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Fjellman-Wiklund, AnncristineORCID iD iconorcid.org/0000-0002-3334-1376
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Publications (10 of 81) Show all publications
Lindelöf, N., Nilsson, I., Littbrand, H., Gustafson, Y., Olofsson, B. & Fjellman-Wiklund, A. (2023). A focus groups study of staff team experiences of providing interdisciplinary rehabilitation for people with dementia and their caregivers: a co-creative journey. BMC Geriatrics, 23(1), Article ID 572.
Open this publication in new window or tab >>A focus groups study of staff team experiences of providing interdisciplinary rehabilitation for people with dementia and their caregivers: a co-creative journey
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2023 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 23, no 1, article id 572Article in journal (Refereed) Published
Abstract [en]

Background: The World Health Organization claims that rehabilitation is important to meet the needs of persons with dementia. Rehabilitation programmes, however, are not routinely available. Person-centred, multidimensional, and interdisciplinary rehabilitation can increase the opportunities for older adults with dementia and their informal primary caregivers to continue to live an active life and participate in society. To our knowledge, staff team experiences of such rehabilitation programmes, involving older adults with dementia and their informal caregivers has not been previously explored.

Methods: The aim of this qualitative focus group study was to explore the experiences of a comprehensive staff team providing person-centred multidimensional, interdisciplinary rehabilitation to community-dwelling older adults with dementia, including education and support for informal primary caregivers. The 13 staff team members comprised 10 professions who, during a 16-week intervention period, provided individualised interventions while involving the rehabilitation participants. After the rehabilitation period the staff team members were divided in two focus groups who met on three occasions each (in total six focus groups) and discussed their experiences. The Grounded Theory method was used for data collection and analysis.

Results: The analysis resulted in four categories: Achieving involvement in rehabilitation is challenging, Considering various realities by acting as a link, Offering time and continuity create added value, and Creating a holistic view through knowledge exchange, and the core category: Refining a co-creative process towards making a difference. The core category resembles the collaboration that the staff had within their teams, which included participants with dementia and caregivers, and with the goal that the intervention should make a difference for the participants. This was conducted with flexibility in a collaborative and creative process.

Conclusions: The staff team perceived that by working in comprehensive teams they could provide individualised rehabilitation in creative collaboration with the participants through interaction, knowledge exchange, time and continuity, coordination and flexibility, and a holistic view. Challenges to overcome were the involvement of the person with dementia in goal setting and the mediating role of the staff team members. The staff pointed out that by refinement they could achieve well-functioning, competence-enhancing and timesaving teamwork.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Dementia, Experiences, Grounded theory, Informal caregiver, Interdisciplinary health team, Person-centered care, Rehabilitation
National Category
Nursing Geriatrics
Identifiers
urn:nbn:se:umu:diva-214772 (URN)10.1186/s12877-023-04269-3 (DOI)37723442 (PubMedID)2-s2.0-85171536442 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-0897Promobilia foundationThe Dementia Association - The National Association for the Rights of the DementedThe Janne Elgqvist Family FoundationRegion VästerbottenAlzheimerfondenFoundation for the Memory of Ragnhild and Einar LundströmStiftelsen Gamla Tjänarinnor
Available from: 2023-10-18 Created: 2023-10-18 Last updated: 2023-10-18Bibliographically approved
Wallin, S., Fjellman-Wiklund, A. & Fagerström, L. (2023). Aging engineers' occupational self-efficacy: a mixed methods study. Frontiers in Psychology, 14, Article ID 1152310.
Open this publication in new window or tab >>Aging engineers' occupational self-efficacy: a mixed methods study
2023 (English)In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 14, article id 1152310Article in journal (Refereed) Published
Abstract [en]

Introduction: Engineers' work has become more complex with increased demands in today's changing working life. Self-efficacy is essential to successfully adapt to work-related changes and to cope with adverse job demands. However, less is known about aging engineers' occupational self-efficacy. Therefore, this study explores facilitators and barriers to aging engineers' occupational self-efficacy beliefs to continue working until expected retirement age. An additional purpose is to explore if any of the aspects described by the engineers are more prominent.

