Ulrika Lindmark

The distribution of ‘‘sense of coherence’’ among Swedish adults : A quantitative cross-sectional population study

Background: Antonovsky’s concept of ‘‘sense of coherence’’ (SOC) has been shown to be related to health. The aim of this study was to describe the distribution of SOC scores and their components in an adult Swedish population aged 20—80 years. Methods: A random sample of 910 individuals from Jönköping, Sweden, aged 20, 30, 40, 50, 60, 70 and 80 years, of which 589 agreed to participate in an oral health examination. The participants answered Antonovsky’s 13-item version of ‘‘the life orientation questionnaire scale’’. The response to the items and the distribution of the three components of comprehensibility, manageability and meaningfulness were analyzed for different age groups and genders using mean values and standard deviations, Student’s t-test and ANOVA. Results: A total of 526 individuals, 263 men and 263 women, answered all 13 questions and constituted the final material for the study (response rate 89%). The individual SOC score increased with age. The 20 year olds had a statistically significantly lower SOC score compared with the other age groups and 55% of them had a low SOC (≤66 points) compared with 17% of the 80 year olds. Men in the 60 and 70 year age groups had a statistically significantly higher SOC score compared with women of the same age. Conclusions: The individual distribution of SOC varied with age and gender. Twenty year olds had a significantly lower SOC score compared with elderly age groups. Elderly men had a statistically significantly higher SOC score compared with women of the same age.

Sense of coherence and its relationship with oral health–related behaviour and knowledge of and attitudes towards oral health

OBJECTIVE To investigate the relationship between sense of coherence (SOC), oral health-related behaviour, knowledge of and attitudes towards oral health in an adult Swedish population. METHODS A cross-sectional design with a stratified random sample of 910 individuals aged 20, 30, 40, 50, 60, 70 and 80 years were invited to the study, from Jönköping, Sweden. The investigation used the Swedish short version of the SOC questionnaire comprising 13 items and self-reported questions about oral health habits and knowledge of and attitudes towards oral health. In addition, a self-report questionnaire to elicit demographic information was included. RESULTS A total of 525 individuals, 261 men and 264 women, answered all the 13-item SOC questions, which constituted the final number of the participants. After adjustment for all the sociodemographic factors included in the analysis, individuals with a stronger SOC had twice as high a chance of having healthier behaviour, including a lower frequency of snacks and drinks between meals, as well as a more positive attitude, such as the importance of having ones own teeth as one gets older, satisfaction with their own teeth, perceiving their teeth as good and no feeling of dental fear, compared with individuals with a poorer SOC. Moreover, SOC and a good knowledge of caries were significantly associated after adjustment for age and gender. CONCLUSIONS SOC was significantly associated with several oral health-related behaviours, attitudes towards oral health and knowledge of dental caries. When working with oral health promotion, SOC could be a way for promoting a better understanding of the behaviour and attitudes of individuals and for enabling dental personals to use that knowledge for the guidance of the individual.

Sense of coherence and oral health status in an adult Swedish population

Abstract Objective . To investigate sense of coherence in relation to oral health status in an adult Swedish population in order to better understand the determinants of positive oral health-promoting behavior and differences in oral health. Material and methods . A stratified random sample of 910 individuals from Jönköping, Sweden aged 20, 30, 40, 50, 60, 70 and 80 years was obtained. The investigation used the Swedish short version of the Sense of Coherence (SOC) questionnaire comprising 13 items and a self-report questionnaire to elicit demographic information. In addition, a clinical and radiographic oral examination was performed. Results. A total of 525 individuals, 261 men and 264 women, consented to participate in the study. Bivariate analysis revealed that higher mean SOC scores were statistically significantly associated with more decayed and filled surfaces (DFS) and filled surfaces (FS), fewer decayed surfaces (DS), fewer teeth with calculus and periodontal health. Multivariate analysis showed that higher SOC scores represented a predictor of fewer occurrences of a periodontal probing pocket depth of ≥4 mm and a lower risk of plaque in different regression models. Conclusions. Higher SOC scores may be a protective determinant of plaque and periodontal disease, indicating an association between SOC and oral health.

