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Fridlund, Bengt
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Publications (10 of 400) Show all publications
Algurén, B., Coenen, M., Malm, D., Fridlund, B., Mårtensson, J. & Årestedt, K. (2020). A scoping review and mapping exercise comparing the content of patient-reported outcome measures (PROMs) across heart disease-specific scales. Journal of Patient-Reported Outcomes, 4(1), Article ID 7.
Open this publication in new window or tab >>A scoping review and mapping exercise comparing the content of patient-reported outcome measures (PROMs) across heart disease-specific scales
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2020 (English)In: Journal of Patient-Reported Outcomes, ISSN 2509-8020, Vol. 4, no 1, article id 7Article, review/survey (Refereed) Published
Abstract [en]

BACKGROUND: Over the past decade, the importance of person-centered care has led to increased interest in patient-reported outcome measures (PROMs). In cardiovascular care, selecting an appropriate PROM for clinical use or research is challenging because multimorbidity is often common in patients. The aim was therefore to provide an overview of heart-disease specific PROMs and to compare the content of those outcomes using a bio-psycho-social framework of health.

METHODS: A scoping review of heart disease-specific PROMs, including arrhythmia/atrial fibrillation, congenital heart disease, heart failure, ischemic heart disease, and valve diseases was conducted in PubMed (January 2018). All items contained in the disease-specific PROMs were mapped to WHO's International Classification of Functioning, Disability and Health (ICF) according to standardized linking rules.

RESULTS: A total of 34 PROMs (heart diseases in general n = 5; cardiac arrhythmia n = 6; heart failure n = 14; ischemic heart disease n = 9) and 147 ICF categories were identified. ICF categories covered Body functions (n = 61), Activities & Participation (n = 69), and Environmental factors (n = 17). Most items were about experienced problems of Body functions and less often about patients' daily activities, and most PROMs were specifically developed for heart failure and no PROM were identified for valve disease or congenital heart disease.

CONCLUSIONS: Our results motivate and provide information to develop comprehensive PROMs that consider activity and participation by patients with various types of heart disease.

Place, publisher, year, edition, pages
Springer, 2020
Keywords
Healthcare quality, Patient outcome assessment, Heart disease, International Classification of Functioning, Disability and Health, Patient-reported outcome measures, Person-centered, Review
National Category
Cardiac and Cardiovascular Systems Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-47543 (URN)10.1186/s41687-019-0165-7 (DOI)31974688 (PubMedID)2-s2.0-85078179151 (Scopus ID)GOA HHJ 2020;HHJADULTIS,HHJIMPROVEIS (Local ID)GOA HHJ 2020;HHJADULTIS,HHJIMPROVEIS (Archive number)GOA HHJ 2020;HHJADULTIS,HHJIMPROVEIS (OAI)
Note

On behalf of the Collaboration and Exchange in Swedish cardiovascular caring Academic Research (CESAR) group.

Available from: 2020-01-27 Created: 2020-01-27 Last updated: 2020-02-04Bibliographically approved
Broström, A., Pakpour, A. H., Nilsen, P., Fridlund, B. & Ulander, M. (2019). Psychometric properties of the Ethos Brief Index (EBI) using factorial structure and Rasch Analysis among patients with obstructive sleep apnea before and after CPAP treatment is initiated. Sleep and Breathing, 23(3), 761-768
Open this publication in new window or tab >>Psychometric properties of the Ethos Brief Index (EBI) using factorial structure and Rasch Analysis among patients with obstructive sleep apnea before and after CPAP treatment is initiated
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2019 (English)In: Sleep and Breathing, ISSN 1520-9512, E-ISSN 1522-1709, Vol. 23, no 3, p. 761-768Article in journal (Refereed) Published
Abstract [en]

Background: Continuous positive airway treatment (CPAP) is the recommended treatment for patients with obstructive sleep apnea (OSA). Outcome measures often focus on clinical and/or self-rated variables related to the medical condition. However, a brief validated instrument focusing on the whole life situation (i.e., ethos) suitable for clinical practice is missing. The aim of this study was to investigate factorial structure, categorical functioning of the response scale, and differential item functioning across sub-populations of the Ethos Brief Index (EBI) among patients with obstructive sleep apnea (OSA) before and after initiation of continuous positive airway pressure (CPAP).

