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Biomedical subjects

K Alexanderson

Publications and source records attributed to K Alexanderson.

At least 19 recordsLinked to original sources
PubMed2006

Comparison of seven measures of sickness absence based on data from three counties in Sweden.

The objective was to compare the applicability of and results provided by the two measures of sickness absence used most often within the Swedish social insurance administration (that is, unadjusted sick-leave rate and adjusted sick-leave rate) and five measures suggested by epidemiological researchers. Data consisted of four cross-sectional data sets of registry sick-leave data covering four separate years (1997-2000) in three counties. In total 454,000 persons qualified for sickness insurance and aged 20-64 years were included. The two measures used within the social insurance administration and three of the five measures suggested by epidemiological researchers revealed sex-related dissimilarities in absence patterns that indicated that women had more sickness absence than men. However, in marked contrast to those results, two of the epidemiologically based measures (i.e., length of sickness absence and duration of sickness absence) instead showed highly comparable rates of sick leave for men and women, and such information is seldom obtained, albeit definitely of importance, when trying to make a correct assessment of sickness absence. The measure of sickness absence that is used influences the findings and should therefore be chosen with care. Complementing the measures used in the social insurance administration by five measures suggested by epidemiological researchers provided a more informative and comprehensive picture of sickness absence in a population. Further investigations into the effect of using different measures is needed, as well as international consensus on what to call different measures.

Adult↗
PubMed2004

The association between sex segregation, working conditions, and sickness absence among employed women.

AIMS: To analyse the association between sickness absence and sex segregation of occupation and of work site, respectively, and to analyse work environmental factors associated with high sickness absence. METHODS: The study group consisted of 1075 women employed as nurses, assistant nurses, medical secretaries, or metal workers who answered a questionnaire comprising 218 questions on women's health and living conditions. Sickness absence was collected from employers' and social insurance registers. RESULTS: Women working in the male dominated occupation had in general higher sickness absence compared to those working in female dominated occupations. However, metal workers at female dominated work sites had 2.98 (95% CI 2.17 to 3.79) sick-leave spells per woman and year compared to 1.70 (95% CI 1.29 to 2.10) among those working with almost only men. In spite of a better physical work environment, female metal workers at a female dominated work site had a higher sickness absence than other women, which probably could be explained by the worse psychosocial work environment. Working with more women also had a positive association to increased frequency of sick-leave spells in a multivariate analysis including several known indicators of increased sick-leave. CONCLUSIONS: There was an association between sickness absence and sex segregation, in different directions at the occupational and work site level. The mechanism behind this needs to be more closely understood regarding selection in and out of an occupation and a certain work site.

Adolescent↗
PubMed2001

A 12-year follow-up of subjects initially sicklisted with neck/shoulder or low back diagnoses.

BACKGROUND AND PURPOSE: Neck/shoulder and low back pain are common in the Western world and can cause great personal and economic consequences, but so far there are few long term follow-up studies of the consequences of back pain, especially studies that separate the location of back pain. More knowledge is needed about different patterns of risk factors and prognoses for neck/shoulder and low back pain, respectively, and they should not be treated as similar conditions. The aim of the present study was to investigate possible long-term differences in neck/shoulder and low back symptoms, experienced over a 12-year period, with regard to work status, present health, discomfort and influence on daily activities. METHOD: A retrospective cohort study of individuals sicklisted with neck/shoulder or low back diagnoses 12 years ago was undertaken. Included were all 213 people who, in 1985, lived in the municipality of Linköping, Sweden, were aged 25-34 years and who had taken at least one new period of sickleave lasting > 28 days with a neck/shoulder or low back diagnosis. In 1996, a questionnaire was mailed to the 204 people who were still resident in Sweden (response rate 73%). RESULTS: Those initially absent with neck/shoulder diagnoses rated their present state of discomfort as worse than those sicklisted with low back diagnoses. Only 4% of the neck/shoulder group reported no present discomfort compared with 25% of the low back group. Notably, both groups reported the same duration of low back discomfort during the last year, which may indicate a higher risk for symptoms in more than one location for subjects with neck/shoulder problems. CONCLUSIONS: Individuals with sickness absence of more than 28 days with neck/shoulder or low back diagnoses appear to be at high risk of developing long-standing symptoms significantly more so for those initially having neck/shoulder diagnoses.

