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A 10-year follow-up of a population-based study of people with multiple sclerosis in Stockholm, Sweden: changes in disability and the value of different factors in predicting disability and mortality.

https://arctichealth.org/en/permalink/ahliterature108382
Source
J Neurol Sci. 2013 Sep 15;332(1-2):121-7
Publication Type
Article
Date
Sep-15-2013
Author
Charlotte Chruzander
Sverker Johansson
Kristina Gottberg
Ulrika Einarsson
Sten Fredrikson
Lotta Widén Holmqvist
Charlotte Ytterberg
Author Affiliation
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden. charlotte.chruzander@ki.se
Source
J Neurol Sci. 2013 Sep 15;332(1-2):121-7
Date
Sep-15-2013
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Community Health Planning
Disability Evaluation
Disabled Persons
Female
Humans
Longitudinal Studies
Male
Middle Aged
Multiple Sclerosis - epidemiology - mortality - physiopathology
Predictive value of tests
Sweden - epidemiology
Walking - physiology
Abstract
Most people with multiple sclerosis (PwMS) experience progressively worsening disability over a period of decades, thus further knowledge about the long-term changes in different areas of disability is essential.
The aims of this study were to evaluate changes in disability over ten years in PwMS, and to explore the value of personal and disease-specific factors and depressive symptoms in predicting disability. A further aim was to explore the value of these factors as predictors of mortality.
This study was based on a 10-year follow-up of a population-based study in Stockholm (n=166). Home visits were used to collect data on personal and disease-specific factors, walking ability, manual dexterity, cognitive function, mood, activities of daily living (ADL) and social/lifestyle activities.
The proportion of the study population who had disability in cognition, mood and social/lifestyle activities remained stable, while the proportion with disability in walking, manual dexterity and ADL increased. Disease severity predicted an increase in all studied variables of disability except in depressive symptoms. Older age and depressive symptoms were associated with mortality.
This study illustrates the importance of tailored interventions for PwMS and highlights the need for health-care professionals to consider the psychological aspects of the disease. Furthermore, our results indicate that the Expanded Disability Status Scale was a useful tool for predicting future disability.
PubMed ID
23896259 View in PubMed
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A 10-year follow-up of a population-based study of people with multiple sclerosis in Stockholm, Sweden: changes in health-related quality of life and the value of different factors in predicting health-related quality of life.

https://arctichealth.org/en/permalink/ahliterature259017
Source
J Neurol Sci. 2014 Apr 15;339(1-2):57-63
Publication Type
Article
Date
Apr-15-2014
Author
Charlotte Chruzander
Charlotte Ytterberg
Kristina Gottberg
Ulrika Einarsson
Lotta Widén Holmqvist
Sverker Johansson
Source
J Neurol Sci. 2014 Apr 15;339(1-2):57-63
Date
Apr-15-2014
Language
English
Publication Type
Article
Keywords
Adult
Female
Follow-Up Studies
Health status
Humans
Longitudinal Studies
Male
Middle Aged
Multiple Sclerosis - diagnosis - epidemiology - psychology
Population Surveillance - methods
Predictive value of tests
Quality of Life - psychology
Sweden - epidemiology
Abstract
Health-related quality of life (HRQL) in people with multiple sclerosis (PwMS) is negatively affected compared to that of the general population. Cognitive impairment and depressive symptoms have been shown to predict worse HRQL in a short-term perspective. Considering the progressive nature of MS, it is essential to include the long-term (10 years) perspective of HRQL in PwMS.
The aim of this 10-year follow-up of a population-based sample of PwMS was to explore changes in and the predictive value of personal factors, degree of MS disability, depressive symptoms and cognitive impairment on HRQL.
Data on personal and disease-specific factors, mood, and cognitive function was collected. Data on HRQL was collected, seen as a health profile with the Sickness Impact Profile, as a health index with the EuroQol 5D and as a single global question with the EQ Visual Analog Scale.
HRQL worsened over 10 years according to the health profile (Sickness Impact Profile Total and its physical dimension) and according to the health index. The effect sizes were small. HRQL assessed with the single global question remained unchanged. Depressive symptoms and cognitive impairment predicted worse HRQL.
In a 10-year perspective the HRQL with regard to its physical domain or when seen as a total health profile tends to get worse in PwMS. Yet, HRQL with regard to its psychosocial domain and with regard to PwMS' self-rated health, remains stable. There is a potential for health-care professionals to decrease the impact of modifiable factors on HRQL in PwMS by identifying those with depressive symptoms and/or cognitive impairment and initiating evidence-based treatment as well as meeting the need for environmental facilitators aiming at reducing disability.
PubMed ID
24492009 View in PubMed
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A 10-year population-based study of people with multiple sclerosis in Stockholm, Sweden: use of and satisfaction with care and the value of different factors in predicting use of care.