Methods: A prospective design, including 193 patients with OSA (68% men, 59.66 years, SD 11.51) from two CPAP clinics, was used. Clinical assessment and overnight respiratory polygraphy were used to diagnose patients. Questionnaires administered before and after 6 months of CPAP treatment included EBI, Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale, and global perceived health (initial item in SF-36). The validity and reliability of the EBI were investigated using Rasch and confirmatory factor analysis models. Measurement invariance, unidimensionality, and differential item functioning across gender groups, Apnea-Hypopnea Index, and ESS groups were assessed.

Results: The reliability of the EBI was confirmed using composite reliability and Cronbach’s alpha. The results supported unidimensionality of the EBI in confirmatory factor analysis and the Rasch model. No differential item functioning was found. A latent profile analysis yielded two profiles of patients with low (n = 42) and high (n = 151) ethos. Patients in the low ethos group were younger and had higher depression scores, lower perceived health, and higher body mass index.

Conclusions: The EBI is a valid tool with robust psychometric properties suitable for use among patients with OSA before and after treatment with CPAP is initiated. Future studies should focus on its predictive validity. 

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Continuous positive airway treatment, Ethos, Obstructive sleep apnea, Reliability, Validity
National Category
Neurology
Identifiers
urn:nbn:se:hj:diva-42408 (URN)10.1007/s11325-018-1762-z (DOI)000482433800006 ()30523558 (PubMedID)2-s2.0-85058127213 (Scopus ID)HOA HHJ 2019;HHJADULTIS (Local ID)HOA HHJ 2019;HHJADULTIS (Archive number)HOA HHJ 2019;HHJADULTIS (OAI)
Available from: 2019-01-02 Created: 2019-01-02 Last updated: 2019-10-01Bibliographically approved
Klompstra, L., Johansson Östbring, M., Jaarsma, T., Ågren, S., Fridlund, B., Hjelm, C., . . . Strömberg, A. (2019). The appropriateness and presentation of commonly available cardiovascular web pages providing information about cardiovascular diseases. Computers, Informatics, Nursing, 37(10), 493-497
Open this publication in new window or tab >>The appropriateness and presentation of commonly available cardiovascular web pages providing information about cardiovascular diseases
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2019 (English)In: Computers, Informatics, Nursing, ISSN 1538-2931, E-ISSN 1538-9774, Vol. 37, no 10, p. 493-497Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Wolters Kluwer, 2019
National Category
Information Systems Nursing
Identifiers
urn:nbn:se:hj:diva-47430 (URN)10.1097/CIN.0000000000000595 (DOI)000505544100001 ()31633511 (PubMedID)2-s2.0-85073605939 (Scopus ID);HHJADULTIS (Local ID);HHJADULTIS (Archive number);HHJADULTIS (OAI)
Available from: 2020-01-16 Created: 2020-01-16 Last updated: 2020-01-16Bibliographically approved
Lindmark, U., Bülow, P. H., Mårtensson, J., Rönning, H., Ahlstrand, I., Broström, A., . . . Sandgren, A. (2019). The use of the concept of transition in different disciplines within health and social welfare: An integrative literature review. Nursing Open, 6(3), 664-675
Open this publication in new window or tab >>The use of the concept of transition in different disciplines within health and social welfare: An integrative literature review
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2019 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 3, p. 664-675Article, review/survey (Refereed) Published
Abstract [en]

Aims

To continuing the quest of the concept of transition in nursing research and to explore how the concept of transition is used in occupational therapy, oral health and social work as well as in interdisciplinary studies in health and welfare, between 2003–2013.

Design

An integrative literature review.

Methods

PubMed, CINAHL, PsycINFO, DOSS, SocIndex, Social Science Citation Index and AMED databases from 2003–2013 were used. Identification of 350 articles including the concept of transition in relation to disciplines included. Assessment of articles are in accordance to Meleis' typologies of transition by experts in each discipline. Chosen key factors were entered into Statistical Package for the Social Sciences (SPSS).

