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Birkeland S, Bismark M, Barry MJ, Möller S. Complaint behaviour among healthcare users: self-reported complaint experience and complaint proneness in adult men. BMJ Open Qual 2024; 13:e002581. [PMID: 38365433 PMCID: PMC10875482 DOI: 10.1136/bmjoq-2023-002581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/25/2024] [Indexed: 02/18/2024] Open
Abstract
AIMS When patients are harmed by, or dissatisfied with, healthcare, only a minority will lodge a complaint or file a claim for compensation. This survey aimed to investigate complaint behaviour and inequalities in complaints using self-reports and hypothetical case vignettes. METHODS Cross-sectional, web-based survey among 6755 Danish men aged 45-70 years (response rate=30%). Participants reported their lifetime complaint experience and the likelihood that they would complain in response to hypothetical case vignettes. RESULTS Overall, 4.8% of participants had complained about healthcare. Predictors were younger age (OR 2.08, 95% CI 1.32 to 3.27, p=0.002 45-50 years compared with 65-70 years), chronic illness (OR 1.49, 95% CI 1.12 to 1.98, p=0.006), rural residence (OR 2.11, 95% CI 1.20 to 3.73, p=0.010 comparing least and most populated areas), high healthcare utilisation (OR 1.55, 95% CI 1.18 to 2.03, p=0.002 primary care, and OR 1.97, 95% CI 1.52 to 2.55, p=0.000 hospital care) and decreased agreeableness on the 10-item Big Five personality inventory (OR 0.91, 95% CI 0.83 to 0.99, p=0.034). Complaint experience was associated with increased wish to complain about the treatment in the hypothetical vignettes (p=0.006). CONCLUSIONS Roughly 1 in 20 men reported having complained about healthcare. Complaints were more common among men who were younger, living in rural areas, diagnosed with chronic illness and high users of healthcare services. Prior complaint experience may be associated with a higher proclivity for complaining about future healthcare. Findings suggest differences in the way healthcare users respond to care experiences, pointing to the importance of aligning expectations and providing clear information about treatment options.
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Affiliation(s)
- Søren Birkeland
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Open Patient data Exploratory Network, Odense University Hospital, Odense, Denmark
| | - Marie Bismark
- Public Health Law, University of Melbourne, Parkville, Victoria, Australia
| | | | - Sören Möller
- Open Patient data Exploratory Network, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Nilou FE, Christoffersen NB, Pedersen PV, Ekholm O, Ahlmark NG. The Danish Health Survey among Marginalized People: Study design and respondent characteristics. Scand J Public Health 2024:14034948231224239. [PMID: 38326783 DOI: 10.1177/14034948231224239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
AIM The Danish Health Survey among Marginalized People is a nationwide health survey targeting people in marginalized life situations in Denmark. The aim of this paper is to present the study design, data collection methods and respondent characteristics of the survey, which was conducted in 2007, 2012, 2017 and 2022. METHODS The survey applies an outreach data collection approach which entails reaching out to social services (public and private) asking for their help with distributing self-administered paper questionnaires among their users. Themes include self-rated health, mental health, morbidity, pain, oral health, health behaviours, gambling problems, social relations, violence, sexual harassment and assault, suicide, and source of income. RESULTS The overall number of respondents has decreased slightly from 2007 (1290) to 2022 (1134). In all survey waves, men were overrepresented among the respondents. In 2007, women represented only 28%, which increased to 37% in 2022. There have been remarkable changes in the age distribution among respondents between 2007 and 2022. For example, the oldest age group (55-80 years) accounted for 15% of the respondents in 2007 and 40% in 2022. CONCLUSIONS Conducting surveys among marginalized people entails methodological challenges and ethical considerations. However, continually attempting to reach marginalized people in surveys by tailoring data collection strategies to their specific life situation is essential to gain insight into their health and well-being.
