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Biomedical subjects

Hege R Eriksen

Publications and source records attributed to Hege R Eriksen.

At least 19 recordsLinked to original sources
PubMed2007

Motivating disability pensioners with back pain to return to work--a randomized controlled trial.

OBJECTIVE: To investigate the outcome of a brief vocational-oriented intervention aiming to motivate disability pensioners with back pain to return to work, and to evaluate prognostic factors for having entered a return to work process during the following year. DESIGN: A randomized controlled trial was conducted. SUBJECTS: Participants (n = 89) (mean age 49 years, 65% women) who had received disability pension for more than one year were randomized into an intervention group (education, reassurance, motivation, vocational counselling, n = 45) and a control group (n = 44). METHODS: Primary outcome measures were return to work or having entered a return to work process. Secondary outcome measures were life satisfaction, disability, fear avoidance behaviour and expectancy. RESULTS: The intervention had no statistically significant effect on return to work or having entered a return to work process at 1-year follow-up. Twice as many in the intervention group (n = 10, 22%) had entered a return to work process compared with the controls (n = 5, 11%). The number needed to treat was 9.2 (95% confidence interval (CI) = 3.4, Inf). Only minor differences in secondary outcome measures were demonstrated. Positive expectancy, better physical performance and less pain were related to return to work. CONCLUSION: The effort of returning disability pensioners to work by a brief vocational-oriented intervention may be of clinical relevance. The effect needs to be explored further in larger samples of disability pensioners.

Adult↗
PubMed2006

Health complaints and sickness absence in Norway, 1996-2003.

BACKGROUND: From 1996 to 2003, the total number of sickness absence days increased by 65% in Norway. AIM: To investigate if this could be explained by a corresponding increase in the prevalence of self-reported health complaints in the same period. METHODS: Representative samples of the Norwegian working population in 1996 (n = 838) and 2003 (n = 637) answered the subjective health complaints (SHC) questionnaire. The single items of the SHC questionnaire were matched with the corresponding sickness absence statistics from the National Insurance Administration in 1996 and 2003. RESULTS: The main finding was a poor concordance between the change in prevalence of health complaints and the change in the prevalence of sickness absence for diagnoses corresponding to these complaints. The prevalence of health complaints in Norway was high and relatively stable from 1996 to 2003. The only complaints that increased in prevalence during the period were allergy and severe asthma. Sickness absence for health complaints, however, showed a general increase. The diagnoses with the largest percentage increase in sickness absence were sleep problems, tiredness, anxiety and palpitation, although the absolute number of individuals with sickness absence for these complaints was small. CONCLUSIONS: The increased sickness absence in Norway from 1996 to 2003 cannot be explained by an increase in health complaints in the general population in the same period. The increase in sickness absence is most likely to be explained by multifactorial causes, such as changes in working life and health expectations.

Absenteeism↗
PubMed2006

Comorbid subjective health complaints in low back pain.

STUDY DESIGN: Cross-sectional study. OBJECTIVES: To compare subjective health complaints in subacute patients with low back pain with reference values from a Norwegian normal population. SUMMARY OF BACKGROUND DATA: Comorbidity is common with nonspecific low back pain. We wanted to investigate if these complaints were specific or part of a more general unspecific condition comparable to subjective health complaints in the normal population. MATERIALS AND METHODS: The study group consisted of 457 patients sick-listed 8 to 12 weeks for low back pain. All subjects filled out questionnaires. The subjective health complaints in the study group were compared with reference values from a Norwegian normal population using logistic regression analysis. RESULTS: Compared with the normal reference population, the patients with low back pain had significantly more low back pain, neck pain, upper back pain, pain in the feet during exercise, headache, migraine, sleep problems, flushes/heat sensations, anxiety, and sadness/depression. The prevalence of pain in arms, pain in shoulders, and tiredness was also high, but not significantly higher than in the reference population. CONCLUSIONS: Our findings indicate that patients with low back pain suffer from what may be referred to as a "syndrome," consisting of muscle pain located to the whole spine as well as to legs and head, and accompanying sleep problems, anxiety, and sadness/depression.

Adult↗
PubMed2006

Prevalence of low back pain and sickness absence: a "borderline" study in Norway and Sweden.