Methods: The study design was exploratory, using mixed methods with a qualitative to quantitative approach. A total of 125 engineers, aged between 45 and 65 years, answered two open-ended survey questions about what positively and negatively affect their occupational self-efficacy beliefs to continue working. First, data was analyzed using an inductive manifest qualitative content analysis. Next, descriptive statistics were performed based on the results of the qualitative study.

Results: The analyses revealed that health and working conditions that affect health were crucial facilitators and barriers for the aging engineers' occupational self-efficacy to continue working until expected retirement age. Furthermore, the engineers emphasized competence, motivation from meaningful tasks, family and leisure, and private economy.

Discussion: The aging engineers' own health seems to be prominent in their self-efficacy regarding a full working life; consequently, support still needs to address issues affecting health.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2023
Keywords
aging workers, engineers, full working life, mixed methods, occupational self-efficacy, personal resources
National Category
Occupational Therapy
Identifiers
urn:nbn:se:umu:diva-209885 (URN)10.3389/fpsyg.2023.1152310 (DOI)000998418500001 ()37275701 (PubMedID)2-s2.0-85161079048 (Scopus ID)
Available from: 2023-06-15 Created: 2023-06-15 Last updated: 2023-09-05Bibliographically approved
Ilgunas, A., Fjellman-Wiklund, A., Häggman-Henrikson, B., Lobbezoo, F., Visscher, C. M., Durham, J. & Lövgren, A. (2023). Patients' experiences of temporomandibular disorders and related treatment. BMC Oral Health, 23(1), Article ID 653.
Open this publication in new window or tab >>Patients' experiences of temporomandibular disorders and related treatment
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2023 (English)In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 23, no 1, article id 653Article in journal (Refereed) Published
Abstract [en]

Background: Temporomandibular disorders (TMD) are common and therefore managed by dentists on a daily basis. However, patients with TMD consistently go undetected and therefore untreated in dentistry. The reasons for these shortcomings have not been fully explored, specifically with regard to patients’ perspectives. Therefore, this study aimed to explore patients’ experiences of TMD and related treatment, with special focus on the experiences of having TMD, factors related to seeking care, and perspectives on received treatment.

Methods: Purposive sampling was used to recruit adult patients at the Public Dental Health services (PDHS) in the Region of Västerbotten, Sweden, during 2019. Individual semi-structured interviews were conducted and analysed using Qualitative Content Analysis. Sixteen patients were interviewed (ten women and six men, 20–65 years). The interviews probed the patients’ perspectives of having TMD, seeking care, and receiving treatment. All participants were also examined according to the Diagnostic Criteria for TMD (DC/TMD) and qualified for at least one DC/TMD diagnosis.

Results: The data analysis led to the main theme Seeking care when the situation becomes untenable, but dental care fails to meet all needs. The patients expressed worry and social discomfort because of the symptoms but still strived to have an as normal daily life as possible. However, severe symptoms and associated consequences compelled them to seek professional help. Experiences of distrust together with challenges to access the PDHS were identified and related to the patients’ unfulfilled expectations.

Conclusions: Patients’ reported experiences indicate that receiving timely and appropriate care is more of an unfulfilled expectation than the current state of management of patients with TMD in dentistry.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
General practice, Dental, Temporomandibular joint disorders, Qualitative research
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-202143 (URN)10.1186/s12903-023-03230-5 (DOI)37684660 (PubMedID)2-s2.0-85170284061 (Scopus ID)
Funder
Umeå UniversityRegion Västerbotten
Note

Originally included in thesis in manuscript form.

