Niclas Olofsson

The impact of preoperative information on state anxiety, postoperative pain and satisfaction with pain management

The primary objective of this study was to test whether specific information given prior to surgery can help patients obtain better pain relief after total knee arthroplasty (TKA). Secondary objectives were to study the impact of preoperative information on state and trait anxiety, satisfaction with pain management and satisfaction with nursing care. The study was an intervention study with two groups of equal size (n=30). The intervention group was given specific information while the control group received routine information. Pain assessments were made preoperatively and every 3h for the first three postoperative days, using the visual analogue scale (VAS). The results of this study suggest that information does influence the experience of pain after surgery and related psychological factors. The postoperative pain declined more rapidly for patients in the treatment group, the degree of preoperative state anxiety was lower and they were more satisfied with the postoperative pain management.

Fear of crime and psychological and physical abuse associated with ill health in a Swedish population aged 65-84 years

OBJECTIVES To assess the association between fear of crime and/or psychological and/or physical abuse in relation to self-reported physical and psychological health, using a large representative sample of elderly women and men in Sweden. STUDY DESIGN Cross-sectional national survey. METHODS Data were taken from a nationwide representative public health survey (2006). Men and women between the ages of 65 and 84 years were selected for the present analyses (4386 men and 4974 women). The response rate for this age group was 59% for men and 70% for women. RESULTS Psychological and physical abuse against elderly women and men led to higher odds ratios for negative health outcomes, independently of socio-economic status. Strong correlation was found between psychological abuse and negative health outcomes in both men and women, while the correlation was less strong for physical abuse, especially among women. The men had high odds ratios for suicidal thoughts and even for attempted suicide in connection with physical and psychological abuse and fear of crime. CONCLUSIONS The study provides representative results addressing an extensive negative health outcome panorama caused by fear of crime and exposure to abuse.

Long-term health consequences of violence exposure in adolescence: a 26–year prospective study

BackgroundViolence victimization represents a serious risk factor for health related symptoms, for both men and women. The aim of this study was to evaluate the long-term effects of violence exposure in late adolescence and early adulthood on adult health, physical as well as mental, using a long-term prospective population-based study, with a follow up of 9, 19, and 26 years.MethodsThe primary data source is a longitudinal panel from one of the longest running social science surveys in the world, the Swedish Level-of-Living surveys (LNU). We analyzed three cohorts, individuals aged 15–19 in 1974 and 1981, and individuals aged 18–19 in 1991 which were followed up 2000. Structured interviews on childhood, family relationships, life-events, living conditions, health history and status, working conditions, behavioral, psychosocial, and demographic variables were repeatedly used in all cohorts.ResultsMultivariate models of violence exposures in adolescence in the 1974–91 cohorts as predictors of adult health in 2000 are reported for both men and women. Women exposed to violence had raised odds ratios for ill health, measured as heavy illness burden, and poor self rated health, after controlling for possible confounders. No such associations were found for men.ConclusionsThis study’s findings provide additional empirical support for the importance of policies and practices to identify and prevent violence exposure in adolescence and young adulthood and to supply treatments for adolescence exposed to violence and above all the young women.

Did a health dialogue matter? Self-reported cardiovascular disease and diabetes 11 years after health screening.

Objective. To study the potential impact of health screening, with or without a motivational health dialogue, on the risk and morbidity of cardiovascular diseases (CVD) and diabetes (DM). Design. Two cross-sectional studies with an interval of 11 years. Setting. The community of Härnösand, Sweden. Subjects. In the first study, 402 men born in 1934, 1944, or 1954 underwent health screening for CVD prevention in 1989. In the second study, 415 men (of the same ages) completed a questionnaire in 2000 (11 years later). Main outcome measures. Odds ratio (OR) for self-reported CVD and DM. Results. The odds ratio of self-reported CVD and DM was more than doubled among participants in the health screening without a health dialogue (OR 2.5; 95% CI 0.8–7.4) and threefold for those not participating (OR 3.0; 95% CI 1.0–8.8) compared with those who reported participation in health screening that included a structured health dialogue. Conclusions. Health screening for the prevention of CVD and DM benefits from inclusion of a structured, motivational health dialogue.

