Summary Workers often attribute poor sleep to factors at work. Despite the large number of workers with sleep disturbances, there is a lack of consensus on the relationship between the work ...environment and sleep. The purpose of this systematic review therefore was to conduct a comprehensive evaluation. To this end, we employed standardized methods to systematically locate, review, and tabulate the results of prospective or randomized studies of the impact of work factors on sleep disturbances. From the 7981 articles located in five databases, 24 fulfilled our inclusion criteria and formed the base of the review including meta-analyses of the effect sizes. Results showed that the psychosocial work variables of social support at work, control, and organizational justice were related to fewer sleep disturbances, while high work demands, job strain, bullying, and effort-reward imbalance were related to more future sleep disturbances. Moreover, working a steady shift was associated with disturbances while exiting shift work was associated with less disturbed sleep. We conclude that psychosocial work factors and the scheduling of work have an impact on sleep disturbances and this might be utilized in the clinic as well as for planning work environments. Future research needs to employ better methodology and focus on underlying mechanisms.
Objectives Common mental disorders in combination with work-related stress are widespread in the western world, not least in Sweden. Various interactive factors, primarily work-related, have impact ...on the return to work process, for example; a supportive communicative function between the person on sick leave and the employer may facilitate this process. The aim was to investigate experiences of being part of a collaborative care model including a person-centered dialogue meeting with the employer and with a rehabilitation coordinator as the moderator. Methods A qualitative design based on individual interviews with 13 persons diagnosed with common mental disorders who participated in an extensive collaborative care model, called the Co-Work-Care model. Persons were recruited as a heterogeneous sample with respect to age, gender, work background, and time since the intervention. All interviews were analyzed with Systematic Text Condensation. Results Five codes synthesized the results: 1) A feeling of being taken care of, 2) Collaboration within the team was perceived as supportive, 3) An active and sensitive listener, 4) Structure and planning in the dialogue meeting, 5) The person-centered dialogue meeting was supportive and provided increased understanding. Conclusions Participants experienced the close collaborative contact with the care manager and the rehabilitation coordinator as highly valuable for their rehabilitation process. Participants valued a well-structured dialogue meeting that included initial planning and a thorough communication involving the patient, the employer, and coordinator. Further, participants appreciated having an active role during the meeting, also empowering the return to work process.
Background
Difficulty in communicating can lead to stressful situations both for foreign‐born female patients suffering from common mental disorders (CMDs) and for the health care professionals.
Aim
...The aim of the study was to explore how foreign‐born female patients with CMDs experienced their health care encounters and how they perceived a care manager could be a support during their illness, as well as to explore the care managers' perceptions and experiences concerning this group.
Methods
A qualitative method with semi‐structured interview was chosen. The data were analysed with systematic text condensation. The study was conducted in primary care in western Sweden. Eight Persian‐speaking female patients were recruited by the snowball method and participated in the study. Furthermore, nine care managers participated.
Results
Foreign‐born female patients felt shame and anxiety because of language difficulties, interpreter presence, mental illness, and feelings of dependency. The care managers and the patients felt that physical meetings, access to translated assessment scales and female telephone interpreters, and early and continuous contact and access to health care personnel with a similar cultural background could facilitate communication.
Conclusion
In order to facilitate mutual understanding and knowledge, accessibility and continuity of health care are needed to enable foreign‐born female patients with CMD to support their own health development. Female interpreters, telephone interpreting, translated scales, and telephone contacts combined with face‐to‐face visits could facilitate communication.
ObjectivesThis study aimed to examine the association between anxiety disorders and/or major depression disorder (ADs/MDD) and all-cause mortality in a 50-year perspective and to examine specific ...risk and health factors that may influence such an association.DesignObservational population study, 1968–2019.SettingThe Population Study of Women in Gothenburg, Sweden (PSWG).ParticipantsIn 1968–1969, 899 (out of 1462) women from PSWG were selected according to date of birth for a psychiatric investigation, including diagnostic evaluation. Eight hundred (89%) were accepted. Twenty-two women were excluded. Of the 778 included, 135 participants (17.4 %) had solely ADs, 32 (4.1%) had solely MDD and 25 (3.2%) had comorbid AD/MDD.Primary and secondary outcome measuresAssociations between ADs, MDD, comorbid AD/MDD and all-cause mortality with adjustments for potential confounding factors. Differences between the groups concerning health and risk factors and their association with mortality.ResultsIn a fully adjusted model, ADs were non-significantly associated with all-cause mortality (HR 1.17, 95% CI 0.98 to 1.41). When examining age during risk time as separate intervals, a significant association between mortality and AD was seen in the group of participants who died at the age of 65–80 years (HR 1.70, 95% CI 1.26 to 2.29). In the younger or older age interval, the association did not reach significance at the 95% level of confidence. Among confounding factors, smoking and physical activity were the strongest contributors. The association between smoking and mortality tended to be further increased in the group with ADs versus the group without such disorders (HR 2.10, 95% CI 1.60 to 2.75 and HR 1.82, 95% CI 1.56 to 2.12, respectively).ConclusionsThis study suggests potential links between ADs, age and mortality among women with 50 years of follow-up, but does not provide definitive conclusions due to the borderline significance of the results.