Available from: 2023-01-02 Created: 2023-01-02 Last updated: 2023-09-20Bibliographically approved
Andersdotter Sandström, A., Fjellman-Wiklund, A., Sandlund, M. & Eskilsson, T. (2023). Patients with stress-induced exhaustion disorder and their experiences of physical activity prescription in a group context. Global Health Action, 16(1), Article ID 2212950.
Open this publication in new window or tab >>Patients with stress-induced exhaustion disorder and their experiences of physical activity prescription in a group context
2023 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 16, no 1, article id 2212950Article in journal (Refereed) Published
Abstract [en]

Background: Physical activity is a useful means to improve symptoms and memory performance to some extent in individuals with stress-induced exhaustion disorder. Individuals in this group commonly do not need to reach the recommended levels of physical activity. Developing methods to support physical activity as a lasting behaviour is important.

Objective: The aim of the study was to explore the processes involved when using physical activity prescription as part of rehabilitation in a group context for individuals with stress-induced exhaustion disorder.

Method: A total of 27 individuals with stress-induced exhaustion disorder participated in six focus groups. The informants underwent a multimodal intervention including prescription of physical activity. The physical activity prescription had a cognitive behaviour approach and included information about physical activity, home assignments and goal setting. The data was analysed with grounded theory method using constant comparison.

Results: The analysis of the data was developed into the core category ‘trying to integrate physical activity into daily life in a sustainable way’, and three categories: ‘acceptance of being good enough’, ‘learning physical activity by doing’ and ‘advocation for physical activity in rehabilitation’. The informants identified that during the physical activity prescription sessions they learned what physical activity was, what was ‘good enough’ in terms of dose and intensity of physical activity, and how to listen to the body’s signals. These insights, in combination with performing physical activity during home assignments and reflecting with peers, helped them incorporate physical activity in a new and sustainable way. A need for more customised physical activity with the ability to adjust to individual circumstances was requested.

Conclusion: Prescription of physical activity in a group context may be a useful method of managing and adjusting physical activity in a sustainable way for individuals with stress-induced exhaustion disorder. However, identifying people who need more tailored support is important.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
Burnout, Physical activity, Focus groups, Goals, Grounded theory
National Category
Physiotherapy
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-210098 (URN)10.1080/16549716.2023.2212950 (DOI)001005756700001 ()37314383 (PubMedID)2-s2.0-85163193261 (Scopus ID)
Available from: 2023-06-22 Created: 2023-06-22 Last updated: 2023-09-05Bibliographically approved
Einarsson, S., Johansson, A., Kautto, E., Lindberg, V., Ljusbäck, A. M., Rydén, P., . . . Wiklund, M. (2023). Thinking and re-thinking: a qualitative study of university teachers' perspectives on the development process for a new online interprofessional education curriculum in a Swedish higher education institution. Nordic Studies in Education, 43(3), 225-240
Open this publication in new window or tab >>Thinking and re-thinking: a qualitative study of university teachers' perspectives on the development process for a new online interprofessional education curriculum in a Swedish higher education institution
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2023 (English)In: Nordic Studies in Education, ISSN 1891-5914, E-ISSN 1891-5949, Vol. 43, no 3, p. 225-240Article in journal (Refereed) Published
Abstract [en]

The objective was to reflect on the experience of working collaboratively across education programmes, departments, and faculties from the perspective of university teachers at a higher education institution. Nine teachers from five programmes working together to develop a new curriculum for interprofessional education (IPE) participated in a focus group discussion. Data were analysed using thematic analysis. Findings suggest that teacher experiences can be understood in terms of teamwork processes valued from both professional and IPE experiential variations within the group. Since findings illustrate pedagogical collaboration across department and faculty boundaries, they can inspire teachers who are planning a similar process.