Results

Meleis' four typologies were found in all studied disciplines, except development in oral health. The health‐illness type was the most commonly explored, whereas in social work and in occupation therapy, situational transitions dominated.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
literature review, nursing theory, occupational therapy, oral health, social welfare, social work, theory–practice gap, transition
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-43307 (URN)10.1002/nop2.249 (DOI)000476917700002 ()31367388 (PubMedID)2-s2.0-85069778425 (Scopus ID)GOA HHJ 2019 (Local ID)GOA HHJ 2019 (Archive number)GOA HHJ 2019 (OAI)
Available from: 2019-03-07 Created: 2019-03-07 Last updated: 2019-09-13Bibliographically approved
Arenhall, E., Eriksson, M., Nilsson, U., Steinke, E. E. & Fridlund, B. (2018). Decreased sexual function in partners after patients’ first-time myocardial infarction. European Journal of Cardiovascular Nursing, 17(6), 521-526
Open this publication in new window or tab >>Decreased sexual function in partners after patients’ first-time myocardial infarction
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2018 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, no 6, p. 521-526Article in journal (Refereed) Published
Abstract [en]

Background: A myocardial infarction event affects not only patients but also partners, although how it affects the partners’ sexual function is not studied.

Aim: The purpose of this study was to describe and compare how partners experienced their sexual function one year before with one year after first-time myocardial infarction of their partner.

Methods: A longitudinal and comparative design was used. Self-reported data on Watts Sexual Function Questionnaire was collected retrospectively at two occasions from 123 partners (87 women and 36 men), measuring the year prior to the first-time myocardial infarction and the year after. Data were analysed using descriptive and inferential statistics.

Results: The total score for Watts Sexual Function Questionnaire showed a significant decrease over time. In all four subscales a decrease was found, which were statistically significant in three out of the four subscales (sexual desire, 19.39 vs 18.61; p<0.001, orgasm, 14.11 vs 13.64; p=0.027 and satisfaction, 12.61 vs 12.31; p=0.042). Twenty-six partners reported that their intercourse frequencies decreased over time, while six partners reported an increased intercourse frequency.

Conclusions: Partners’ sexual function decreased after patients’ first-time myocardial infarction. It is important for health personnel to offer information and discussion about sexual function and concerns with both patients and partners after a first-time myocardial infarction. 

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Longitudinal, myocardial infarction, sexual function, sexual relationships, spouse, Watts Sexual Function Questionnaire
National Category
Cardiac and Cardiovascular Systems Nursing
Identifiers
urn:nbn:se:hj:diva-38892 (URN)10.1177/1474515117751904 (DOI)000440433800007 ()29291637 (PubMedID)2-s2.0-85041537787 (Scopus ID)HHJADULTIS (Local ID)HHJADULTIS (Archive number)HHJADULTIS (OAI)
Available from: 2018-02-21 Created: 2018-02-21 Last updated: 2018-08-24Bibliographically approved
Malm, D., Fridlund, B., Ekblad, H., Karlström, P., Hag, E. & Pakpour, A. H. (2018). Effects of brief mindfulness-based cognitive behavioural therapy on health-related quality of life and sense of coherence in atrial fibrillation patients. European Journal of Cardiovascular Nursing, 17(7), 589-597
Open this publication in new window or tab >>Effects of brief mindfulness-based cognitive behavioural therapy on health-related quality of life and sense of coherence in atrial fibrillation patients
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2018 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, no 7, p. 589-597Article in journal (Refereed) Published
Abstract [en]

Background: The aim of this study was to evaluate the effects of a brief dyadic cognitive behavioural therapy (CBT) programme on the health-related quality of life (HRQoL), as well as the sense of coherence in atrial fibrillation patients, up to 12 months post atrial fibrillation.

Methods: A longitudinal randomised controlled trial with a pre and 12-month post-test recruitment of 163 persons and their spouses, at a county hospital in southern Sweden. In all, 104 persons were randomly assigned to either a CBT (n=56) or a treatment as usual (TAU) group (n=55). The primary outcome was changes in the HRQoL (Euroqol questionnaire; EQ-5D), and the secondary outcomes were changes in psychological distress (hospital anxiety and depression scale; HADS) and sense of coherence (sense of coherence scale; SOC-13).