AIMS: Low back pain (LBP) is a major public health problem in both Norway and Sweden. The aim of the study was to estimate the prevalence of LBP and sickness absence due to LBP in two neighbouring regions in Norway and Sweden. The two areas have similar socioeconomic status, but differ in health benefit systems. METHODS: A representative sample of 1,988 adults in Norway and 2,006 in Sweden completed questionnaires concerning LBP during 1999 and 2000. For this study only individuals in part or full time jobs, (n = 1,158 in Norway and n = 1,129 in Sweden) were included. RESULTS: In Norway the lifetime prevalence was 60.7% and in Sweden 69.6%, the one-year prevalence was 40.5% and 47.2%, and the point prevalence 13.4% and 18.2% respectively. There was a significantly higher risk of reporting LBP in Sweden, even after controlling for gender, age, education, and physical workload. There was no difference in risk of self-certified short-term sickness absence (1-3 days), but it was a 40% lower risk of sickness absence with medical sickness certification in Sweden compared with Norway. CONCLUSION: The prevalence of LBP was higher in the Swedish area than in the Norwegian. The risk of self-certified sickness absence, however, showed no differences and the risk of medically certified sickness absence was lower in the Swedish area. This contradiction might partly be explained by the economical "disincentives" in the Swedish health compensation system.

Adult↗
PubMed2006

The relations between psychosocial factors at work and health status among workers in home care organizations.

A considerable proportion of sickness absence and disability pension is caused by subjective health complaints, especially low back pain (LBP). In recent years focus has been on psychosocial characteristics of work as potential risk factors. The aim of this study is to examine the relations between psychosocial work aspects and subjective health complaints, LBP, and need for recovery. A total of 779 employees working in home care participated in a cross-sectional study. Higher psychological demands were associated with subjective health complaints and need for recovery. However, decision authority, skill discretion, and the 2 aspects of social support did not seem to be important factors. Higher psychological demands do not seem to be associated with severity of LBP, but does show an association with sick leave.

Adolescent↗
PubMed2005

Predictors and modifiers of treatment effect influencing sick leave in subacute low back pain patients.

STUDY DESIGN: Modifying effects in multivariate analyses of a randomized controlled trial. OBJECTIVES: To identify prognostic factors for the effect of a brief intervention ("modifiers") at a spine clinic on return to work in patients with subacute low back pain. SUMMARY OF BACKGROUND DATA: A previous study of a brief intervention showed significant reduction of sick leave, compared with usual primary healthcare treatment. Randomized controlled trials give data only on the group as an average. Identifying prognostic factors that interact with the treatment ("modifiers") may identify specific groups requiring this or other types of treatment. METHODS: A total of 457 patients who had been sick-listed 8 to 12 weeks for low back pain were randomized into an intervention group (spine clinic with medical examination, information, reassurance, encouragement to engage in physical activity, n = 237), and a control group (primary health care, n = 220). All subjects filled out questionnaires. Logistic regression and tests for interaction were used to identify prognostic factors and modifiers for return to work in the two groups, at 3 and 12 months of follow-up. RESULTS: At 3 months of follow-up, the strongest modifying effect on return to work was the perception of constant back strain when working and beliefs about reduced ability to work. At 12 months, gastrointestinal complaints were the strongest modifier for the effect of the intervention. CONCLUSION: The spine clinic intervention seems to have a main effect on work absenteeism via interacting with the concerns of being unable to work.

Adolescent↗
PubMed2005

Subjective health complaints and modern health worries in patients with subjective food hypersensitivity.

Perceived food hypersensitivity is much more common than food allergy as medically verified. Unexplained symptoms and wrong attribution are typical in subjective health complaints. We hypothesize that subjective health complaints and worries are abnormally prevalent among patients with subjective food hypersensitivity. Forty-six patients with subjective food hypersensitivity and two control groups, one formed by 50 health care workers and one by 70 sex- and age-matched volunteers from the general population, were included in our study. All filled in two questionnaires: Subjective Health Complaints Inventory and Modern Health Worries Scale. None of the patients had IgE-mediated food allergy. The patients scored significantly higher than the controls on sum scores for four domains of subjective health complaints, including gastrointestinal complaints (P < 0.001), musculoskeletal complaints (P < 0.01), "pseudoneurology" (P < 0.001), and allergy (P < 0.001). Sum scores on modern health worries did not differ significantly between groups. The results support our hypothesis of an association between subjective food hypersensitivity and subjective health complaints, corroborating the view that, in the absence of food allergy, the conditions are sharing pathogenetic mechanisms.

Adult↗
PubMed2005

Neurasthenia, subjective health complaints and sensitization.

Patients (n=997) visiting general practitioners in an area in Western Norway completed a battery of questionnaires related to subjective health complaints and fatigue. An additional 78 patients were referred directly to the hospital for neurasthenia. After screening the questionnaires and interviews with a selected sample, a total of 73 patients were finally accepted as 'neurasthenia' patients satisfying the ICD-10 diagnosis. These patients were compared with the remaining 1002 patients. Patients with neurasthenia had more prevalent and more severe subjective health complaints, particularly pseudoneurological and musculoskeletal complaints than the reference population of patients. They reported low levels of instrumental coping and poorer physical fitness, in spite of a comparable level of self reported physical activity and exercise. Women were over-represented in this group. This overall higher score on subjective complaints from all organ systems is in accordance with the hypothesis of an overall and general sensitization to the afferent inputs from their psychophysiological systems.

