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Stålnacke, Britt-Marie
Alternative names
Publications (10 of 88) Show all publications
Stenberg, M., Stålnacke, B.-M. & Saveman, B.-I. (2019). Family Illness Trajectory During Seven Years After A Severe Traumatic Brain Injury-Family Interviews. Paper presented at The International Brain Injury Association’s 13th World Congress on Brain Injury, Toronto, Canada, 13−16 March, 2019. Brain Injury, 33, 147-147
Open this publication in new window or tab >>Family Illness Trajectory During Seven Years After A Severe Traumatic Brain Injury-Family Interviews
2019 (English)In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 33, p. 147-147Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Severe traumatic brain injury, long-term perspective, family interviews
National Category
Neurology Neurosciences
Identifiers
urn:nbn:se:umu:diva-159384 (URN)10.1080/02699052.2019.1608749 (DOI)000466897000307 ()
Conference
The International Brain Injury Association’s 13th World Congress on Brain Injury, Toronto, Canada, 13−16 March, 2019
Note

Supplement: 1

Meeting abstract: 0413

Available from: 2019-06-10 Created: 2019-06-10 Last updated: 2019-06-10Bibliographically approved
Nilsson, P. A. & Stålnacke, B.-M. (2019). Life satisfaction among inbound university students in northern Sweden. Fennia, 197(1), 94-107
Open this publication in new window or tab >>Life satisfaction among inbound university students in northern Sweden
2019 (English)In: Fennia, E-ISSN 1798-5617, Vol. 197, no 1, p. 94-107Article in journal (Refereed) Published
Abstract [en]

Will life satisfaction among international students change after having an experience of studying abroad? Some previous studies indicate inequalities and issues of social mobility embedded in international student mobility. International student mobility implies physical movement and new experiences gained while studying abroad. The ubiquity of international students and their generally successful adaptation makes it necessary to understand how they manage to turn a seemingly difficult situation into satisfying adaptation. One area of such concern that this study sought to explore was the students’ level of satisfaction with life. This study investigated the self-reported life satisfaction of inbound university students upon arrival to a university in northern Sweden and at follow-up six months later. After the study period abroad, the students’ levels of perceived satisfaction with their somatic health and activities of daily living had significantly increased. Higher levels, while non-significant, were found for the domains life as a whole, study situation and economy. These findings may indicate that studying abroad could have an impact on students’ reported life satisfaction, which highlights the value of a period of studying abroad. However, when exploring life satisfaction outcomes among internationally mobile students, it seems pertinent to study student mobility within a context. This study mostly targets international student mobility in a Western/European contex

Place, publisher, year, edition, pages
Geographical Society of Finland, 2019
Keywords
Student mobility, life satisfaction, inbound students, Studentmobilitet, livstillfredsställelse, inresande studenter
National Category
Human Geography
Research subject
Social and Economic Geography
Identifiers
urn:nbn:se:umu:diva-158277 (URN)10.11143/fennia.70337 (DOI)000466176600007 ()
Available from: 2019-04-18 Created: 2019-04-18 Last updated: 2019-06-10Bibliographically approved
Stenberg, M., Stålnacke, B.-M. & Saveman, B.-I. (2019). Long-Term Follow-Up Observation Study 7 Years after Severe Traumatic Brain Injury in Northern Sweden. Brain Injury, 33, 161-161
Open this publication in new window or tab >>Long-Term Follow-Up Observation Study 7 Years after Severe Traumatic Brain Injury in Northern Sweden
2019 (English)In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 33, p. 161-161Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Taylor & Francis, 2019
National Category
Neurology Neurosciences
Identifiers
urn:nbn:se:umu:diva-159383 (URN)10.1080/02699052.2019.1608749 (DOI)000466897000333 ()
Note

Supplement: 1

Meeting abstract: 0442

Available from: 2019-06-10 Created: 2019-06-10 Last updated: 2019-06-10Bibliographically approved
Stålnacke, B.-M., Saveman, B.-I. & Stenberg, M. (2019). Long-Term Follow-Up of Disability, Cognitive, and Emotional Impairments after Severe Traumatic Brain Injury. Behavioural Neurology, 2019, Article ID 9216931.
Open this publication in new window or tab >>Long-Term Follow-Up of Disability, Cognitive, and Emotional Impairments after Severe Traumatic Brain Injury
2019 (English)In: Behavioural Neurology, ISSN 0953-4180, E-ISSN 1875-8584, Vol. 2019, article id 9216931Article in journal (Refereed) Published
Abstract [en]