Results: At the 12-month follow-up, the CBT group experienced a higher HRQoL than the TAU group (mean changes in the CBT group 0.062 vs. mean changes in the TAU group −0.015; P=0.02). The sense of coherence improved in the CBT group after the 12-month follow-up, compared to the TAU group (mean changes in the CBT group 0.062 vs. mean changes in the TAU group −0.16; P=0.04). The association between the intervention effect and the HRQoL was totally mediated by the sense of coherence (z=2.07, P=0.04).

Conclusions: A dyadic mindfulness-based CBT programme improved HRQoL and reduced psychological distress up to 12 months post atrial fibrillation. The sense of coherence strongly mediated the HRQoL; consequently, the sense of coherence is an important determinant to consider when designing programmes for atrial fibrillation patients. 

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
atrial fibrillation, Cognitive behavioural therapy, health-related quality of life, intervention, randomised controlled trial, sense of coherence, spouse, aged, Article, cognitive behavioral therapy, controlled study, distress syndrome, dyspnea, female, Hospital Anxiety and Depression Scale, hospital discharge, human, Likert scale, longitudinal study, major clinical study, male, priority journal, quality of life, questionnaire, randomized controlled trial
National Category
Cardiac and Cardiovascular Systems Nursing
Identifiers
urn:nbn:se:hj:diva-42334 (URN)10.1177/1474515118762796 (DOI)000446099600003 ()29493266 (PubMedID)2-s2.0-85057837415 (Scopus ID)HHJMPROVEIS (Local ID)HHJMPROVEIS (Archive number)HHJMPROVEIS (OAI)
Funder
Medical Research Council of Southeast Sweden (FORSS), 464211
Available from: 2018-12-18 Created: 2018-12-18 Last updated: 2018-12-18Bibliographically approved
Bala, S.-V., Forslind, K., Fridlund, B. & Hagell, P. (2018). Measuring person-centred care in nurse-led outpatient rheumatology clinics. Musculoskeletal Care, 16(2), 296-304
Open this publication in new window or tab >>Measuring person-centred care in nurse-led outpatient rheumatology clinics
2018 (English)In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 16, no 2, p. 296-304Article in journal (Refereed) Published
Abstract [en]

Background: Measurement of person-centred care (PCC) outcomes is underdeveloped owing to the complexity of the concept and lack of conceptual clarity. A framework conceptualizing outpatient PCC in rheumatology nurse-led clinics has therefore been suggested and operationalized into the PCC instrument for outpatient care in rheumatology (PCCoc/rheum).

Objective: The aim of the present study was to test the extent to which the PCCoc/rheum represents the underpinning conceptual outpatient PCC framework, and to assess its measurement properties as applied in nurse-led outpatient rheumatology clinics.

Methods: The 24-item PCCoc/rheum was administered to 343 persons with rheumatoid arthritis from six nurse-led outpatient rheumatology clinics. Its measurement properties were tested by Rasch measurement theory.

Results: Ninety-two per cent of individuals (n = 316) answered the PCCoc/rheum. Items successfully operationalized a quantitative continuum from lower to higher degrees of perceived PCC. Model fit was generally good, including lack of differential item functioning (DIF), and the PCCoc/rheum was able to separate individuals with a reliability of 0.88. The four response categories worked as intended, with the exception of one item. Item ordering provided general empirical support of a priori expectations, with the exception of three items that were omitted owing to multidimensionality, dysfunctional response categories and unexpected ordering. The 21-item PCCoc/rheum showed good accordance with the conceptual framework, improved fit, functioning response categories and no DIF, and its reliability was 0.86.

Conclusion: We found general support for the appropriateness of the PCCoc/rheum as an outcome measure of patient-perceived PCC in nurse-led outpatient rheumatology clinics. While in need of further testing, the 21-item PCCoc/rheum has the potential to evaluate outpatient PCC from a patient perspective.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
measurement, nurse-led rheumatology clinics, outpatient, person-centred care
National Category
Nursing Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:hj:diva-40947 (URN)10.1002/msc.1234 (DOI)000435802900007 ()29484828 (PubMedID)2-s2.0-85042523791 (Scopus ID)
Note

This study was supported by grants from the Stig and Ragna Gorthon Foundation in Helsingborg, Sweden, and the Foundation for Assistance to Disabled People in Skåne (Stiftelsen för Bistånd åt Rörelsehindrade i Skåne). The authors thank all participants for their cooperation and for sharing their experiences, and the nurses for their commitment and help in recruiting participants. We also thank the BARFOT study group for facilitating the conduct of the study.