Adaptation, Psychological↗
PubMed2005

Cognitive activation theory of stress (CATS): from fish brains to the Olympics.

The Cognitive Activation Theory of Stress (CATS) offers formal and systematic definitions of the terms and concepts used in stress research. The stress response depends on acquired expectancies to the outcome of the stimulus and the available responses. The stress response itself is an alarm, an increase in arousal necessary for performance and adequate reactions to challenges. The response is healthy and necessary for survival. Only when sustained over time may potential health risks occur. The basic rules for when stress occurs are the same across cultures and species, from fish to Olympic performance in humans. The important dimensions for health are positive expectancies of outcome (coping), control, and safety, for all individuals in all species.

Animals↗
PubMed2005

Myths and perceptions of back pain in the Norwegian population, before and after the introduction of guidelines for acute back pain.

AIM: Deyo's seven "myths" about back pain are based on common misconceptions of causality and therapy of back pain. These myths were alive in the Norwegian population in 2001; this report investigates whether this is true two years later. METHODS: A representative sample of the Norwegian population in 2003 (n = 1,014) were asked to rate their agreement with the seven myths. RESULTS: There is significantly less acceptance of all myths except "Most back pain is caused by injuries or heavy lifting" in 2003. Myths concerning the use and importance of X-ray were still common: 43% agreed that "X-ray and newer imaging tests can always identify the cause of pain" and 50% that "Everyone with back pain should have a spine X-ray". Low level of education is still associated with high acceptance of the myths, but the changes from 2001 are most pronounced for these groups. CONCLUSION: Perceptions in the general population in Norway are slowly changing to be more in accordance with existing knowledge on accurate behaviour and treatment of back pain. This may be related to introduction of new evidence-based guidelines. The difference between educational groups is reduced, but is still a challenge to health professionals and health authorities.

Acute Disease↗
PubMed2005

Effect of a brief cognitive training programme in patients with long-lasting back pain evaluated as unfit for surgery.

The aim of the study was to evaluate the effect of cognitive intervention (information and physical exercise), on patients with long-lasting back pain referred for surgical evaluation at an orthopaedic hospital, but evaluated as unfit for surgery. One hundred and fifty-two patients were randomized to a five days intervention or control. The intervention had no significant effects on pain. At three-month follow-up, the patients in the intervention group used significantly more active strategies to cope with the back pain compared to the control group. This effect seemed to increase over time, being more pronounced at one-year follow-up evaluation.

Adult↗
PubMed2004

The "myths" of low back pain: status quo in norwegian general practitioners and physiotherapists.

BACKGROUND: In 2001, several myths of low back pain still were alive in the general population in Norway, myths that were not in concordance with current guidelines. OBJECTIVES: To investigate perceptions about back pain in Norwegian general practitioners and physiotherapists and to compare these with perceptions in the general population. METHODS: During June 2001, 436 general practitioners (mean age 44.8, range 26-69 years) and 311 physiotherapists (mean age 47.6, range 25-70) were asked to rate their agreement with 7 statements, corresponding to Deyo's 7 myths that formulate 7 common misbeliefs on back pain. The corresponding data from the general population of 807 individuals (mean age 45.5, range 25-70) were sampled during early spring 2001. RESULTS: There were significant differences between the general population, general practitioners, and physiotherapists for all myths, the general population being more likely to agree with all myths. The differences were maintained even after controlling for educational level in the general population. There were no differences between general practitioners and physiotherapists except for the myths "radiographs and newer imaging tests can always identify the cause of pain" and "back pain is usually disabling," whereas general practitioners were less likely to disagree with the myths. Few gender and age differences were found in the professional groups. CONCLUSION: In Norwegian general practitioners and physiotherapists, Deyo's 7 myths mostly seem to be dead and buried. However, it does not seem that this has extended to the public yet, as many myths still are alive in the general population.

Adult↗
PubMed2004

The cognitive activation theory of stress.

This paper presents a cognitive activation theory of stress (CATS), with a formal system of systematic definitions. The term "stress" is used for four aspects of "stress", stress stimuli, stress experience, the non-specific, general stress response, and experience of the stress response. These four meanings may be measured separately. The stress response is a general alarm in a homeostatic system, producing general and unspecific neurophysiological activation from one level of arousal to more arousal. The stress response occurs whenever there is something missing, for instance a homeostatic imbalance, or a threat to homeostasis and life of the organism. Formally, the alarm occurs when there is a discrepancy between what should be and what is-between the value a variable should have (set value (SV)), and the real value (actual value (AV)) of the same variable. The stress response, therefore, is an essential and necessary physiological response. The unpleasantness of the alarm is no health threat. However, if sustained, the response may lead to illness and disease through established pathophysiological processes ("allostatic load"). The alarm elicits specific behaviors to cope with the situation. The level of alarm depends on expectancy of the outcome of stimuli and the specific responses available for coping. Psychological defense is defined as a distortion of stimulus expectancies. Response outcome expectancies are defined as positive, negative, or none, to the available responses. This offers formal definitions of coping, hopelessness, and helplessness that are easy to operationalize in man and in animals. It is an essential element of CATS that only when coping is defined as positive outcome expectancy does the concept predict relations to health and disease.