Aim. To assess the clinical course of disability, cognitive, and emotional impairments in patients with severe TBI (s-TBI) from 3 months to up to 7 years post trauma. Methods. A prospective cohort study of s-TBI in northern Sweden was conducted. Patients aged 18-65 years with acute Glasgow Coma Scale 3-8 were assessed with the Glasgow Outcome Scale Extended (GOSE), the Hospital Anxiety and Depression Scale (HADS), and the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) at 3 months, 1 year, and 7 years after the injury. Results. The scores on both GOSE and BNIS improved significantly from 3 months (GOSE mean: 4.4 +/- 2.3, BNIS mean: 31.5 +/- 7.0) to 1 year (GOSE mean: 5.5 +/- 2.7, p=0.003, BNIS mean: 33.2 +/- 6.3, p=0.04), but no significant improvement was found from 1 year to 7 years (GOSE mean: 4.7 +/- 2.8, p=0.13, BNIS mean: 33.5 +/- 3.9, p=0.424) after the injury. The BNIS subscale "speech/language" at 1 year was significantly associated with favourable outcomes on the GOSE at 7 years (OR=2.115, CI: 1.004-4.456, p=0.049). Conclusions. These findings indicate that disability and cognition seem to improve over time after s-TBI and appear to be relatively stable from 1 year to 7 years. Since cognitive function on some of the BNIS subscales was associated with outcome on the GOSE, these results indicate that both screening and follow-up of cognitive function could be of importance for the rehabilitation of persons with s-TBI.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2019
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-164648 (URN)10.1155/2019/9216931 (DOI)000485989300001 ()31534558 (PubMedID)2-s2.0-85072378106 (Scopus ID)
Available from: 2019-10-25 Created: 2019-10-25 Last updated: 2019-10-25Bibliographically approved
Tseli, E., Stålnacke, B.-M., Boersma, K., Enthoven, P., Gerdle, B., Äng, B. O. & Grooten, W. J. (2019). Prognostic Factors for Physical Functioning After Multidisciplinary Rehabilitation in Patients with Chronic Musculoskeletal Pain: A Systematic Review and Meta-analysis. The Clinical Journal of Pain, 35(2), 148-173
Open this publication in new window or tab >>Prognostic Factors for Physical Functioning After Multidisciplinary Rehabilitation in Patients with Chronic Musculoskeletal Pain: A Systematic Review and Meta-analysis
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2019 (English)In: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 35, no 2, p. 148-173Article, review/survey (Refereed) Published
Abstract [en]

OBJECTIVES: This systematic review aimed to identify and evaluate prognostic factors for long-term (≥6 mo) physical functioning in patients with chronic musculoskeletal pain following multidisciplinary rehabilitation (MDR).

METHODS: Electronic searches conducted in MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, and Cochrane CENTRAL revealed 25 original research reports, published 1983-2016, (n=9436). Potential prognostic factors relating to initial pain and physical and psychological functioning were synthesized qualitatively and quantitatively in random effects meta-analyses. The level of evidence (LoE) was evaluated with GRADE.

RESULTS: Pain related factors (intensity and chronicity) were not associated with function/disability at long-term follow up, OR=0.84, 95% CI: 0.65-1.07 and OR=0.97, 95% CI: 0.93-1.00 respectively (moderate LoE). A better function at follow up was predicted by Physical factors; higher levels of initial self-reported functioning, OR=1.07, 95% CI: 1.02-1.13 (low LoE), and Psychological factors; low initial levels of emotional distress, OR=0.77, 95% CI: 0.65-0.92, low levels of cognitive behavioural risk factors, OR 0.85, 95% CI: 0.77-0.93 and high levels of protective cognitive behavioural factors, OR=1.49; 95% CI: 1.17-1.90 (moderate LoE).