Place, publisher, year, edition, pages
Cappelen Damm Akademisk, 2023
Keywords
teacher collaboration, teacher experience, higher education, curriculum development
National Category
Pedagogy
Identifiers
urn:nbn:se:umu:diva-214363 (URN)10.23865/nse.v43.4165 (DOI)2-s2.0-85173957819 (Scopus ID)
Funder
Umeå University
Available from: 2023-09-12 Created: 2023-09-12 Last updated: 2023-10-30Bibliographically approved
Eliasson, K., Fjellman-Wiklund, A., Dahlgren, G., Hellman, T., Svartengren, M., Nyman, T. & Lewis, C. A. (2022). Ergonomists’ experiences of executing occupational health surveillance for workers exposed to hand-intensive work: a qualitative exploration. BMC Health Services Research, 22(1), Article ID 1223.
Open this publication in new window or tab >>Ergonomists’ experiences of executing occupational health surveillance for workers exposed to hand-intensive work: a qualitative exploration
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2022 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 22, no 1, article id 1223Article in journal (Refereed) Published
Abstract [en]

Background: In order to reduce work-related upper limb disorders, the Swedish Work Environment Authority introduced an occupational health surveillance targeting hand-intensive work. A process model, aimed at supporting the employers as well as the occupational health service provider (i.e., ergonomist) in the work process with the occupational health surveillance, was developed. The objective of this qualitative study was to explore ergonomists’ experiences of the execution of occupational health surveillance for hand-intensive work when following the novel process model as well as factors influencing the execution.

Methods: Semi-structured individual interviews were conducted with ten ergonomists on one occasion regarding their experience of following the work process. Qualitative content analysis with an inductive approach was used for analyzing the data.

Results: The ergonomists’ experiences were summarized in one theme “A joint roadmap supporting a participatory process” and two categories “Clear structure provided by the components” and “The process influenced by collaboration and context”. The ergonomists valued being guided by the systematics of the model, which provided structure and clarity in their work. Factors affecting the execution were related to communication deficiencies and uncertainties regarding expectations between different roles and functions (e.g., ergonomists and contact person, lack of information to workers). Additional factors, for instance, companies’ routines and the ergonomist’s intra-organizational support, such as access to IT-resources, could also affect the process.

Conclusions: The findings reveal that this process model facilitates the ergonomists’ work and cooperation with a client company. However, the process model needs to be developed and accompanied by a guideline with information related to the process, including e.g., description of a start-up meeting and of the roles/functions of the involved parties.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2022
Keywords
Ergonomics, Legislation, Medical health checks, Qualitative research, Risk assessment, Sweden, Work environment, Work-related upper limb disorders
National Category
Occupational Health and Environmental Health
Research subject
Occupational and Environmental Medicine
Identifiers
urn:nbn:se:umu:diva-200389 (URN)10.1186/s12913-022-08601-2 (DOI)000862559500004 ()36182924 (PubMedID)2-s2.0-85139122555 (Scopus ID)
Available from: 2022-11-03 Created: 2022-11-03 Last updated: 2022-11-03Bibliographically approved
Stenberg, G., Fjellman-Wiklund, A., Strömbäck, M., Eskilsson, T., From, C., Enberg, B. & Wiklund, M. (2022). Gender matters in physiotherapy. Physiotherapy Theory and Practice, 38(13), 2316-2329
Open this publication in new window or tab >>Gender matters in physiotherapy
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2022 (English)In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 38, no 13, p. 2316-2329Article in journal (Refereed) Published
Abstract [en]