Activities of Daily Living↗
PubMed2001

Do mental health problems increase sickness absence due to other diseases?

BACKGROUND: The incidence of mental health problems is rising. Large sex differences are found for mental health problems, which also is reflected in sick-leave. The aim of this study was to analyse the association of mental health problems with sickness absence in general. METHODS: Employed women (n = 1407) in four occupational groups, namely metal workers, enrolled nurses, medical secretaries and nurses, were included. Sick-leave data were collected through social insurance and employers' registers. Five indicators reflecting different aspects of mental health problems were analysed in relation to sickness absence. RESULTS: Women with mental health problems, irrespective of indicator used, had higher levels of sickness absence than women without mental health problems. The association was found for frequency, incidence, length and duration of sickness absence, and it was found also with respect to less severe forms of mental health problems. For example, women with worries had a frequency of 3.5 sick-leave spells per year, while women without worries had 2.5 spells. Furthermore, women with self-reported mental illness (SF-36) had a 1.93 times increase in sick-leave length over 1 year. CONCLUSIONS: We conclude that mental health problems need to be recognised in relation to sickness absence, rehabilitation and prevention in all diagnoses.

Adolescent↗
PubMed2001

Influence of pregnancy-related diagnoses on sick-leave data in women aged 16-44.

Data on sickness absence frequently are used as a measure of morbidity and its social consequences in the employed population. The effects of sickness absence, as well as any possible differences in diagnoses among pregnant women as compared the sick leave data among the total population of women in fertile age have so far not been studied. The aim of this study was to investigate the relative contribution of pregnant women to the level of sickness absence, in general and in different diagnostic groups, as well as the extent to which sick-listed pregnant women can be identified through diagnoses on sickness certificates. In a cross-sectional study of all sick leave insured women aged 16-44 years (n = 24,481) in Linköping, Sweden (117,000 inhabitants), data from two population-based research registers were used, one of sickness absence for the whole population, one of sickness absence among pregnant women in the same population and year. Pregnant women (5%) had a significantly higher cumulative incidence of sickness absence (0.64) compared with all women (0.18) and accounted for 20% of the women listed as absent because of sickness. The duration of the sickness absence was also significantly longer among pregnant women, 44.8 days compared with 9.7 days among all women. Practically all diagnoses among pregnant women were related to pregnancy or back pain (93%). When using diagnoses on the sickness certificates, only 46% of all sick-listed pregnant women could be identified, suggesting methodological difficulties in studies on sickness absence. Studies on sickness absence among women of fertile age should also contain information on the proportion of sick-listed pregnant women, as a small proportion of pregnant women may have a deep impact on the results and conclusions among all women.

Adolescent↗
PubMed2001

"It was really nice to have someone"--lay people with musculoskeletal disorders request supportive relationships in rehabilitation.

AIMS: To explore the lay person's perspective on the rehabilitation process. METHODS: A total of 20 interviews were conducted with women and men who had recent or more distant experience of sickness absence with musculoskeletal diagnoses. Grounded theory was used, which includes an inductive approach and theoretical sampling. The interviews focused on the individuals' own stories and experiences of factors that promoted or hindered the rehabilitation process. RESULTS: The interviewees emphasized how and by whom they had been treated rather than what type of rehabilitation programmes they had attended. They focused on the importance of supportive relationships from the private. occupational, and health care arenas. The relationship with rehabilitation agents (professionals who implemented rehabilitation) was described as having either supportive or non-supportive qualities. Based on the interviewees' descriptions, a model was developed on the socioemotional qualities of the rehabilitation agent. The most promoting factor in the rehabilitation process was to have a professional mentor that is a rehabilitation agent who combines a supportive approach with individually chosen rehabilitation measures and goals. CONCLUSIONS: The lay person's perspective gave additional knowledge regarding rehabilitation and recovery from musculoskeletal disorders. The socioemotional qualities of the rehabilitation agents were emphasized by the interviewees and a model regarding these qualities was developed. This model needs to be tested further. A clinical implication of the present study is the need for rehabilitation agents to develop their communication skills further.

Adult↗
PubMed2001

Predictive factors for disability pension--an 11-year follow up of young persons on sick leave due to neck, shoulder, or back diagnoses.