DISCUSSION: While pain intensity and long-term chronicity did not predict physical functioning in chronic pain patients after MDR, poor pre-treatment physical and psychological functioning influenced the prognosis negatively. Thus, treatment should further target and optimize these modifiable factors and an increased focus on positive, psychological protective factors may perhaps provide an opening for yet untapped clinical gains.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2019
Keywords
chronic musculoskeletal pain, GRADE, interdisciplinary rehabilitation, meta-analysis, prognostic factors, treatment outcome
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-154906 (URN)10.1097/AJP.0000000000000669 (DOI)000458401700006 ()30371517 (PubMedID)
Available from: 2019-01-04 Created: 2019-01-04 Last updated: 2019-04-16Bibliographically approved
Rivano Fischer, M., Persson, E. B., Stålnacke, B.-M., Schult, M.-L. & Lofgren, M. (2019). Return to work after interdisciplinary pain rehabilitation: one- and two-year follow-up study based on the Swedish quality registry for pain rehabiliation. Journal of Rehabilitation Medicine, 51(4), 281-289
Open this publication in new window or tab >>Return to work after interdisciplinary pain rehabilitation: one- and two-year follow-up study based on the Swedish quality registry for pain rehabiliation
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2019 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 51, no 4, p. 281-289Article in journal (Refereed) Published
Abstract [en]

Objectives: To investigate: (1) changes in sick-leave benefits from 1 year prior to multimodal rehabilitation to 1 and 2 years after rehabilitation; (ii) sex differences in sick leave; and (iii) the impact of policy changes on sick leave.

Methods: All patients undergoing multimodal rehabilitation registered in a national pain database for 2007-11 (n = 7,297) were linked to the Swedish Social Insurance Agency database. Sick leave was analysed in 3-month periods: T0: 1 year before rehabilitation; T1: before start; T2: 1 year after; and T3: 2 years after rehabilitation. Four sick-leave benefit categories were constructed: no sick leave, part-time sick leave, full-time sick leave, and full-time permanent sick leave. The individual change in sick-leave category at each time-period was analysed.

Results: Sick-leave benefits increased from T0 to T1 (p <0.001) and decreased from T1 to T3 (p < 0.001). Reductions were significant for both men and women from T1 to T3, but men had less sick-leave benefits at T2 and T3. Positive changes in sick-leave benefits at T2 and T3 were found both prior to and after policy changes, with less sick-leave benefits after policy changes at all time-points.

Conclusion: Multimodal rehabilitation may positively influence sick-leave benefits for patients with chronic pain, regardless of their sick-leave situation, sex or policy changes.

Place, publisher, year, edition, pages
Foundation of Rehabilitation Information, 2019
Keywords
chronic pain, rehabilitation, registries, return to work, sick leave
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-158082 (URN)10.2340/16501977-2544 (DOI)000462720100007 ()30847496 (PubMedID)
Available from: 2019-04-15 Created: 2019-04-15 Last updated: 2019-04-15Bibliographically approved
Gerdle, B., Åkerblom, S., Jansen, G. B., Enthoven, P., Ernberg, M., Dong, H.-J., . . . Boersma, K. (2019). Who benefits from multimodal rehabilitation: an exploration of pain, psychological distress, and life impacts in over 35,000 chronic pain patients identified in the Swedish Quality Registry for Pain Rehabilitation. Journal of Pain Research, 12, 891-908
Open this publication in new window or tab >>Who benefits from multimodal rehabilitation: an exploration of pain, psychological distress, and life impacts in over 35,000 chronic pain patients identified in the Swedish Quality Registry for Pain Rehabilitation
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2019 (English)In: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 12, p. 891-908Article in journal (Refereed) Published
Abstract [en]

Background: Chronic pain patients frequently suffer from psychological symptoms. There is no consensus concerning the prevalence of severe anxiety and depressive symptoms and the strength of the associations between pain intensity and psychological distress. Although an important aspect of the clinical picture is understanding how the pain condition impacts life, little is known about the relative importance of pain and psychological symptoms for individual’s life impact. The aims of this study were to identify subgroups of pain patients; to analyze if pain, psychological distress, and life impact variables influence subgrouping; and to investigate how patients in the subgroups benefit from treatments.

Methods: Background variables, pain aspects (intensity/severity and spreading), psychological distress (depressive and anxiety symptoms), and two life impact variables (pain interference and perceived life control) were obtained from the Swedish Quality Registry for Pain Rehabilitation for chronic pain patients and analyzed mainly using advanced multivariate methods.