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Affiliation(s)
- Freja E Nilou
- National Institute of Public Health, University of Southern Denmark, Denmark
| | | | - Pia V Pedersen
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Nanna G Ahlmark
- National Institute of Public Health, University of Southern Denmark, Denmark
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Rosenkilde S, Sørensen TIA, Algren MH, Thygesen LC. Changes in weight status during the COVID-19 pandemic: impact of educational level and mental health. Eur J Public Health 2024; 34:190-195. [PMID: 37968230 PMCID: PMC10843948 DOI: 10.1093/eurpub/ckad188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has resulted in a disruption of daily routines and changes in health behaviors leading to widespread concerns about unfavorable changes in weight status and a potential increase in the prevalence of obesity. This study examined the long-term impact of the COVID-19 pandemic on changes in weight status and its possible dependency on educational level and mental health. METHODS The study utilizes the Danish Health and Well-being Survey with repeated self-reported information on weight status collected before the COVID-19 pandemic (autumn of 2019) and twice during the pandemic (autumns of 2020 and 2021). Information on educational level was derived from registers, whereas mental health was measured using validated scales. Generalized estimating equations were performed to investigate changes in mean weight and body mass index (BMI) category (BMI < 30 to BMI ≥ 30) between 2019 and 2021 and to investigate potential differences in changes in weight status by pre-pandemic educational level and mental health. RESULTS Mean weight significantly increased by 0.34 kg [95% confidence interval (CI): 0.16-0.51] in 2020 and by 0.46 kg (95% CI: 0.26-0.66) in 2021 compared with pre-pandemic weight status. The increase was greater among individuals with lower educational levels and poorer mental health. There were no significant changes in BMI category during the pandemic. CONCLUSION The results showed a significant increase in mean weight among the Danish population, particularly among individuals with lower educational levels and poorer mental health, but without detectable differences in obesity, supporting a long-term but minor impact of the COVID-19 pandemic on weight status.
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Affiliation(s)
- Siri Rosenkilde
- National Institute of Public Health, University of Southern Denmark, Copenhagen K, Denmark
| | - Thorkild I A Sørensen
- National Institute of Public Health, University of Southern Denmark, Copenhagen K, Denmark
- Department of Public Health, Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen K, Denmark
| | - Maria H Algren
- National Institute of Public Health, University of Southern Denmark, Copenhagen K, Denmark
| | - Lau C Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen K, Denmark
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Møller SR, Ekholm O, Christensen AI. Trends in the use of complementary and alternative medicine between 1987 and 2021 in Denmark. BMC Complement Med Ther 2024; 24:23. [PMID: 38184579 PMCID: PMC10770893 DOI: 10.1186/s12906-023-04327-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 12/23/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND Complementary and alternative medicine (CAM) has been widely and increasingly used worldwide during the past decades. Nevertheless, studies in long-term trends of CAM use are limited. The aim of this study was to assess long-term trends in the prevalence of CAM use (both overall and for specific CAMs) between 1987 and 2021 in the adult Danish population and to examine certain sociodemographic characteristics of CAM users. METHODS Data derived from nationally representative health surveys in the general adult population (≥ 16 years) in Denmark (the Danish Health and Morbidity Surveys) conducted in 1987, 1994, 2000, 2005, 2010, 2013, 2017, and 2021. The response proportion declined from 79.9% in 1987 to 45.4% in 2021. CAM use was assessed by questions on ever use of specific types of CAMs and overall use within the past 12 months. Differences in use of CAMs across educational levels were assessed using the Slope Index of Inequality (SII). RESULTS An overall increase in the prevalence of CAM use within the past 12 months was found between 1987 (10.0%) and 2021 (24.0%). However, a stagnation was observed between 2010 and 2017, after which the prevalence decreased in 2021. In all survey waves, the prevalence was higher among women than men. For both sexes, the prevalence tended to be highest among respondents aged 25-44 years and 45-64 years. The group with 13-14 years of education had the highest prevalence of CAM use compared to the other educational groups (< 10 years, 10-12 years, and ≥ 15 years). SII values for both men and women increased between 1987 and 2021, which indicates an increase in differences of CAM use across educational groups. In all survey waves the most frequently used CAMs included massage and other manipulative therapies, acupuncture, and reflexology. CONCLUSIONS The use of CAM has increased markedly within the last decades and recently stagnated at high levels, which underlines the importance of securing high quality information and education for the public, health professionals, and legislators to ensure and promote safe use of CAMs.
