umu.sePublications
Change search
Link to record
Permanent link

Direct link
BETA
Stålnacke, Britt-Marie
Alternative names
Publications (10 of 90) 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
Show others...
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
Show others...
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
Lampa, E., Wänman, A., Nordh, E., Stålnacke, B.-M. & Häggman-Henrikson, B. (2019). The Course of Orofacial Pain and Jaw Disability after Whiplash Trauma: A 2-year Prospective Study. Spine
Open this publication in new window or tab >>The Course of Orofacial Pain and Jaw Disability after Whiplash Trauma: A 2-year Prospective Study
Show others...
2019 (English)In: Spine, ISSN 0362-2436, E-ISSN 1528-1159Article in journal (Refereed) Accepted
Abstract [en]

Study Design: Prospective cohort study.

Objective: To evaluate the course of orofacial pain and jaw disability in relation to neck pain, neck disability and psychosocial factors at the acute stage and the chronic stage after whiplash trauma.

Summary of Background Data: Many individuals report chronic pain in the orofacial region after whiplash trauma. The possible association between whiplash trauma and orofacial pain is debated. Prospective studies are therefore needed to evaluate the development of orofacial pain after whiplash trauma.

Methods: Within one month following a whiplash trauma, 176 cases were examined and compared to 116 controls with questionnaires concerning neck and jaw pain and related disability, non-specific physical symptoms and depression. At the 2-year follow-up, 119 cases (68%) and 104 controls (90%) were re-examined.

Results: Compared to controls, cases reported more jaw and neck pain, both at baseline and follow-up. A majority (68%) of cases with pain in the jaw region in the acute stage also reported jaw pain at the follow-up. The intensity of jaw and neck pain was correlated both at baseline and follow-up. Both neck pain and jaw pain was correlated to non-specific physical symptoms and to depression.

Conclusion: Orofacial pain and jaw disability related to neck pain is often present already at the acute stage after whiplash trauma and persist into the chronic stage for most individuals. Assessment following whiplash trauma should therefore include both the neck and the orofacial regions. More studies are needed to further evaluate risk factors for development of orofacial pain after whiplash trauma.

Level of Evidence: 3

Place, publisher, year, edition, pages
Wolters Kluwer, 2019
Keywords
Jaw pain, Neck Pain, Neck disability, Orofacial pain, Psychosocial factors, Temporomandibular disorders, TMD, Temporomandibular joint, TMJ, Whiplash injury
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-153180 (URN)10.1097/BRS.0000000000003212 (DOI)31513116 (PubMedID)2-s2.0-85072222876 (Scopus ID)
Note

Originally included in thesis in manuscript form.

Available from: 2018-11-08 Created: 2018-11-08 Last updated: 2020-01-10
Gerdle, B., Åkerblom, S., Stålnacke, B.-M., Jansen, G. B., Enthoven, P., Ernberg, M., . . . Boersma, K. (2019). The importance of emotional distress, cognitive behavioural factors and pain for life impact at baseline and for outcomes after rehabilitation: a SQRP study of more than 20,000 chronic pain patients. Scandinavian Journal of Pain, 19(4), 693-711
Open this publication in new window or tab >>The importance of emotional distress, cognitive behavioural factors and pain for life impact at baseline and for outcomes after rehabilitation: a SQRP study of more than 20,000 chronic pain patients
Show others...
2019 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 19, no 4, p. 693-711Article in journal (Refereed) Published
Abstract [en]

Background and aims: Although literature concerning chronic pain patients indicates that cognitive behavioural variables, specifically acceptance and fear of movement/(re)injury, are related to life impact, the relative roles of these factors in relation to pain characteristics (e.g. intensity and spreading) and emotional distress are unclear. Moreover, how these variables affect rehabilitation outcomes in different subgroups is insufficiently understood. This study has two aims: (1) to investigate how pain, cognitive behavioural, and emotional distress variables intercorrelate and whether these variables can regress aspects of life impact and (2) to analyse whether these variables can be used to identify clinically meaningful subgroups at baseline and which subgroups benefit most from multimodal rehabilitation programs (MMRP) immediately after and at 12-month follow-up.