Results: Based on >35,000 patients, 35%–40% had severe anxiety or depressive symptoms. Severe psychological distress was associated with being born outside Europe (21%–24% vs 6%–8% in the category without psychological distress) and low education level (20.7%–20.8% vs 26%–27% in the category without psychological distress). Dose relationships existed between the two psychological distress variables and pain aspects, but the explained variances were generally low. Pain intensity/severity and the two psychological distress variables were significantly associated (R2=0.40–0.48; P>0.001) with the two life impact variables (pain interference and life control). Two subgroups of patients were identified at baseline (subgroup 1: n=15,901–16,119; subgroup 2: n=20,690–20,981) and the subgroup with the worst situation regarding all variables participated less in an MMRP (51% vs 58%, P<0.001) but showed the largest improvements in outcomes.

Conclusion: The results emphasize the need to assess both pain and psychological distress and not take for granted that pain involves high psychological stress in the individual case. Not all patients benefit from MMRP. A better matching between common clinical pictures and the content of MMRPs may help improve results. We only partly found support for treatment resistance in patients with psychological distress burden.

Place, publisher, year, edition, pages
Dovepress, 2019
Keywords
anxiety, chronic pain, control, depression, life impact, sociodemographic
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-157794 (URN)10.2147/JPR.S190003 (DOI)000461272300001 ()30881099 (PubMedID)2-s2.0-85062948895 (Scopus ID)
Available from: 2019-04-02 Created: 2019-04-02 Last updated: 2019-04-02Bibliographically approved
Spinord, L., Kassberg, A.-C., Stenberg, G., Lundqvist, R. & Stålnacke, B.-M. (2018). Comparison of two multimodal pain rehabilitation programmes, in relation to sex and age. Journal of Rehabilitation Medicine, 50(7), 619-628
Open this publication in new window or tab >>Comparison of two multimodal pain rehabilitation programmes, in relation to sex and age
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2018 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, no 7, p. 619-628Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate patient-reported outcome measures in 2 different multimodal pain rehabilitation programmes and to determine whether outcomes are related to sex or age at 1-year follow-up.

Design: Longitudinal retrospective study.

Subjects: Patients who had participated in 1 of 2 multimodal pain rehabilitation programmes at 2 rehabilitation centres. A total of 356 women and 83 men, divided into 3 age groups.

Methods: Data from the Swedish Quality Registry for Pain Rehabilitation regarding activity and physical functions, pain intensity, health status and emotional functions analysed with descriptive statistics.

Results: Significant improvements in activity and physical functions, pain intensity and emotional functions were found in both multimodal pain rehabilitation programmes. Women improved more than men. The older group improved in all emotional functions (depression, anxiety, mental component summary), while the younger group improved only in depression. The intermediate group improved in all variables except anxiety.

Conclusion: Patients improved regardless of the design of the multimodal pain rehabilitation programme. Although only small differences were found between men and women and among the 3 age groups in terms of the measured variables, these findings may have clinical relevance and indicate a need to vary the design of the interventions in multimodal rehabilitation programmes for these subgroups.

Place, publisher, year, edition, pages
FOUNDATION REHABILITATION INFORMATION, 2018
Keywords
chronic pain, musculoskeletal pain, rehabilitation, sex, age
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-150738 (URN)10.2340/16501977-2352 (DOI)000438084000007 ()29881867 (PubMedID)2-s2.0-85051041391 (Scopus ID)
Available from: 2018-08-27 Created: 2018-08-27 Last updated: 2018-08-27Bibliographically approved
Rankin, L., Stålnacke, B.-M., Fowler, C. J. & Gallego, G. (2018). Differences in Swedish and Australian medical student attitudes and beliefs about chronic pain, its management, and the way it is taught. Scandinavian Journal of Pain, 18(3), 533-544
Open this publication in new window or tab >>Differences in Swedish and Australian medical student attitudes and beliefs about chronic pain, its management, and the way it is taught
2018 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 18, no 3, p. 533-544Article in journal (Refereed) Published
Abstract [en]

Background and aims: Medical students receive training in the management of chronic pain, but the training is often suboptimal. Considering that the basis for physician’s knowledge is their medical education, it is important to explore the attitudes and beliefs of medical students with respect both to chronic pain management and to their views on current pain education. Therefore, the aim of this study was to compare Swedish and Australian medical student’s attitudes and beliefs about patients with chronic pain, and their perceptions regarding their chronic pain management education.

Methods: An online survey was conducted with final year Australian and Swedish medical students from two different universities between December 2016 and February 2017. Attitudes and beliefs towards chronic pain patients were measured using the Health Care Providers’ Pain and Impairment Scale (HC-PAIRS). A thematic analysis was conducted on open end questions regarding their views on their education and important skills for chronic pain management.