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Affiliation(s)
- Sofie Rossen Møller
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, Copenhagen K, 1455, Denmark.
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, Copenhagen K, 1455, Denmark
| | - Anne Illemann Christensen
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, Copenhagen K, 1455, Denmark
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Zangger G, Mortensen SR, Tang LH, Thygesen LC, Skou ST. Association between digital health literacy and physical activity levels among individuals with and without long-term health conditions: Data from a cross-sectional survey of 19,231 individuals. Digit Health 2024; 10:20552076241233158. [PMID: 38410789 PMCID: PMC10896057 DOI: 10.1177/20552076241233158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 02/28/2024] Open
Abstract
Objectives This study explored associations between digital health literacy and physical activity levels and assessed potential interactions of long-term health conditions. Methods A cross-sectional survey was sent to 34,000 inhabitants in Region Zealand, Denmark. The survey included items on physical activity levels and three electronic Health Literacy Questionnaire (eHLQ) scales (1, 4, and 5). Associations were assessed by logistic regression and adjusted for confounders. Results A total of 19,231 participated in the survey. Positive associations were found between higher digital health literacy and being active >30 min./week at moderate-to-vigorous intensity (eHLQ 1: OR 1.24, p < 0.001; eHLQ 4: OR 1.13, p = 0.012; eHLQ 5: OR 1.25, p < 0.001), compliance with the World Health Organization minimum recommendations for physical activity (eHLQ 1: OR 1.33 p < 0.001; eHLQ 4: OR 1.08 p = 0.025; eHLQ 5: OR 1.32, p < 0.001), and self-reported physical active (eHLQ 1: OR 1.50 p < 0.001; eHLQ 4: OR 1.24 p < 0.001; eHLQ 5: OR 1.54 p < 0.001), even when fully adjusted for covariates. No significant interaction was found for long-term health conditions. However, individuals with more long-term health conditions exhibited the lowest digital health literacy scores (9% to 19% scored <2.0). Conclusion A higher digital health literacy is positively associated with higher physical activity levels. This highlights the importance of screening and promoting digital health literacy in managing digital health and digital physical activity interventions. Future research should explore strategies and targeted interventions to enhance digital health literacy and improve health outcomes.
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Affiliation(s)
- Graziella Zangger
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Region Zealand, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Sofie Rath Mortensen
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Region Zealand, Slagelse, Denmark
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lars Herman Tang
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Region Zealand, Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Søren T. Skou
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Region Zealand, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Høgsholt M, Kierkegaard-Brøchner S, Sørensen UM, Lange LB, Mortensen LS, Bruun JM. Participation in a multicomponent lifestyle intervention for people with obesity improves glycated hemoglobin (HbA 1c). Front Clin Diabetes Healthc 2023; 4:1274388. [PMID: 38188588 PMCID: PMC10766760 DOI: 10.3389/fcdhc.2023.1274388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/06/2023] [Indexed: 01/09/2024]
Abstract
Introduction Obesity is associated with compromised glucose metabolism. Hence, it is of interest to investigate if the lifestyle interventions used in the LIBRA-cohort, which aimed at not only weight loss, but also patient well-being, could also help obese patients improve glucose metabolism by evidence of reduced HbA1c. The aim of the study was to retrospectively investigate if patients who were referred to a lifestyle intervention for obesity, were able to alter HbA1c. Research design and methods Patients with a BMI≥30 undergoing a 6-month lifestyle intervention, who also completed physical and mental health surveys and whose baseline and 6-month blood samples were available, were included in the analysis. For changes in HbA1c and body weight a clinically relevant change of 5≥mmom/mol and 5%≥, respectively, was chosen. Participants were divided into groups according to their baseline HbA1c level: "Diabetes": HbA1c of ≥6.5% (≥48 mmol/mol), "Prediabetes": HbA1c of 5.7% to 6.4% (39-47.99 mmol/mol) or "Normal" HbA1c <5.7% (<39 mmol/mol). Results 180 patients met the stated inclusion criteria and these patients were divided into groups (median age (25th;75th quartile): Diabetes: n=47, age 54 (43;60), 51% women, Prediabetes: n=68, age 60 (50;66), 71% women and Normal: n=65, median age 61 (50;66), 85% women. Significant reductions were found in all three groups and specifically in the diabetes group HbA1c was reduced (mean [95%CI]) -5[-8;-2] mmol/mol from baseline to the end of the intervention. Furthermore, 35% of patients with prediabetes normalized their HbA1c (<39) and 30% patients with diabetes reduced their HbA1c <48. All groups had clinically relevant (≥5%) reductions in body weight (p<0.01). There was an association between body weight reduction and HbA1c reduction in the diabetes group (p<0.01). All groups reported improvements in physical health (p<0.01). Conclusion In this retrospective cohort study, all patients achieved clinically relevant weight loss after participation in the lifestyle intervention and obese patients with diabetes achieved clinically relevant reductions in HbA1c after 6-months. More than 1/3 of patients with prediabetes normalized their HbA1c.