Higher Risk of Violence Exposure in Men and Women With Physical or Sensory Disabilities Results From a Public Health Survey

The World Health Organization has declared that violence is a global public health problem. The prevalence of violence exposure among adults with intellectual and unspecific disabilities has been demonstrated in several studies, whereas only a few articles on people with sensory disabilities have been published. The aim of this study was to investigate the prevalence and risk for exposure to physical violence, psychological offence, or threats of violence in people with physical and/or sensory disabilities, compared with people with no such disabilities, controlling for socioeconomic data. Data from a public health survey were analyzed. A nationally representative sample of women and men aged 16 to 84 years had answered a questionnaire. In the present study, the whole sample, comprised of 25,461 women and 21,545 men, was used. Women with auditory disabilities were generally more often violence exposed than non-disabled women, whereas men with physical disabilities were more often violence exposed than non-impaired men. Some age groups among both women and men with visual disabilities had higher prevalence rates than women and men without disabilities. The adjusted odds ratios (ORs) were significantly higher among the auditory impairment group for exposure to physical (OR = 1.4, confidence interval [CI] = [1.1, 1.9]) and psychological (OR = 1.4, CI = [1.1, 1.8]) violence among women. Men with physical disabilities had raised odds ratios for physical violence (OR = 1.7, CI = [1.2, 2.4]) and psychological violence (OR = 1.4, CI = [1.0, 2.0]) compared with the non-disabled group. Both men and women with a physical or sensory disability showed higher odds of being exposed to violence than men and women without a disability. The results indicated that socioeconomic situation, smoking, and hazardous drinking strengthened the association between impairment and violence.

Violence victimisation—a watershed for young women’s mental and physical health

Purpose: The association between victimisation and adverse health in children is well established but few studies have addressed the effect of victimisation, especially multiple victimisations, in older adolescents and young adults. The aim of this study was to assess self-reported health in young women (15–22 years) victimised to one or more types of violence, compared with non-victimised. Methods: Young women visiting youth health centres in Sweden answered a questionnaire constructed from standardised instruments addressing violence victimisation (emotional, physical, sexual and family violence), socio-demographics, substance use and physical and mental health. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and attributable risk (AR) were assessed. Results: Of 1051 women (73% of eligible women), 25% were lifetime victims of one type of violence and 31% of two or more types of violence. Sexual-minority young women were more victimised than heterosexual women. Violence victimisation increased the risk for adverse health outcomes, especially evident for those multiply victimised. Victims of two or more types of violence had AOR 11.8 (CI 6.9–20.1) for post-traumatic stress symptoms, 6.3 (CI 3.9–10.2) for anxiety symptoms and 10.8 (CI 5.2–22.5) for suicide ideation. The AR of victimisation accounted for 41% of post-traumatic stress symptoms, 30% of anxiety symptoms and 27% of suicide ideation. Stratified analyses showed that lower economic resources did not influence health negatively for non-victimised, whereas it multiplicatively reinforced ill-health when combined with violence victimisation. Conclusion: Violence victimisation, and particularly multiple victimisations, was strongly associated with mental ill-health in young women, especially evident in those with low economic resources.

Transitions in the Swedish school system and the impact on student’s positive self-reported-health

BackgroundTo explore three school based transitions and their impact on positive self- reported- health (SRH), pre-school to elementary school (6–10 y), elementary school to junior high school (10-13y), and junior high school to upper secondary school/high school (13-16y), in a long-term longitudinal population based study.MethodsThe study followed three cohorts through one school transition each.A longitudinal study with data from 6693 Health Dialogue questionnaires were used. Data were collected in the middle of Sweden during 2007–2012 with school children age 6–16 years old.ResultsSeveral significant factors were identified with an impact for a positive self-reported-health among children age 6-16y; not feeling sad or depressed, afraid or worried, positive school environment (schoolyard and restrooms), not bullied, good sleep, daily physical activity and ability to concentrate. There was no single factor identified, the factors differed according to gender and age.ConclusionThe study have identified several gender and age specific factors for successful school transitions relevant for a positive SRH. This is valuable information for school staff, parents and school children and provides a possibility to provide support and assistance when needed.

Violence Against Young Men and Women A Vital Health Issue

Objectives: Violence is regarded as a major health issue in an increasing amount of literature and is known as an important factor in womens ill health. Little however is known about violence against young men and women and its impact on their health. The principal aim of this study was to analyze health outcomes and health care utilization as reported among men and women aged 18-25 exposed and not exposed to physical and/or emotional violence. Study design: A cross-sectional national health survey in Sweden. Methods: Postal questionnaires were sent to nearly 3,000 men and women. Three questions were used to ask about violence. Sociodemographic characteristics for those exposed to violence during the past 12 months were analyzed and compared to those not exposed. Crude and adjusted odds ratios were calculated for health outcomes and medical care utilization. Results: Increased odds ratios were found for most health outcomes, and health care utilization for those exposed to violence compared to non-exposed. After adjusting for socioeconomic factors, smoking, and use of alcohol and cannabis, most variables were principally unchanged for women but considerably lower for men. Socioeconomic factors, smoking, and the use of drugs were all correlated to victimization. Conclusions: A strong association between those exposed to violence and physical and mental ill health was demonstrated also after adjusting for possible confounders, specifically for women. It is time to include questions about violence in public health questionnaires aimed at young people, but also to start asking about it more frequently in health care settings.