To assess the hypothesis that low internal health locus of control (IHLC) and psychological distress (PD) are associated with insulin resistance.
In 2002-2005, a random population sample of 2,816 men ...and women aged 30-74 years participated (76%) in two municipalities in southwestern Sweden. This study included 2,439 participants without previously known diabetes or cardiovascular disease. IHLC was measured by a global scale and PD was measured by the 12-item General Health Questionnaire. Insulin resistance was estimated using HOMA-ir. General linear models were used to estimate differences in HOMA-ir between groups with low IHLC, PD, and both low IHLC and PD, respectively.
Five per cent (n = 138) had both PD and low IHLC, 62 per cent of participants (n = 1509) had neither low IHLC nor PD, 18 per cent (n = 432) had PD, and 15 per cent (n = 360) low IHLC. Participants with both low IHLC and PD had significantly higher HOMA-ir than participants with neither low IHLC nor PD (Δ = 24.8%, 95%CI: 12.0-38.9), also in the fully adjusted model (Δ = 11.8%, 95%CI: 1.5-23.0). Participants with PD had significantly higher HOMA-ir (Δ = 12%, 95%CI: 5.7-18.7), but the significance was lost when BMI was included in the model (Δ = 5.3%, 95%CI:0.0-10.8). Similarly, participants with low IHLC had significantly higher HOMA-ir (Δ = 10.1%, 95%CI: 3.5-17.0) but the significance was lost in the fully adjusted model (Δ = 3.5%, 95%CI: -1.9-9.3).
Internal health locus of control (IHLC) and psychological distress (PD) were associated with insulin resistance. Especially individuals with both PD and low IHLC may need special attention.
Our aim was to explore how the care managers put the complex care manager task into practice and how they perceived their task, which was to facilitate effective, person-centred treatment for ...stress-related disorder concordant with evidence-based guidelines in primary care.
This was a qualitative study using examination reports from the course for care managers. Systematic text condensation according to Malterud was used for the analysis.
Primary health care centres.
Twenty-eight newly educated care managers in primary health care participated in the study. The median age was 50 (31-68) years. Twenty-seven were women and one was a man. Twenty-one were employed as nurses and seven as counsellors.
The informants perceived the role as care manager as meaningful but at times complicated. To participate in teams and to work closely with the general practitioner was experienced as important. The co-ordinating function was emphasised as especially important, as well as the increased continuity in care. The dual role as care manager and counsellor was sometimes experienced as problematic.
The informants took advantage of the knowledge they had attained during the course. They perceived themselves as being a bridge between patients and other professionals. The result of having dual roles at the primary health care centre unexpectedly revealed difficulties for some professionals. The nurses seemed more familiar with the new way of working.
To describe the personality and social characteristics associated with regular and episodic alcohol consumption in a Swedish cohort of women.
406 women aged 38 and 50 who participated in the ...Population Study of Women in Gothenburg in 2004–2005 with complete data on the key variables are included. Regular alcohol use was based on frequencies of alcoholic beverage consumption, reported to examining physicians. Regular drinking was defined as those consuming wine, beer, or spirits at least twice weekly. Episodic drinking was defined as consumption of six drinks or more on a single occasion at least once during the last year. Personality traits were studied using the self-administered 57-item Eysenck Personality Inventory, which includes a ‘lie scale’ measuring the tendency toward social desirability, a ‘neuroticism scale’, and an ‘extraversion scale’. Logistic regression was used to estimate odds ratios (OR) for regular and episodic drinking, respectively, in relation to standardized (SD) personality scores and selected social characteristics.
49% of the women reported episodic drinking, while 58% reported regular drinking, and 34% reported both. Women with a higher tendency toward socially desirable responses were less likely to report episodic drinking (odds ratio OR = 0.67, 95% confidence interval CI = 0.53–0.84) per standard deviation (SD), a trait that was not associated with regular drinking.
The strong inverse association between the propensity to lie scale with episodic but not regular drinking suggests that episodic drinking is subject to greater social desirability and under-reporting biases than regular drinking. Our findings indicate that this type of problem drinking may be missed in medical examinations, which limits the ability of health professionals to intervene.
•A tendency toward socially desirable answers is associated with less episodic drinking.•Neuroticism was inversely associated with regular drinking.•Questions on a food frequency questionnaire capture greater honesty in reporting.
To examine whether positive associations between alcohol and liver enzymes were modified by coffee consumption, smoking, or weight status in a female population.
Regular consumption of beer, wine, ...and spirits was assessed in a representative cohort of 1462 Swedish women aged 38-60 in 1968, and re-assessed in 1974. In 1980, gamma-glutamyltransferase (GGT) and aspartase transaminase (AST) were measured in 1130 women. Exposures were averaged over values obtained in 1968 and 1974. Multivariable linear regression linked total ethanol intake to log-transformed enzyme values, including interactions by coffee, smoking, and overweight in mutually adjusted models.