Available from: 2018-07-05 Created: 2018-07-05 Last updated: 2018-07-05Bibliographically approved
Amofah, H. A., Broström, A., Fridlund, B., Haaverstad, R., Instenes, I., Kuiper, K. K., . . . Norekval, T. M. (2018). Octogenarian patients experiences with hypnotics in relation to sleep disturbances and delirium after aortic valve therapy. European Journal of Cardiovascular Nursing, 17, 104-105
Open this publication in new window or tab >>Octogenarian patients experiences with hypnotics in relation to sleep disturbances and delirium after aortic valve therapy
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2018 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, p. 104-105Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Sleep disturbance and delirium are complications after surgical aortic valve replacement (SAVR) and transcutaneous aortic valve replacement (TAVI), especially in octogenarian patients. Sedatives and z-hypnotics are medications distributed to promote sleep. However, a knowledge-gap exists on patient experiences with these medications, and sleep and delirium after the cardiac treatment.

Aim: To explore and describe how octogenarians suffering from delirium after SAVR/TAVI experience their sleep situation related to sedatives and z-hypnotics, in a long-term perspective.

Methods An explorative and descriptive design with a longitudinal qualitative approach was applied. Inclusion criteria; age 80+, treated with SAVR or TAVI and had experienced delirium. Information about administration of sedatives and z-hypnotics was collected from the patients journals. The Confusion Assessment Method (CAM) was used to assess delirium, the Sleep Sufficient Index (SSI) and Minimal Insomnia Symptom Scale (MISS) were used to document self-reported sleep and insomnia. All measures were performed at baseline and daily the five first postoperative days. Ten patients were interviewed 6-12 months after treatment with focus on delirium. Five of these patients were re-interviewed four years later, focusing on their sleep situation.

Findings: For the initial interview, five men and five woman, four after TAVI and six after SAVR, mean age 83 were included. One overarching theme revealed; hours in bed represented an emotional chaos. Three sub-themes described the patients experiences with sleep and delirium, a cascade of distressful experiences, the struggle between sleep and activity and elements influencing sleep. In the category physical sleep distractions, sleep medications emerged as a sleep disturbing element but also to evoke delirium. Patients described to be offered sedatives and z-hypnotics in hospital. However, they did not have a positive experience with this as the medication did not make them sleep better. Moreover, they associated the nightmares by the sedatives Four years after the cardiac treatment, the octogenarian patients described that medication did not have a sleep promoting effect, and they did not want it.

Conclusion: Octogenarian patients are vulnerable to complications like sleep disturbances and delirium. In preventing and treating these conditions, health-care professionals should be aware of the effect and side-effect of sedatives and z-hypnotics in the octogenarian patients. Our findings show that medications should be cautiously used within this group of patients.

Place, publisher, year, edition, pages
Sage Publications, 2018
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:hj:diva-41230 (URN)10.1177/1474515118787764 (DOI)000440339600176 ()
Available from: 2018-08-24 Created: 2018-08-24 Last updated: 2018-08-24Bibliographically approved
Bala, S.-V., Forslind, K., Fridlund, B., Samuelson, K., Svensson, B. & Hagell, P. (2018). Person-centred care in nurse-led outpatient rheumatology clinics: Conceptualization and initial development of a measurement instrument. Musculoskeletal Care, 16(2), 287-295
Open this publication in new window or tab >>Person-centred care in nurse-led outpatient rheumatology clinics: Conceptualization and initial development of a measurement instrument
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2018 (English)In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 16, no 2, p. 287-295Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Person-centred care (PCC) is considered a key component of effective illness management and high-quality care. However, the PCC concept is underdeveloped in outpatient care. In rheumatology, PCC is considered an unmet need and its further development and evaluation is of high priority. The aim of the present study was to conceptualize and operationalize PCC, in order to develop an instrument for measuring patient-perceived PCC in nurse-led outpatient rheumatology clinics.

