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Biomedical subjects

H Westerlund

Publications and source records attributed to H Westerlund.

6 recordsLinked to original sources
PubMed2003

Downsizing of staff is associated with lowered medically certified sick leave in female employees.

AIM: To determine whether changes in number of staff in work sites are associated with medically certified sick leave among employees with an increased risk of developing cardiovascular disease. METHODS: The 5720 employees (aged 18-65) were from the WOLF study of cardiovascular risk factors in working men and women in greater Stockholm during the years 1992-95. From the medical examination a cardiovascular score was calculated for each participant. The WOLF study base was linked to a Statistics Sweden registry of economic and administrative activities. Sick leave spells lasting for at least 15 days during the calendar year following downsizing/expansion were identified for each subject. RESULTS: In multiple logistic regression an increased likelihood of having no medically certified sick leave (15 days or more) was found in women during the year following both downsizing and expansion. These analyses were adjusted for age and cardiovascular score. A high cardiovascular risk score reduced the likelihood of having no medically certified sick leave. The inclusion of psychosocial work environment variables did not change the results markedly. Separate analyses of women with and without high cardiovascular score showed that downsizing had a more pronounced effect on reduced long term sick leave among those with high than among those without low cardiovascular score. There were no consistent findings in men. CONCLUSIONS: There is evidence of a reduction of long term sick leave in women after downsizing and this is particularly evident among those with high cardiovascular score.

Adolescent↗
PubMed2001

Psychophysiological effects of temporary alternative employment.

Twenty-one participants in a mobilising labour market project offering temporary, alternative employment in Sweden were followed longitudinally for one year, including a six month post-participation follow-up period. Earlier analyses of self-rated psychosocial data have indicated consistent improvements in mental health and quality of life. In the present study, however, a significant rise in serum prolactin, plus decreased dehydro-epiandro-sterone sulphate levels and tendencies towards increased alanine aminotransferase, gamma-glutamyl transferase and diastolic blood pressure, seem to disconfirm the hypothesis that biological markers of psychosocial health would improve in a similar fashion. It is speculated that this apparent inconsistency could be part of a protective adaptation to long-term unemployment similar to the cocooning tendencies in maternal behaviour. Specifically, we argue that this could protect against the stress of being in an uncontrollable and 'helpless' situation by facilitating a re-focusing on more private matters as opposed to 'hopeless' job seeking. While being potentially detrimental for people with fair chances on the labour market, it is possible that such an adaptation may be helpful for more vulnerable groups.

Adaptation, Psychological↗
PubMed1999

Unemployment, labour market policy and health in Sweden during years of crisis in the 1990's.

OBJECTIVE: To give an overview of an economic crisis in Sweden and its health consequences for employed and unemployed groups together with some health-related data from participants in labour market programmes. OUTCOME AND CONCLUSIONS: During the first half of the 1990's, Sweden was hit by a pervasive crises characterised by steeply increasing unemployment and growing job insecurity. Long-term survey data show that somatic well-being continued to improve in the population, while psychological well-being deteriorated, and this deterioration was of a similar magnitude among unemployed and employed groups. Two non-traditional labour market programmes for unemployed individuals are briefly described. Both programmes resulted in some positive effects on subjective health, which, however, were not corroborated by psychophysiological data. It is argued that the employment-unemployment dichotomy can be replaced by a dimensional view on labour market connection, as insecure jobs may have as detrimental health effects as open unemployment. Impediments to empowerment in the labour market programmes are discussed.

Health Status↗
PubMed1998

Emotional distress before coronary bypass grafting limits the benefits of surgery.

BACKGROUND: The inclusion of large, heterogeneous groups of patients for coronary bypass grafting (CABG) surgery has resulted in a more mixed treatment outcome. Thus it becomes important to identify patients who are less likely to benefit from surgery or who may require additional support to improve treatment outcome. The aim of the present study was to examine whether psychological status measured before CABG can contribute to prediction of short- and long-term outcomes of the surgery. METHODS AND RESULTS: One hundred seventy-one consecutive patients from two large university hospitals in Stockholm completed a psychosocial questionnaire before being scheduled for surgery. One year after CABG, patients again completed the questionnaire. Follow-up of medical charts was conducted during the first 3 years after surgery. All major cardiac events (cardiac death, definite myocardial infarction, revascularization, and unstable angina verified by angiography or myocardial scintigraphy) were recorded. Although the overall effect of surgery was excellent in the majority of cases, the patients exhibiting a high degree of distress (anxiety, depression, and tiredness) before surgery assessed their status as being much worse both before the operation and at the 1-year follow-up. Equally important was the fact that patients considered distressed before surgery had significantly higher rates of cardiac events (16%) in the 3-year follow-up period compared with nondistressed patients (5%) (chi-square=5.11, degrees of freedom=1, p < 0.02). CONCLUSIONS: Systematic evaluation and treatment of emotional distress in the candidates for coronary revascularization may be expected to result in more optimal subjective results and a reduction in the number of serious cardiac events after surgery.

Adult↗
PubMed1998

Treatment of patients with chronic somatic symptoms by means of art psychotherapy: a process description.

BACKGROUND: Inability to express emotions is common in patients with long-lasting somatic symptoms associated with incapacitation and impaired quality of life. One method for treating this inability is art psychotherapy. In this study the typical course in such treatments is described. Patients were followed longitudinally before therapy and every 4th to 6th month during the treatment. METHODS: Patients with long-lasting psychosomatic conditions resulting in partial or total loss of working capacity for at least 1 year have been treated in the programme. All of them had chronic pain. The majority of the patients that were referred to us were offered treatment. Three-fourths of those who started treatment stayed in treatment as long as the therapist considered it optimal. Twenty-four patients (22 women and 2 men) in the present study had their treatment started on average 2 years (range 13-42 months) before the end of the treatment period. In addition these 24 patients were contacted 6-48 months after the end of the therapy (average 23 months) and a short post-evaluation was made by telephone. RESULTS: The first year of treatment was characterized by emotional turmoil paralleled by increased energy level reflected in temporary elevation of serum uric acid. Significant improvement was observed with regard to anxiety-depression after one year of treatment. A tendency towards decreased levels of psychosomatic symptoms in general was observed after two years of treatment. One-fourth of the 20 non-working or part-time working patients increased their working activity. CONCLUSIONS: A slow partial recovery was observed. Art psychotherapy may have contributed to this.

Adult↗