Coronary heart disease (CHD) is the leading cause of death for both men and women in the Western world. Some studies show that the observed decline in cardiovascular mortality is not as pronounced among women as among men. There is a growing awareness that most earlier studies both on primary and secondary risk factors, diagnosis, prognosis, and rehabilitation have focused mainly on men. Thus, there is a need to develop knowledge about women with CHD and to address gender issues in treatment and rehabilitation strategies. Negative affect and emotions increase risk and may interfere with effective cardiac rehabilitation. Therefore, methods for coping with emotional stress need to be included in treatment regimens after a coronary event. The feasibility of a stress management program for women with CHD was assessed in a pilot study. The program consisted of twenty 2-hr group sessions during 1 year, with 5 to 9 participants per group. The pilot study showed that this treatment program had a low dropout rate and resulted in improvement in quality of life and reduction in stress and symptoms. Further work to optimize psychosocial interventions for women with CHD is needed.
The aim of this cross-sectional study was to investigate physical and psychosocial aspects of the work environment, sociodemographic data and certain lifestyle factors, and the relationship between these variables and complaints in the shoulder/neck and low back area among female home care personnel. A questionnaire was completed by 361 randomly selected women. Multiple logistic regression analyses were conducted to evaluate the importance of several exposure factors for complaints in the shoulder/neck and low back areas. The results of this study clearly indicate that 'standing in forward-bent and twisted postures' can be viewed as a risk factor for shoulder/neck pain. A combination of this physical exposure and 'no possibility of influencing the planning of work' gave an increase in odds ratio, indicating an interaction between these two exposure indices. However, this interaction was not found for low back pain. 'Standing in forward-bent and twisted postures', 'standing in awkward positions' and whether the subject had children staying at home were significantly correlated to complaints about the low back. In fact, the latter factor decreased the risk of having complaints. The results indicated that certain physical and psychosocial work risk factors could influence shoulder/neck and low back pain.
The aim of this cross-sectional study was to investigate physical and psychosocial aspects of the work environment, sociodemographic data and certain lifestyle factors, and the relationship between these variables and complaints in the shoulder/neck and low back area among female home care personnel. A questionnaire was completed by 361 randomly selected women. Multiple logistic regression analyses were conducted to evaluate the importance of several exposure factors for complaints in the shoulder/neck and low back areas. The results of this study clearly indicate that 'standing in forward-bent and twisted postures' can be viewed as a risk factor for shoulder/neck pain. A combination of this physical exposure and 'no possibility of influencing the planning of work' gave an increase in odds ratio, indicating an interaction between these two exposure indices. However, this interaction was not found for low back pain. 'Standing in forward-bent and twisted postures', 'standing in awkward positions' and whether the subject had children staying at home were significantly correlated to complaints about the low back. In fact, the latter factor decreased the risk of having complaints. The results indicated that certain physical and psychosocial work risk factors could influence shoulder/neck and low back pain.
The aim of the present controlled study was to evaluate the effect of a general fitness program, performed by an occupational health service, using pre-post assessment for a number of different outcome measures. A total of 160 employees working in the central home care service district of Umeå, Sweden were asked to participate in a program of a 1-year long exercise program. Of the 160 selected, 54 subjects declined to participate and nine subjects were rejected after a medical check up. The remaining 97 subjects participated in a schedule consisting of pre-post medical and physiotherapy examinations, questionnaires concerning sociodemography, musculoskeletal and general health complaints and work environment, physiological tests of cardiovascular fitness, and of strength and endurance of shoulder flexors and knee extensors, and registration of sick leave. The subjects were randomly assigned to an exercise (treatment) or control group. The exercise group trained twice a week for 1 year using a mixed program including exercises for coordination, strength/endurance, and fitness. The test schedule was repeated for both groups after 1 year. The exercise intervention was associated with positive changes in prevalence and intensity of musculoskeletal and psychosomatic complaints, better physiotherapy status (less muscle tightness, better neck mobility, and less tender points), increased shoulder strength and increased coordination in thigh muscles. However, the exercise group reported worse situations post-exercise concerning aspects of their physical and psychosocial work-environment (i.e., concerning ergonomy, influence, appreciation and communication with work manager), which might have been due to stress associated with the exercise situation.
Several components of motivation for exercise were investigated in a sample of 5 1 subjects who participated in a five-month exercise program designed for people with back pain. Assessment of motivation was made prior to the program using a self-report questionnaire. Tests were made of the motivational factors' ability to classify subjects as higher or lower adherers. A combination of age, perceived lack of time to exercise, expected consequences of not taking action to relieve the back pain, and adherence self-efficacy, resulted in a logistic regression model that correctly identified 96% of the higher adherers and 84% of the lower adherers after five months of participation. The present pilot study offers preliminary data on potentially influential motivational components. In addition, the results clearly support the notion that motivation is best viewed as a complex psychological construct, thus indicating that assessments of motivation should be multifactorial.
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