The World Health Organization states that gender has implications for health across the course of a person's life in terms of norms, roles and relations. It also has implications in rehabilitation. In this article, we argue the need of gender perspectives in the field of physiotherapy; gender matters and makes a difference in health and rehabilitation. We highlight a number of central areas where gender may be significant and give concrete examples of social gender aspects in physiotherapy practice and in diverse patient groups. We also discuss why it can be important to consider gender from an organizational perspective and how sociocultural norms and ideals relating to body, exercise and health are gendered. Further we present useful gender theories and conceptual frameworks. Finally, we outline future directions in terms of gender-sensitive intervention, physiotherapy education and a gendered application of the ICF model. We want to challenge physiotherapists and physiotherapy students to broaden knowledge and awareness of how gender may impact on physiotherapy, and how gender theory can serve as an analytical lens for a useful perspective on the development of clinical practice, education and research within physiotherapy.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
clinical practice, Gender, gender theory, physiotherapy, physiotherapy education, physiotherapy research
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-187700 (URN)10.1080/09593985.2021.1970867 (DOI)000692330800001 ()34470538 (PubMedID)2-s2.0-85114352521 (Scopus ID)
Funder
Umeå University
Available from: 2021-09-23 Created: 2021-09-23 Last updated: 2022-11-28Bibliographically approved
Lundberg, V., Sandlund, M., Eriksson, C., Janols, R., Lind, T. & Fjellman-Wiklund, A. (2022). How children and adolescents with juvenile idiopathic arthritis participate in their healthcare: health professionals' views. Disability and Rehabilitation, 44(10), 1908-1915
Open this publication in new window or tab >>How children and adolescents with juvenile idiopathic arthritis participate in their healthcare: health professionals' views
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2022 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 44, no 10, p. 1908-1915Article in journal (Refereed) Published
Abstract [en]

Background: The study explores how healthcare professionals view participation of children and adolescents with juvenile idiopathic arthritis, in healthcare encounters.

Methods: This qualitative study includes focus groups of HCPs from different professions. The interviews were analysed with qualitative content analysis.

Results: The theme “Creating an enabling arena” illuminates how HCPs face possibilities and challenges when enabling children to communicate and participate in clinical encounters. HCPs, parents, and the healthcare system need to adjust to the child. The sub-theme “Bringing different perspectives” describes how children and their parents cooperate and complement each other during healthcare encounters. The sub-theme “Building a safe and comfortable setting” includes how HCPs address the child’s self-identified needs and make the child feel comfortable during encounters. The sub-theme “Facilitating methods in a limiting organisation” includes how HCPs’ working methods and organization may help or hinder child participation during encounters.

Conclusions: HCPs encourage children and adolescents to make their views known during healthcare encounters by creating an enabling arena. Collaboration and building good relationships between the child, the parents and the HCPs, before and during the healthcare encounters, can help the child express their wishes and experiences. Clinical examinations and use of technology, such as photos, films and web-bases questionnaires can be a good start for a better child communication in healthcare encounters.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
Adolescent, child, chronic condition, communication, healthcare professionals, participation, qualitative
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-175079 (URN)10.1080/09638288.2020.1811406 (DOI)000565631500001 ()32875956 (PubMedID)2-s2.0-85090155995 (Scopus ID)
Available from: 2020-09-30 Created: 2020-09-30 Last updated: 2022-07-12Bibliographically approved
Fjellman-Wiklund, A., Söderman, K., Lundqvist, M. & Häger, C. (2022). Retrospective experiences of individuals two decades after anterior cruciate ligament injury: a process of re-orientation towards acceptance. Disability and Rehabilitation, 44(21), 6267-6276
Open this publication in new window or tab >>Retrospective experiences of individuals two decades after anterior cruciate ligament injury: a process of re-orientation towards acceptance
2022 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 44, no 21, p. 6267-6276Article in journal (Refereed) Published
Abstract [en]

Purpose: Individual perspectives of long-term consequences decades after anterior cruciate ligament (ACL) injury are unexplored. We addressed experiences and the impact on life of former athletes >20 years post-ACL injury.

Methods: Individual interviews, analysed using Grounded Theory, were conducted with 18 persons injured mainly during soccer 20–29 years ago.

Results: A theoretical model was developed with the core category Re-orientation towards acceptance, overarching three categories illustrating the long-term process post-injury. Initially the persons felt like disaster had struck; their main recall was strong pain followed by reduced physical ability and fear of movement and re-injury. In the aftermaths of injury, no participant reached the pre-injury level of physical activity. Over the years, they struggled with difficult decisions, such as whether to partake or refrain from different physical activities, often ending-up being less physically active and thereby gaining body weight. Fear of pain and re-injury was however perceived mainly as psychological rather than resulting from physical limitations. Despite negative consequences and adjustments over the years, participants still found their present life situation manageable or even satisfying.

