alpha (CA) was used to check internal consistency. Results: The analysis resulted in a two-factor model, and the indexes were named intrapersonal characteristics (CA= 0.90) and interactive function (CA= 0.84), summarised into health complete (CA= 0.92). Kappa values ranged from 0.44 to 0.67, and correlations with self-rated health status were stronger than those with self-rated sick-leave. Conclusions: Our health description was characterized by complexity, but the instrument is a short salutogenic health indicator scale. The shortness increases the usability. The instrument seems to be able to offset the current problem of there being a lack of salutogenic health measurement instruments. The results indicate that further testing is justified.

Characteristics of disability pensioners returning to work: an interview study among individuals with musculoskeletal disorders.

Purpose. To explore adaptation patterns among disability pensioners with musculoskeletal disorders returning to work by means of the Swedish law on ‘resting disability pension’. Method. Qualitative analyses of interviews with 17 individuals going back to work. Results. Three adaptation patterns were identified: The Go-getter, the Realist and the Indifferent. These differed regarding influence factors, own expectations, motive, morals and mentality. Conclusion. Several actors may support a return to work for individuals who received a disability pension due to musculoskeletal disorders. In order to succeed, however, it is essential that the disability pensioner is motivated for a reconstruction of his/her life.

Positive work experience factors relate to salutogenic health-a survey among Swedish hospital employees

Positive work experience factors relate to salutogenic health-a survey among Swedish hospital employeesLarge scale surveys show that perceived stress and stress-related complaints are common among young people. Perceived stress increase with age and are more common in girls than boys, resulting in l ...

Salutogenetic and pathogenetic factors of equal importance to predict mortality in a Swedish general population

Social support and physical exercise seem to be salutogenetic factors of importance for longterm survival to balance traditional risk factors such as smoking and defined diseases. The results suppo ...