Methods: Pain aspects, background variables, psychological distress, cognitive behavioural variables, and two life impact variables were obtained from the Swedish Quality Registry for Pain Rehabilitation (SQRP) for chronic pain patients. These data were analysed mainly using advanced multivariate methods.

Results: The study includes 22,406 chronic pain patients. Many variables, including acceptance variables, showed important contributions to the variation in clinical presentations and in life impacts. Based on the statistically important variables considering the clinical presentation, three clusters/subgroups of patients were identified at baseline; from the worst clinical situation to the relatively good situation. These clusters showed significant differences in outcomes after participating in MMRP; the subgroup with the worst situation at baseline showed the most significant improvements.

Conclusions: Pain intensity/severity, emotional distress, acceptance, and life impacts were important for the clinical presentation and were used to identify three clusters with marked differences at baseline (i.e. before MMRP). Life impacts showed complex relationships with acceptance, pain intensity/severity, and emotional distress. The most significant improvements after MMRP were seen in the subgroup with the lowest level of functioning before treatment, indicating that patients with complex problems should be offered MMRP.

Implications: This study emphasizes the need to adopt a biopsychosocial perspective when assessing patients with chronic pain. Patients with chronic pain referred to specialist clinics are not homogenous in their clinical presentation. Instead we identified three distinct subgroups of patients. The outcomes of MMRP appears to be related to the clinical presentation. Thus, patients with the most severe clinical presentation show the most prominent improvements. However, even though this group of patients improve they still after MMRP show a complex situation and there is thus a need for optimizing the content of MMRP for these patients. The subgroup of patients with a relatively good situation with respect to pain, psychological distress, coping and life impact only showed minor improvements after MMRP. Hence, there is a need to develop other complex interventions for them.

Place, publisher, year, edition, pages
Walter de Gruyter, 2019
Keywords
anxiety, acceptance, control, depression, distress, fear, mood, interference, pain
National Category
General Practice
Identifiers
urn:nbn:se:umu:diva-166510 (URN)10.1515/sjpain-2019-0016 (DOI)000489140000007 ()31150362 (PubMedID)
Available from: 2019-12-18 Created: 2019-12-18 Last updated: 2019-12-18Bibliographically approved
Rankin, L., Fowler, C. J., Stålnacke, B.-M. & Gallego, G. (2019). What influences chronic pain management?: A best-worst scaling experiment with final year medical students and general practitioners. British Journal of Pain, 13(4), 214-225
Open this publication in new window or tab >>What influences chronic pain management?: A best-worst scaling experiment with final year medical students and general practitioners
2019 (English)In: British Journal of Pain, ISSN 2049-4637, Vol. 13, no 4, p. 214-225Article in journal (Refereed) Published
Abstract [en]

Background: Chronic pain education is an essential determinant for optimal chronic pain management. Given that attitudes and preferences are involved in making treatment decisions, identifying which factors are most influential to final year medical students’ and general practitioners’ (GPs) chronic pain management choices is of importance. This study investigates Swedish and Australian students’ preferences with respect to a chronic pain condition, using a best–worst scaling (BWS) experiment, which is designed to rank alternatives.

Methods: BWS, a stated-preference method grounded in random utility theory, was used to explore the importance of factors influencing chronic pain management.

Results: All three cohorts considered the patients’ pain description and previous treatment experience as the most important factors in making treatment decisions, whereas their demographics and voices or facial expressions while describing their pain were considered least important. Factors such as social support, patient preferences and treatment adherence were, however, disregarded by all cohorts in favour of pain assessment factors such as pain ratings, description and history. Swedish medical students and GPs show very high correlation in their choices, although the GPs consider their professional experience as more important compared to the students.

Conclusion: This study suggests that the relative importance of treatment factors is cemented early and thus underline the critical importance of improving pain curricula during undergraduate medical education.

Keywords
Pain management, pain education, best-worst scaling, medical students, general practitioners
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-165668 (URN)10.1177/2049463719832331 (DOI)000489776800003 ()31656627 (PubMedID)
Funder
Swedish Research Council, 12158
Available from: 2019-12-06 Created: 2019-12-06 Last updated: 2019-12-06Bibliographically 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
Show others...
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
Organisations

Search in DiVA

Show all publications