AIMS: Although back diagnoses are recurrent and the main diagnoses behind sickness absence and disability pension surprisingly few longitudinal studies have been performed. This study identifies predictive factors for disability pension among young persons initially sick-listed with back diagnoses. METHODS: An 11-year prospective cohort study was conducted, including all individuals in a Swedish city who, in 1985, were aged 25-34 and sick-listed > or =28 days owing to neck, shoulder, or back diagnoses (n = 213). The following data was obtained: disability pension, emigration, and death for 1985-96, sickness absence for 1982-84, and demographics in 1985 regarding sex, income, occupation, marital status, diagnosis, socioeconomic group, and citizenship. Cox regression and life tables were used in the analyses. RESULTS: In 1996, i.e. within 11 years, 22% of the individuals (27% of the women and 14% of the men) had been granted disability pension. The relative risk for disability pension was higher for women (2.4; p = 0.010), persons with foreign citizenship (3.6; p=0.009), and those who had had >14 sick-leave days per spell during the three years before inclusion, compared to those with <7 days/spell (3.1; p=0.003). CONCLUSIONS: This cohort of young persons proved to be a high-risk group for disability pension. Some of the factors known to predict long-time sickness absence also predict disability pension in a cohort of already sick-listed persons.

Adult↗
PubMed1999

An assessment protocol for gender analysis of medical literature.

Although medical research has been criticized for gender bias, few studies have dealt with how such bias affects medical education and textbooks. There is an extensive body of literature showing that most scientific research has been performed by men on men or on male laboratory animals. The male is often considered the norm, the female the exception. This probably has a significant impact on the training of medical students, which is often gender biased, as well as on medical practice. A few studies have actually evaluated medical textbooks from a gender perspective, but a standard instrument or protocol is needed for such assessment. The present work, which was commissioned by a Swedish university, entailed the construction of an instrument that will facilitate gender analysis of medical textbooks.

Bibliometrics↗
PubMed1998

How to measure sickness absence? Literature review and suggestion of five basic measures.

OBJECTIVE: To examine different sick-leave measures used in sickness absence research, and to suggest a systematic way of assessing sickness absence. METHODS: A review and analysis of five major studies on sick-leave performed 1983-1988 with an epidemiological approach. RESULTS: Terminology and measures used varied in the different studies reviewed. The choice of a certain measure was seldom discussed in relation to the aim of the study. Based on the review five measures are suggested: frequency, length, incidence rate, cumulative incidence and duration. The definition of incidence rate is new and is a measure useful in studies of recurrent events within epidemiology. CONCLUSIONS: We have reviewed sick-leave measures previously used in the literature and suggested five basic measures for assessing sick-leave.

Absenteeism↗
PubMed1998

Gender trends in sick-listing with musculoskeletal symptoms in a Swedish county during a period of rapid increase in sickness absence.

UNLABELLED: Sickness absence and disability pension due to musculoskeletal diagnoses has increased in Sweden. STUDY OBJECTIVE: To study gender trends in sickness absence with musculoskeletal diagnoses and its changes in 1985-87. DESIGN: A prospective population-based study of all new sick-leave spells exceeding seven days in 1985-87. Sickness absence with "all diagnoses" was compared to "all musculoskeletal diagnoses", the latter group was also divided into three sub-groups. SETTING: The county of Ostergötland, Sweden. PARTICIPANTS: All sick-leave insured aged 16-65; 107,000 women and 100,000 men. RESULTS: More women than men were sick-listed in "all diagnoses" in 1985. There were corresponding gender differences in sickness absence with musculoskeletal diagnoses except with the diagnosis "low back pain". Sick-listing with musculoskeletal diagnoses increased for both women and men from 1985 to 1987, but the increase was consistently much higher for women, especially for younger women.

Absenteeism↗
PubMed1998

Sickness absence: a review of performed studies with focused on levels of exposures and theories utilized.

BACKGROUND: Despite the major impact sickness absence has on society, companies and individuals, surprisingly little scientific knowledge has been accumulated, and the studies that have been performed vary greatly. AIM AND METHOD: Examination of about 320 studies of sickness absence regarding structural levels of exposures studied and theories utilized. RESULTS: Theories concerning sickness absence were found to vary greatly. Along with exposures and factors explaining sickness absence these theories were categorized with respect to different structural levels, i.e. they were deemed national, occupational, or individual. A classification of different types of absences is presented. CONCLUSION: Although most of the reviewed studies were performed within the realm of medicine, only a few of the investigators used medical explanatory models or even considered the health status of individuals. Moreover, it is known that factors at "higher" structural levels have a substantial effect on sickness absence, but these were seldom taken into account, or even mentioned, in the reports scrutinized.