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Affiliation(s)
- Mathias Høgsholt
- Department of Lifestyle Rehabilitation and Physio and Occupational Therapy, Horsens Regional Hospital, Horsens, Denmark
| | - Signe Kierkegaard-Brøchner
- Department of Lifestyle Rehabilitation and Physio and Occupational Therapy, Horsens Regional Hospital, Horsens, Denmark
| | - Ulla Milther Sørensen
- Department of Lifestyle Rehabilitation and Physio and Occupational Therapy, Horsens Regional Hospital, Horsens, Denmark
| | - Lene Bastrup Lange
- Department of Lifestyle Rehabilitation and Physio and Occupational Therapy, Horsens Regional Hospital, Horsens, Denmark
| | | | - Jens Meldgaard Bruun
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Steno Diabetes Centre, Aarhus University Hospital, Aarhus, Denmark
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Jensen A, Folker AP, Lindström M, Ekholm O. Arts and culture engagement for health: a Danish population-based study. Public Health 2023; 225:120-126. [PMID: 37925836 DOI: 10.1016/j.puhe.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/28/2023] [Accepted: 09/13/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVES Global health challenges are complex and new approaches are pivotal. Engagement in arts and cultural activities is commonplace across different cultures, and research shows associations with benefits for health and wellbeing. Using the arts for health promotion and prevention of illness has increased worldwide. STUDY DESIGN A population-based study. METHODS Data were obtained from the Danish Health and Wellbeing Survey in 2019. A self-administered questionnaire was sent to 14,000 randomly selected adults (aged ≥15 years). The questionnaire included items on self-rated health and frequency of participation in various cultural activities (concerts or musical events; participation in a choir, band, or orchestra; theatre show or other performing arts; cinema; art museum or exhibition; library). A cultural participation index was calculated based on the six questions on cultural activities. Logistic regression models were fitted to examine the associations between the index and good self-rated health, adjusting for relevant covariates. RESULTS In total, 6629 individuals completed the questionnaire (47.4%). The most frequent activity, used at least once a month, was visiting a library. A strong association between the cultural participation index and self-reported health was observed. A one-point-higher index score was associated with a 10% higher likelihood of having good self-reported health (adjusted odds ratio: 1.10; 95% confidence interval: 1.08-1.12). CONCLUSIONS This study supports the understanding that engagement in arts and cultural activities is beneficial for self-rated good health. Individuals with higher frequency of arts and culture engagement were more likely to report good health than those with lower engagement.
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Affiliation(s)
- Anita Jensen
- Social Medicine and Health Policy, Department of Clinical Science & Centre for Primary Health Care, Lund University and Region Skåne, Sweden.