METHODS: A conceptual outpatient PCC framework was developed, based on the experiences of people with rheumatoid arthritis (RA), person-centredness principles and existing PCC frameworks. The resulting framework was operationalized into the PCC instrument for outpatient care in rheumatology (PCCoc/rheum), which was tested for acceptability and content validity among 50 individuals with RA attending a nurse-led outpatient clinic.

RESULTS: The conceptual framework focuses on the meeting between the person with RA and the nurse, and comprises five interrelated domains: social environment, personalization, shared decision-making, empowerment and communication. Operationalization of the domains into a pool of items generated a preliminary PCCoc/rheum version, which was completed in a mean (standard deviation) of 5.3 (2.5) min. Respondents found items easy to understand (77%) and relevant (93%). The Content Validity Index of the PCCoc/rheum was 0.94 (item level range, 0.87-1.0). About 80% of respondents considered some items redundant. Based on these results, the PCCoc/rheum was revised into a 24-item questionnaire.

CONCLUSIONS: A conceptual outpatient PCC framework and a 24-item questionnaire intended to measure PCC in nurse-led outpatient rheumatology clinics were developed. The extent to which the questionnaire represents a measurement instrument remains to be tested.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
measurement, nurse-led rheumatology clinics, outpatient, person-centred care conceptual framework
National Category
Nursing Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:hj:diva-38893 (URN)10.1002/msc.1233 (DOI)000435802900006 ()29417713 (PubMedID)2-s2.0-85041676259 (Scopus ID)
Available from: 2018-02-21 Created: 2018-02-21 Last updated: 2018-07-05Bibliographically approved
Pakpour, A. H., Lin, C.-Y., Kumar, S., Fridlund, B. & Jansson, H. (2018). Predictors of oral health-related quality of life in Iranian adolescents: A prospective study.. Journal of Investigative and Clinical Dentistry, 9(1), Article ID e12264.
Open this publication in new window or tab >>Predictors of oral health-related quality of life in Iranian adolescents: A prospective study.
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2018 (English)In: Journal of Investigative and Clinical Dentistry, ISSN 2041-1618, E-ISSN 2041-1626, Vol. 9, no 1, article id e12264Article in journal (Refereed) Published
Abstract [en]

AIM: In the present study, we evaluated the direct and mediating (indirect) effects of clinical oral conditions, dental anxiety, sense of coherence (SOC), and socioeconomic variables on oral health-related quality of life (OHRQoL) and general health-related quality of life (GHRQoL) in Iranian adolescents.

METHODS: A longitudinal design was used with a sample of 1052 (694 males, mean age=15.05 years) schoolchildren from Qazvin, Iran. Each participant completed a background information sheet and the following scales at baseline: Modified Dental Anxiety Scale, SOC, PedsQL 4.0 Generic Core Scale, and PedsQL Oral Health Scale. The PedsQL 4.0 Generic Core and Oral Health scales were recompleted at the 18-mo follow up.

RESULTS: Father's education, monthly family income, dental anxiety, Community Periodontal Index (CPI), decayed, missing, and filled teeth (DMFT), and SOC significantly and directly predicted OHRQoL at 18 mo. Father's education had indirect effects on OHRQoL through CPI and DMFT, family income had indirect effects through DMFT, and dental anxiety had indirect effects through CPI. OHRQoL at 18 mo (β=0.499) and SOC (β=0.084) had significant and direct and mediating effects through OHRQoL on GHRQoL, while father's education, monthly family income, dental anxiety, CPI, and DMFT only showed mediating effects.

CONCLUSIONS: Clinical oral indicators had direct effects on OHRQoL, but mediated the effects of dental anxiety and socioeconomic status on both OHRQoL and GHRQoL.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
adolescent, longitudinal study, oral health, oral health-related quality of life, structural equation modeling
National Category
Dentistry Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hj:diva-38899 (URN)10.1111/jicd.12264 (DOI)000424272100001 ()28386989 (PubMedID)2-s2.0-85053353498 (Scopus ID)HHJOralIS (Local ID)HHJOralIS (Archive number)HHJOralIS (OAI)
Available from: 2018-02-22 Created: 2018-02-22 Last updated: 2018-10-02Bibliographically approved
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