Conclusion: ACL injury rehabilitation should support coping strategies e.g., also related to fear of re-injury and desirable physical activity levels, also with increasing age.

IMPLICATIONS FOR REHABILITATION

More than 20 years after the ACL injury, the individuals despite re-orientation towards acceptance and a settlement with their life situation, still had fear of both pain and re-injury of the knee, with concerns about physical activity and gaining of body weight. Patients with ACL injury may need better individual guidance and health advice on how to remain physically active, to find suitable exercises and to maintain a healthy body weight. Education related to pain, treatment choices, physical activity, injury mechanisms in participatory discussions with the patient about the ACL injury may be beneficial early in the rehabilitation process to avoid catastrophizing and avoidance behaviour. ACL injury rehabilitation needs to address coping strategies incorporating the psychological aspects of suffering an ACL injury, including fear of movement/secondary injury, in order to support return-to-sport and/or re-orientation over time.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
fear of movement, fear of re-injury, knee injury, long-term consequences, qualitative design, rehabilitation
National Category
Physiotherapy Sport and Fitness Sciences
Research subject
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-186916 (URN)10.1080/09638288.2021.1962415 (DOI)000684732300001 ()34388952 (PubMedID)2-s2.0-85112472778 (Scopus ID)
Available from: 2021-08-26 Created: 2021-08-26 Last updated: 2022-12-06Bibliographically approved
Lövgren, A., Häggman-Henrikson, B., Fjellman-Wiklund, A., Begic, A., Landgren, H., Lundén, V., . . . Österlund, C. (2022). The impact of gender of the examiner on orofacial pain perception and pain reporting among healthy volunteers. Clinical Oral Investigations, 26, 3033-3040
Open this publication in new window or tab >>The impact of gender of the examiner on orofacial pain perception and pain reporting among healthy volunteers
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2022 (English)In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 26, p. 3033-3040Article in journal (Refereed) Published
Abstract [en]

Objectives: Pain on palpation of jaw muscles is a commonly used diagnostic criterion when examining patients with orofacial pain. It is not known, however, if pain reports are affected by the gender of the examiner. Our aim was to investigate if pressure pain threshold (PPT), pressure pain tolerance (PTol), and pain intensity assessed over the masseter muscles in healthy individuals are affected by the gender of the examiner.

Materials and methods: Healthy, pain-free individuals were recruited on a voluntary basis. PPT and PTol were assessed using pressure algometry. At the PTol level, participants also rated pain intensity on a 0–10 numeric rating scale. Assessments of PPT and PTol were conducted with six repeated measurements performed twice, separately by one female and one male examiner, on each participant.

Results: In total, 84 participants (43 women; median age 24, IQR 6) were included. With a female examiner, women reported higher pain intensity than men (Mann Whitney U, p = 0.005). In the multivariable analysis, significantly higher PTol was predicted by male examiner. Also, a higher ratio between PTol and reported pain intensity was predicted by male examiner.

Conclusions: The gender of the examiner influences pain reporting and perception in an experimental setting. This effect on pain perception related to gender of the examiner is probably related to normative gender behaviors rather than to biological alterations within the examined individual.

Clinical relevance: In clinical and experimental settings, gender of the examiner may affect not only pain perception but also pain reporting, with potential implications for diagnostics in patients with pain.

Place, publisher, year, edition, pages
Springer, 2022
Keywords
Experimental pain, Gender roles, Orofacial pain, Pain perception, Pain reporting, Pressure pain
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-190826 (URN)10.1007/s00784-021-04286-9 (DOI)000729669700001 ()34902057 (PubMedID)2-s2.0-85121140336 (Scopus ID)
Available from: 2021-12-29 Created: 2021-12-29 Last updated: 2022-11-29Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3334-1376

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