https://arctichealth.org/en/permalink/ahliterature275585
Source
BMC Health Serv Res. 2015;15:480
Publication Type
Article
Date
2015
Author
Charlotte Chruzander
Sverker Johansson
Kristina Gottberg
Ulrika Einarsson
Jan Hillert
Lotta Widén Holmqvist
Charlotte Ytterberg
Source
BMC Health Serv Res. 2015;15:480
Date
2015
Language
English
Publication Type
Article
Keywords
Ambulatory Care - utilization
Disabled Persons - psychology - statistics & numerical data
Epidemiologic Methods
Female
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Multiple Sclerosis - epidemiology - psychology - therapy
Patient Acceptance of Health Care - psychology
Patient Satisfaction - statistics & numerical data
Primary Health Care - utilization
Sweden - epidemiology
Abstract
The national strategy for treatment of chronic diseases - including MS - and changes in the Swedish welfare system, call for analyses of the use of, and patient satisfaction with, care in a long-term perspective. The aim was therefore to explore the use of care and the predictive value of personal factors, disease-specific factors and functioning on the use of care and to explore patient satisfaction with care in a 10-year perspective.
Information regarding personal factors, disease-specific factors, functioning and satisfaction with care was collected by home-visits; use of care was collected from the Stockholm County Council computerised register.
Data from 121 people with MS (PwMS) was collected. Primary care accounted for the majority of all care. Neurology and Rehabilitation Departments together accounted for two-thirds of all hospital outpatient care. Rehabilitation Departments accounted for one-third of the total number of inpatient days. Lower coping capacity, impaired manual dexterity and activity of daily living dependency at baseline, together with progress in MS disability predicted a higher use of care. Overall, patient satisfaction with care was stable over time.
The extensive use of care offers challenges to care coordination. Implementation of person-centred care could be a strategy to increase efficacy/outcome of care.
Notes
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PubMed ID
26499940 View in PubMed
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Longitudinal changes in sickness absence and disability pension, and associations between disability pension and disease-specific and contextual factors and functioning, in people with multiple sclerosis.

https://arctichealth.org/en/permalink/ahliterature282657
Source
J Neurol Sci. 2016 Aug 15;367:319-25
Publication Type
Article
Date
Aug-15-2016
Author
Charlotte Chruzander
Petter Tinghög
Charlotte Ytterberg
Lotta Widén Holmqvist
Kristina Alexanderson
Jan Hillert
Sverker Johansson
Source
J Neurol Sci. 2016 Aug 15;367:319-25
Date
Aug-15-2016
Language
English
Publication Type
Article
Keywords
Disability Evaluation
Disabled persons - statistics & numerical data
Employment - statistics & numerical data
Female
Follow-Up Studies
Humans
Longitudinal Studies
Male
Middle Aged
Multiple Sclerosis - drug therapy - economics - epidemiology - psychology
Pensions - statistics & numerical data
Prevalence
Proportional Hazards Models
Prospective Studies
Registries
Severity of Illness Index
Sweden - epidemiology
Abstract
Even though it is well known that disability due to MS is highly associated with employment status, the long-term longitudinal perspective on sickness absence and disability pension over the MS trajectory is lacking. In addition, further knowledge of risk factors for future disability pension is needed.
To explore long-term longitudinal changes in the prevalence of sickness absence and disability pension in people with MS (PwMS), as well as to explore associations between disease-specific factors, contextual factors and functioning, and the outcome of future full-time disability pension.
A prospective, population-based survival cohort study, with a nine year follow-up, including 114 PwMS was conducted by combining face-to-face collected data and register-based data.
The prevalence of full-time disability pension increased from 20% to 50%, however 24% of the PwMS had no disability pension at all at end of follow-up. Sex, age, disease severity and impaired manual dexterity were associated with future full-time disability pension.
The large increase in prevalence of PwMS on full-time disability pension during the MS trajectory, calls for the development and implementation of evidence-based interventions, aiming at keeping PwMS in the work force. Modifiable factors, such as manual dexterity should be targeted in such interventions.
PubMed ID
27423611 View in PubMed
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