Adaptation, Psychological↗
PubMed2004

Low back pain interventions at the workplace: a systematic literature review.

OBJECTIVE: To assess the effect of controlled workplace interventions on low back pain (LBP) through a review of controlled studies. The rising costs of employees with LBP have resulted in an abundance of offers to society and organizations of interventions to prevent and/or treat the problem. Little is known of the effect of the different interventions. METHODS: A systematic literature search based on the inclusion criteria: controlled trial, work setting and assessment of at least one of the four main outcome measures: sick leave; costs; new episodes of LBP; and pain. Effect of the interventions was reported for the four main outcome measures. RESULTS: Thirty-one publications from 28 interventions were found to comply with the inclusion criteria. Exercise interventions to prevent LBP among employees and interventions to treat employees with LBP have documented an effect on sick leave, costs and new episodes of LBP. Multidisciplinary interventions have documented an effect on the level of pain. CONCLUSIONS: The results show that there is good reason to be careful when considering interventions aiming to prevent LBP among employees. Of all the workplace interventions only exercise and the comprehensive multidisciplinary and treatment interventions have a documented effect on LBP. There is a need for studies employing good methodology.

Back Pain↗
PubMed2004

Are subjective health complaints a result of modern civilization?

Subjective health complaints without or with minimal somatic findings (pain, fatigue) are common and frequent reasons for encounter with the general practitioner and for long-term sickness leave and disability. The complaints are often attributed to the stressors of modern life. Is this true? We interviewed 120 Aborigine Mangyans (native population, M age = 33.5 years, 72.5% women) living under primitive conditions in the jungle of Mindoro, an island in the Philippines, and 101 persons living in a small coastal town on the same island (coastal population, M age = 33.8 years, 60.4% women). Both groups had more musculoskeletal complaints, fatigue, mood changes, and gastrointestinal complaints than a representative sample from the Norwegian population (N = 1,243). Our common subjective health complaints, therefore, are not specific for industrialized societies.

Adolescent↗
PubMed2003

Does early intervention with a light mobilization program reduce long-term sick leave for low back pain: a 3-year follow-up study.

STUDY DESIGN: A randomized clinical trial. OBJECTIVES: To evaluate long-term clinical and economical effects of a light mobilization program on the duration of sick leave for patients with subacute low back pain. SUMMARY OF BACKGROUND DATA: Twelve-month follow-up results from a previous study showed that early intervention with examination at a spine clinic, giving the patients information, reassurance, and encouragement to engage in physical activity as normal as possible had significant effect in reducing sick leave. At 12-month follow-up, 68.4% in the intervention group were off sick leave, as compared with 56.4% in the control group. Patients in this study were followed-up for a period of 3 years to investigate possible long-term effects. MATERIALS AND METHODS: Four hundred fifty-seven patients placed on a sick list for 8 to 12 weeks for low back pain were randomized into two groups: an intervention group (n = 237) and a control group (n = 220). The intervention group was examined at a spine clinic and given information and advice to stay active. The control group was not examined at the clinic but was treated within the primary health care. RESULTS: Over the 3 years of observation, the intervention group had significantly fewer days of sickness compensation (average 125.7 d/person) than the control group (169.6 d/person). This difference is mainly caused by a more rapid return to work during the first year. There was no significant difference for the second or third year. In particular, there is no increased risk for reoccurrence of illness from early return to work. At 6-month follow-up, patients in the intervention group were less likely to use bed rest and more likely to use stretching and walking to cope with their back pain compared with the control group. This effect diminished. At 12-month follow-up, the only significant difference between the groups was in the use of stretching. Economic returns of the intervention were calculated in terms of increases in the net present value of production for the society because of the reduction in number of days on sick leave. Net benefits accumulated over 3 years of treating the 237 patients in the intervention group amount to approximately 2,822 dollars per person. CONCLUSIONS: For patients with subacute low back pain, a brief and simple early intervention with examination, information, reassurance, and encouragement to engage in physical activity as normal as possible had economic gains for the society. The effect occurred during the first year after intervention. There were no significant long-term effects of the intervention. The initial gain obtained during the first year does not lead to any increased costs or increased risks for reoccurrence of illness over the next 2 years.

Adolescent↗