| | - Anna Paldam Folker
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Martin Lindström
- Social Medicine and Health Policy, Department of Clinical Science & Centre for Primary Health Care, Lund University and Region Skåne, Sweden
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Denmark
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Lyngsøe S, Lophaven S, Jepsen R, Holmager T, Janssens A, Lynge E. Non-participation in a health examination survey in a rural-provincial area of Denmark - results from the Lolland-Falster Health Study (LOFUS). Scand J Public Health 2023:14034948231206879. [PMID: 37953717 DOI: 10.1177/14034948231206879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
BACKGROUND Lolland-Falster Health Study (LOFUS) was a health examination survey that included self-administered questionnaires, clinical examinations, and the collection of biological samples, undertaken in 2016-2020 in a rural, socioeconomically deprived area with the lowest life expectancy in Denmark. The aim of this study was to examine the determinants of non-participation in LOFUS to evaluate the extent to which LOFUS data reflected the general population of the area. METHODS LOFUS invited randomly selected subjects together with their entire household. As determinants of non-participation, we analyzed age, sex, municipality of residency, citizenship, residency status, socioeconomic status, invitation type, and year of invitation. Relative risk regression was used to estimate the association between determinants and non-participation rate, mutually adjusted for other determinants. RESULTS In total, 53,313 subjects were invited of whom 18,949 (36%) participated. In the multivariable analysis, men had a 3% higher non-participation rate than women; subjects with citizenship other than Danish had a 3% higher non-participation rate than Danes. In-migrants had 6% higher non-participation than long-term residents. Compared with self-supported subjects aged 30-64, both publicly supported subjects of this age and younger and older subjects had higher non-participation rates: 16%, 16%, and 13%, respectively. Compared with self-supported, long-term residents, publicly supported in-migrants had 23% higher non-participation. CONCLUSIONS Only about one third of subjects invited to LOFUS participated. Yet, this is a relatively high participation rate compared with other recent health examination surveys in Denmark. Furthermore, there was a relatively flat social gradient in the non-participation rate across the studied determinants.
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Affiliation(s)
- Signe Lyngsøe
- Nykøbing Falster Hospital, Nykøbing Falster, Denmark
| | | | - Randi Jepsen
- Nykøbing Falster Hospital, Nykøbing Falster, Denmark
| | | | - Astrid Janssens
- Bioethics and Health Humanities, Utrecht University Medical Center, University Utrecht, the Netherlands
- Unit of User Perspectives, University of Southern Denmark, Odense, Denmark and Center for Research with Patients and Relatives (ForSa-P), Odense University Hospital, Denmark
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Hansen J, Hansen H, Nilsson C, Ekholm O, Molsted S. Association between educational level and self-reported musculoskeletal pain and physical functioning in Danes 60-70 years old from 2010 to 2017: a longitudinal analysis of trends over time on data from the Danish Health and Morbidity Survey. BMJ Open 2023; 13:e073523. [PMID: 37914297 PMCID: PMC10626833 DOI: 10.1136/bmjopen-2023-073523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 10/13/2023] [Indexed: 11/03/2023] Open
Abstract
OBJECTIVES The aims of this study were to investigate the association between educational level and musculoskeletal pain and physical function, respectively, in persons 60-70 years old, and to investigate if the association changed from 2010 to 2017. DESIGN AND PARTICIPANTS This is a sex-stratified, cross-sectional study based on data from the Danish Health and Morbidity Survey in 2010 (n=15 165) and in 2017 (n=14 022).Self-reported data from respondents who were 60-70 years old and reported data for pain or physical function, sociodemographic, education and behavioural factors were included. PRIMARY OUTCOME MEASURES Prevalence of pain and physical limitations. RESULTS Among men, a high educational level was associated with reduced odds of pain compared with low educational level (OR 0.56 (95% CI 0.41; 0.74)). Medium and high educational levels were associated with reduced odds of pain in women (0.74 (0.59; 0.92) and 0.64 (0.41; 1.00), respectively). High educational level was associated with reduced odds of physical limitations in men (0.35 (0.19; 0.65)) and women (0.33 (0.14; 0.78)). The interaction terms between time and education were not associated with pain and physical function, respectively. CONCLUSION High education was associated with reduced musculoskeletal pain and reduced limitations of physical function. The association between education and musculoskeletal pain and physical function did not change significantly over time. Musculoskeletal pain during the past 14 days and chronic pain among old men and women 60-70 years and their level of physical function contribute to important knowledge of a group near the retirement age. The future perspectives illustrate trends and importance of focusing on adapting job accommodations for senior workers.