Coffee consumption significantly modified the association between ethanol intake and liver enzymes. One g/day higher ethanol intake was associated with 5.5 (3.5, 7.5)% higher values of GGT, and 1.2 (0.4, 2.1)% higher values of AST in women consuming 0-1 cups of coffee per day, while smaller or no effects were observed in women consuming ≥2 cups/day. Synergistic interactions were observed for ethanol and smoking, and for ethanol and overweight. Average alcohol-related effects on GGT in smokers and non-smokers were given by 3.8 (2.7, 4.9)% and 2.1 (0.9, 3.2)% per g ethanol/day, and by 0.9 (0.4, 1.4)% and 0.2 (−0.3, 0.7)% for AST. Similarly, in overweight women, 1 g/day higher ethanol intake was associated with 4.3 (3.0, 5.6)% higher GGT compared to 1.6 (0.7, 2.5)% in non-overweight women.
The results suggest that coffee consumption reduces the enzyme-raising effect of ethanol in the presence of synergistic interactions with smoking and overweight, specifically in women.
To assess stroke incidence over 44 years and association with risk factors. To study total stroke incidence at 60-82 years of age and risk factors.
Prospective population study.
Gothenburg, Sweden, ...with ∼450,000 inhabitants.
A representative sample of a general population of women (1462 in total) in 5 age strata aged 38-60 years in 1968-1969 (the Population Study of Women in Gothenburg, PSWG) were followed up to the ages of 82-104 years in 2012. Further, analysis was also performed for the age interval 60-82 years.
Incidence of total stroke (TS), ischaemic (IS), haemorrhagic (HS), non-specified (NS) and fatal (FS) strokes and association with baseline classic risk factors (such as hypertension, atrial fibrillation, low physical activity, diabetes, high waist-hip-ratio, hyperlipidaemia, smoking), low education, mental stress, pre-eclampsia and oral health as expressed by loss of teeth and bone score. Blood pressure in levels 1-3 according to modern guidelines. Associations with atrial fibrillation, diabetes and myocardial infarction shown in survival analyses. The five cohorts contributed to risk time data concerning associations with TS in the 60-82 age interval from the examination performed when they were 60.
Three hundred and thirty-seven (23%) women had a first-ever stroke, 64 (19%) fatal. TS was associated with physical inactivity, high triglycerides and low education in multivariable analysis. The main sub-type IS was associated with systolic blood pressure, physical inactivity and low education. Pre-eclampsia showed association with IS only in the univariable analysis. FS was associated with systolic blood pressure and smoking. During 60-82 years of age, having <20 teeth (HR 1.74, CI 1.25-2.42), diabetes (HR 2.28 CI 1.09-4.76), WHR (HR 1.29 per 0.1 units CI 1.01-1.63), systolic blood pressure (HR 1.11 per 10 units CI 1.04-1.18) and smoking (HR 1.57, CI 1.14-2.16), were associated with TS in the combined five cohorts.
Several classic risk factors showed independent associations with stroke. Vulnerability factors as low education and oral health, reflected by loss of teeth, also showed association with stroke. All these factors are possible to target in primary care preventive interventions.
Key Points
Stroke is a common disease and the risk of stroke is a key issue demanding preventive strategies in primary health care. The present prospective population study of women shows
Out of 1460 women, almost a quarter got a stroke. The stroke incidence 60-82 years of age was rather stable between the first four age cohorts but somewhat lower in the latest cohort, born 1930.
Hypertension, low physical activity, low education and high triglyceride levels but not cholesterol were associated with stroke in women.
Low education and loss of teeth are vulnerability factors that should need particular attention.
The study is part of the ongoing Prospective Population Study of Women in Gothenburg, Sweden, initiated in 1968-1969 with the aim of characterising a total population of women who were representative ...of middle-aged females. The aim of the present study was to investigate the prevalence of actual analgesic use (prescribed and self-medication) and the possible association with perceived mental stress among women aged 38 and 50 years, respectively, in the Population Study of Women.
Two different cohorts of population-based samples of 38- and 50-year-old women examined in 2004-2005 and 2016-2017, respectively, were eligible participants. The women were representative for their age cohort at the time of the examinations. Use of medicines and especially analgesics, as well as perceived mental stress, was registered. Changes in medicine use among 38- and 50-year-old women between 2004 and 2005 and 38- and 50-year-old women in 2016-2017 were studied. Data were analysed using logistic regression. Use of analgesics and mental stress were analysed controlling for lifestyle factors, use of other medicines and pain.
The overall sample size across the time periods was 1,073 individuals. The frequency of analgesic use in 38- and 50-year-old women was about 26% in 2004-2005 and 58% in 2016-2017. 28% of women who reported high mental stress in 2004-2005 used analgesics, compared to 60% in 2016-2017. There were no associations between self-perceived mental stress and the use of analgesics.
The higher use of analgesics among midlife women in 2016-2017 is in line with global findings and could be due to increased availability in Sweden of over the counter medicines. The impact of mental stress on analgesic use found previously by other researchers was not confirmed. However, medicine use as a potential coping strategy is an important public health issue that needs to be further explored.
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