Absenteeism↗
PubMed1997

Sick-leave among women and the role of psychiatric disorder.

The aim was to assess sick-leave among women in relation to psychiatric disorder. A stratified population-based sample of women in Gothenburg were interviewed and diagnoses were made according to DSM-III-R. Sick-leave data was obtained for a ten year period. Women with psychiatric disorder had higher rates of sick-leave, compared to women without such disorders, in analyses taking into account age, socio-economic status, physical health, marital status and motherhood. Presence of psychiatric and physical illness were both independently associated with higher sick-leave. Highest sick-leave was found among those with a combination of psychiatric and physical morbidity. Psychiatric disorder is an important factor in sick-leave among women, especially regarding length of absence.

Adult↗
PubMed1996

Sex differences in sickness absence in relation to parental status.

The aim of this study was to analyse sex differences in medically certified sickness absence with special regard to parental status and age. All new sick-leave spells exceeding seven days and certified by a physician in a county of Sweden were registered in 1985-1987. The data-base was related to the population at risk by using data from the Swedish Official Population and Housing Census 1985. The analysis concerned the employed population in the age group from 16 to 54 with and without custody of children younger than ten years. In all ages, women with children had more sickness absence than men with children. Corresponding sex differences did not appear for persons without children, except for the oldest age-groups. Men with children had the lowest sickness absence of all groups. Young women with children had the highest. These findings remained the same when pregnancy-related sickness absence was excluded. The common finding of sex differences in sickness absence is here highly interrelated to custody of small children. The results suggest that the often reported positive health effects of multiple roles in women may be counteracted by inequality between the sexes in the responsibility as parents.

Absenteeism↗
PubMed1996

Impact of pregnancy on gender differences in sickness absence.

UNLABELLED: Women in general have a higher sickness absence than men, and sickness absence is particularly high among pregnant women. STUDY OBJECTIVES: To study the level of male sickness absence as compared to female, including and excluding pregnant women. DESIGN: Studies of incidence and length of sickness absence exceeding 7 days using population-based sick-leave records. SETTING: The community of Linköping, Sweden, 117,000 inhabitants. PARTICIPANTS: Subjects included in the analysis were all men and women aged 16-44 who in 1985 or 1986 had at least one sick-leave spell exceeding 7 days. RESULTS: Pregnant women had a very high sickness absence. When pregnant women were excluded, the female sick-leave rate decreased from 0.18 (95% C.I. 0.17-0.18) to 0.15 (95% C.I. 0.15-0.16) for all women. The corresponding male sick-leave rate was 0.12 (95% c.i. 0.12-0.13). Gender differences in length of sickness absence decreased to the same extent. The results were similar when restricting the analysis to employed persons. The decrease varied a little with occupational group and was largest in the age-group 25-34. CONCLUSIONS: When pregnant women were excluded the excess female sick-leave rate was halved, but still remained 25% higher than the male. The impact of excluding pregnant women was highest in the age group 25-34, where the fertility-rate was highest. Although only 5% of all women aged 16-44 were pregnant, they had a large impact on gender differences in sickness absence.

Absenteeism↗
PubMed1996

Sick-leave due to psychiatric disorder: higher incidence among women and longer duration for men.

BACKGROUND: Women take sick-leave more often than men, both in general and because of psychiatric disorders. The aim of the present study was to introduce the new dimension of sick-leave duration in the analysis of gender differences in minor psychiatric disorders. METHOD: A population-based register was used, which included all sick-leave spells exceeding seven consecutive days, 1985-1987, in a Swedish county. RESULTS: Sick-leave duration was longer for men. The greatest gender differences were found in the youngest and oldest age-groups. Women had higher incidence also in the longest spells. An increase in duration over the three years was found among women, leading to decreased gender differences. CONCLUSIONS: Contrary to other studies on minor psychiatric disorders, small gender differences were found. It is suggested that sick-leave duration can be used as a quantitative measure of health-related working capacity.

Adolescent↗