Mechanical massage and mental training programmes affect employees’ anxiety, stress susceptibility and detachment–a randomised explorative pilot study

BackgroundWorking people’s reduced ability to recover has been proposed as a key factor behind the increase in stress-related health problems. One not yet evidence-based preventive method designed to help employees keep healthy and be less stressed is an armchair with built-in mechanical massage and mental training programmes, This study aimed to evaluate possible effects on employees’ experience of levels of “Anxiety”, “Stress Susceptibility”, “Detachment” and “Social Desirability” when using mechanical massage and mental training programmes, both separately and in combination, during working hours.MethodsEmployees from four different workplaces were randomly assigned to one of the following groups: i) Massage and mental training (sitting in the armchair and receiving mechanical massage while listening to the mental training programmes, n = 19), ii) Massage (sitting in the armchair and receiving mechanical massage only, n = 19), iii) Mental training (sitting in the armchair and listening to the mental training programmes only, n = 19), iv) Pause (sitting in the armchair but not receiving mechanical massage or listening to the mental training programmes, n = 19), v) Control (not sitting in the armchair at all, n = 17). In order to discover how the employees felt about their own health they were asked to respond to statements from the ”Swedish Scale of Personality” (SSP), immediately before the randomisation, after four weeks and after eight weeks (end-of-study).ResultsThere were no significant differences between the five study groups for any of the traits studied (“Somatic Trait Anxiety”, “Psychic Trait Anxiety”, “Stress Susceptibility”, “Detachment” and “Social Desirability”) at any of the occasions. However, the massage group showed a significant decrease in the subscale “Somatic Trait Anxiety” (p = 0.032), during the entire study period. Significant decreases in the same subscale were also observed in the pause group between start and week eight (p = 0.040) as well as between week four and week eight (p = 0.049) and also in the control group between the second and third data collection (p = 0.014). The massage and mental training group showed a significant decrease in “Stress Susceptibility” between week four and week eight (p = 0.022). The pause group showed a significant increase in the subscale “Detachment” (p = 0.044).ConclusionsThere were no significant differences between the five study groups for any of the traits studied. However, when looking at each individual group separately, positive effects in their levels of “Anxiety”, “Stress Susceptibility” and “Detachment” could be seen. Although the results from this pilot study indicate some positive effects, mechanical chair massage and mental training programmes used in order to increase employee’s ability to recover, needs to be evaluated further as tools to increase the employees ability to recover.Australian New Zealand clinical trials registryACTRN12615000020583, Date of registration: 15/01/2015.

Oral Health Status of Older Adults in Sweden Receiving Elder Care Findings From Nursing Assessments

BackgroundFrail elderly people often have poor oral hygiene, contributing to oral health problems that can detract significantly from quality of life. ObjectiveThe aim of this study was to describe oral health status of frail elderly individuals using the Revised Oral Assessment Guide-Jönköping (ROAG-J), a mouth assessment instrument that can be used in daily nursing care. MethodsData were obtained from the Swedish Senior Alert quality registry in one Swedish municipality. ROAG-J assessments on admission to elder care and one subsequent occasion were used. ROAG-J measurements documented oral health in nine areas: voice, lips, oral mucosa, tongue, gums, teeth, saliva, swallowing, and presence of any prostheses or implants. Assessments were made by nursing staff during the course of daily nursing care. ResultsIndividuals 65 years of age or older and receiving elder care services (N = 667) were involved; 1,904 assessments made between November 2011 and March 2014 were used for the analysis. On the basis of both assessments, less than one third of participants had oral health problems. No significant difference in any of the oral health variables was found between first and subsequent assessments. At first assessment, men and women differed in tongue health (p < .01); at the subsequent assessment, gender differences in voice (p < .05), mucous membranes (p < .003), tongue (p < .01), and saliva (p < .006) were observed. DiscussionMost participants had good oral health. Assessments made by nursing staff using the ROAG-J demonstrate that this tool can be used in daily nursing care, where different, important oral conditions may be encountered. However, knowledge about oral health conditions and the ROAG-J instrument is important to ensure high validity. The ROAG-J enables nursing staff to detect problems in the mouth and to guide decisions related to oral health interventions.

Changes in division of labour and tasks within public dentistry: relationship to employees work demands, health and work ability.