Results: A total of 57 Swedish and 26 Australian medical students completed the HC-PAIRS scale. The Swedish medical students showed statistically significantly lower total mean HC-PAIRS scores compared to Australian medical students (46 and 51, respectively). Australian students had statistically significantly higher scores than the Swedish students for two of four factors: functional expectations and need for cure, whereas no significant differences were seen for the factors social expectations or for projected cognition. From the open end questions it was evident that final year medical students are knowledgeable about key chronic pain items described in clinical guidelines. However, both cohorts described their chronic pain training as poor and in need of improvement in several areas such as more focus on the biopsychosocial model, working in multidisciplinary teams, seeing chronic pain patients and pharmacological training.

Conclusions: Attitudes and beliefs are formed during medical education, and our study exploring attitudes of medical students towards chronic pain and how it is taught have provided valuable information. Our survey provided detailed and cohesive suggestions for education improvement that also are in line with current clinical guidelines. This study indicates that the Swedish final year students have a more positive attitude towards chronic pain patients compared to their Australian counterparts. The majority of students in both cohorts perceived chronic pain management education in need of improvement.

Implications: This study highlights several areas of interest that warrant further investigation, for example, the impact of a changed medical curriculum in alignment with these clinical guidelines requested by students in this survey, and correspondingly if their attitudes towards chronic pain patients can be improved through education. Further, we conclude that it would be valuable to align the implementation of the HC-PAIRS instrument in order to achieve comparable results between future studies.

Place, publisher, year, edition, pages
Walter de Gruyter, 2018
Keywords
HC-PAIRS; attitudes; chronic pain; medical education; medical students
National Category
Other Clinical Medicine
Identifiers
urn:nbn:se:umu:diva-148376 (URN)10.1515/sjpain-2018-0039 (DOI)000439314200023 ()
Funder
Swedish Research Council, 12158
Available from: 2018-06-04 Created: 2018-06-04 Last updated: 2018-10-29Bibliographically approved
Söderlund, A., Nordgren, L., Sterling, M. & Stålnacke, B.-M. (2018). Exploring patients' experiences of the whiplash injury-recovery process: a meta-synthesis. Journal of Pain Research, 11, 1263-1271
Open this publication in new window or tab >>Exploring patients' experiences of the whiplash injury-recovery process: a meta-synthesis
2018 (English)In: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 11, p. 1263-1271Article, review/survey (Refereed) Published
Abstract [en]

Purpose: The aim of this study was to conduct a meta-synthesis to analyze qualitative research findings and thereby understand patients' experiences of whiplash-associated disorders (WAD) and the injury-recovery process.

Materials and methods: A qualitative meta-synthesis, which is an interpretive integration of existing qualitative findings, was performed. The databases PubMed, PsychINFO, Scopus, and Web of Science were searched. The Critical Assessment Skills Programme was used to assess the quality of the included studies.

Results: Four studies were included. The synthesis resulted in several codes, 6 categories, and 3 themes (distancing from normalcy, self-efficacy in controlling the life situation after the injury, and readjustment and acceptance) that described the participants' pain beliefs, their WAD-related life situation and their future expectations and acceptance. Changes in self-image were difficult to cope with and likely led to perceived stigmatization. Struggling with feelings of loss of control appeared to lead to low confidence and insecurity. Focusing on increasing knowledge and understanding the pain and its consequences were believed to lead to better strategies for handling the situation. Furthermore, recapturing life roles, including returning to work, was challenging, but an optimistic outlook reinforced symptom improvements and contributed to feelings of happiness.

Conclusion: The results of the present study provide a comprehensive understanding of patients' complex, multifaceted experiences of WAD, and the injury-recovery process. The findings can guide us in the development of new ways to evaluate and manage WAD. The results also indicate that a more patient-centered approach is needed to determine the depth and breadth of each patient's problems.

Place, publisher, year, edition, pages
DOVE MEDICAL PRESS LTD, 2018
Keywords
whiplash-associated disorders, control, self-efficacy, happiness, life situation
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-151200 (URN)10.2147/JPR.S158807 (DOI)000437149100001 ()29988716 (PubMedID)
Available from: 2018-09-04 Created: 2018-09-04 Last updated: 2018-09-04Bibliographically approved
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