Abstract Objective: By 2023, fewer dentists are expected in Sweden, at the same time as the demand for dental care is expected to increase. Older people, in particular, are expected to require more dental health than previous generations. To meet this demand, the public sector dentistry in Sweden is moving towards changes in division of labour among dental professionals, including dentists, dental hygienists and dental nurses. However, the impact of this reallocation on the physical and psychosocial wellbeing of employees is unknown. The aim of this study was to compare workplaces with an equal or larger proportion of dental hygienists than dentists (HDH) with workplaces with a larger proportion of dentists than dental hygienists (HD) on the physical and psychosocial work load, musculoskeletal and psychosomatic disorders and sickness presence. Material: A total of 298 persons employed in the Public Dental Service in a Swedish County Council participated in this study. Conclusion: The medium large clinics HDH reported 85% of employee’s with considerably more high psychosocial demands compared to employees in medium HD (53%) and large HD (57%). Employees in medium large clinics HDH also reported sleep problems due to work (25%) compared with employees in medium large clinics HD (6%), large clinics HD (11%) and small clinics HDH (3%). Clinic size does not seem to influence the outcome of the HD and HD clinics to any great extent. Of all employees, about 94–100% reported high precision demands and 78–91% poor work postures.

Occupational balance in health professionals in Sweden

Abstract Background: Health care employees are often women, a group that has high degrees of sick leave and perhaps problems attaining occupational balance. However, people think differently about their everyday activities and it is therefore important to take their perceptions into account but occupational balance has not yet been measured in health professionals. The aim was to describe occupational balance in three different samples of health professionals in Sweden. A further aim was to investigate whether occupational therapists (OTs) rate their occupational balance differently from other health professionals. Material and method: Four hundred and eighty-two health professionals, employees in public dentistry, mental health care and OTs, aged 21–70 years participated. The participants’ occupational balance was measured using the occupational balance questionnaire (OBQ). Results: The ratings of occupational balance were similar to earlier studies and did not differ significantly between the samples. The OTs’ occupational balance was also similar to that of the other health professionals. Conclusion: The similarities in occupational balance indicate the same difficulties in attaining it. Significance: The result highlights the possibility that working people face similar difficulties in achieving occupational balance. Further research is warranted about how to attain it.

Workplace health in dental care – a salutogenic approach

Abstract Objective The purpose was to explore self‐reported psychosocial health and work environments among different dental occupations and workplaces from a salutogenic perspective. A further purpose was to analyse possible associations between three salutogenic measurements: The Sense of Coherence questionnaire (SOC), the Salutogenic Health Indicator Scale (SHIS) and the Work Experience Measurement Scale (WEMS). Methods Employees in the Public Dental Service in a Swedish county council (n = 486) were invited to respond to a self‐reported web survey including demographics, work‐related factors, the SOC, the SHIS and the WEMS. Results This study showed positive associations between employee characteristics and self‐reported overall psychosocial health as well as experienced work environment. Autonomy was reported more among men than women (P < 0.000) and to a higher degree by dentists and dental hygienists than dental nurses (P < 0.000). Meaningfulness, happiness, job satisfaction, autonomy and positive to reorganization were reported by personnels aged less than 40 years (P ≤ 0.047). Clinical coordinators reported significant better health (SOC, SHIS) and experienced more autonomy, better management and more positive to reorganization than other dental professions. Dental hygienists and nurses experienced less time pressure than dentists (P ≤ 0.007). Better health and positive work experiences were also seen in smaller clinics (P ≤ 0.29). Conclusion Dental professionals reported a high degree of overall psychosocial health as well as a positive work experience. Some variations could be seen between employee characteristics such as gender, years in dental care, professionals, managing position and workplace size. Identify resources and processes at each workplace are important and should be included in the employees/employers dialogue.

Sense of coherence of reindeer herders and other Samis in comparison to other Swedish citizens

Background Samis are indigenous people in north Europe. In the territory called Sápmi (Lapland), reindeer herding is the traditional base for the Sami economy. The relation between living conditions and positive health of the Swedish Samis has been sparsely studied. As health is closely linked to sense of coherence (SOC), an understanding of the background factors to SOC may contribute knowledge that might be useful in promoting living conditions and health. Methods The study examines relations between the level of SOC and background factors from surveys in a Sami population (n=613) in comparison to a non-Sami population (n=525) in Sweden, and in comparison between 2 subsamples of Samis, that is, herders and non-herders. Results There are more similarities than differences between the Sami and non-Sami populations. However, dividing the Sami population, reindeer herders had significantly lower SOC, and in specific the subcomponent manageability, that is, less ability to use available resources to meet different demands in life, compared to non-herders. Conclusions In addition to age and health, predictors of SOC are related to the life form of reindeer husbandry and the belonging to the herding community.