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Affiliation(s)
- Jeanette Hansen
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, University College Copenhagen, Copenhagen, Denmark
| | - Henrik Hansen
- Respiratory Research Unit, Department of Respiratory Medicine, Hvidovre Hospital, Hvidovre, Denmark
| | - Charlotte Nilsson
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Ola Ekholm
- Department of Clinical Research, Nordsjællands Hospital, Copenhagen, Denmark
| | - Stig Molsted
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Gabel C, Elholm G, Rasmussen MK, Broholt TH, Jensen SR, Petersen S, Sigsgaard T. The HOME-Health (HOusing, environMEnt, and Health) Study; Description of a Danish natural experiment, designed as a longitudinal study with repeated measurements, providing internal- and external validity of the study. Environ Health Insights 2023; 17:11786302231181489. [PMID: 37456908 PMCID: PMC10345915 DOI: 10.1177/11786302231181489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/25/2023] [Indexed: 07/18/2023]
Abstract
Background The ambient and indoor environment are pivotal to our health. We spend most of our time indoors within our home, why our home is where we are most exposed to indoor pollutants and indoor air quality (IAQ). Populations within social housing areas are more vulnerable due to advanced age, co-morbidity and social economic status. Commonly, studies within social housing are cross-sectional, few Nordic longitudinal studies exist, and fewer studies combine quantitative and qualitative measurements in a mixed method approach. Method This research proposal provides an extensive detailed description of the design and methodology of the HOME-Health study. The study is a longitudinal study and is a natural experiment employing structured surveys, objective measurements of indoor air parameters, lung function test and qualitative semi-structured interviews. Data collection are conducted seasonally (winter and summer), before and after building energy renovation (BER). Generalisability The study population before BER (n = 432) was explored and found similar to the Danish social housing population in terms of age, gender, persons per apartment and migration status. Future analyses should be stratified by multi-family apartments and terraced houses. Research aim The aim of the HOME-Health study is to provide knowledge about residents' seasonal state of health, perception of indoor enviromental quality (IEQ), IEQ-related behaviours and practices, and objective measurements of IAQ before and after BER. By applying a design with repeated measurement before and after BER, and combining both objective and subjective quantitative as well as qualitative data the study is expected to create in-depth knowledge. Future results will provide evidence of both energy-savings and non-energy savings from different BER projects. Knowledge which are expected to benefit future renovation projects within social housing areas.
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Affiliation(s)
- Charlotte Gabel
- Department of Public Health, section of Environment, Occupation and Health, Aarhus University, Aarhus, Denmark
| | - Grethe Elholm
- Department of Public Health, section of Environment, Occupation and Health, Aarhus University, Aarhus, Denmark
| | - Mia Kruse Rasmussen
- Alexandra Institute, Aarhus, Denmark
- Department of Civil and Architectural Engineering, Aarhus University, Aarhus, Denmark
- AART Architects, Aarhus, Denmark
| | - Thea Hauge Broholt
- Department of Civil and Architectural Engineering, Aarhus University, Aarhus, Denmark
| | - Stina Rask Jensen
- Department of Civil and Architectural Engineering, Aarhus University, Aarhus, Denmark
- AART Architects, Aarhus, Denmark
| | - Steffen Petersen
- Department of Civil and Architectural Engineering, Aarhus University, Aarhus, Denmark
| | - Torben Sigsgaard
- Department of Public Health, section of Environment, Occupation and Health, Aarhus University, Aarhus, Denmark
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Schnohr C, Ekholm O, Poulsen LH, Lehrmann L, Andersen T, Funding E, Holm KB, Bjorner JB. Health and quality of life of patients with haemophilia: A national study of 124 Danish men. Haemophilia 2023; 29:538-544. [PMID: 36729615 DOI: 10.1111/hae.14751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 02/03/2023]
Abstract
PURPOSE In the past decades, haemophilia treatment has greatly improved the health of persons with haemophilia (PWH). This study compares PWH to the general population on social conditions and health. METHODS In December 2021, all Danes with moderate or severe haemophilia A or B, or von Willebrands disease type 3 were invited to participate in an online self-report survey concerning sociodemographic factors, self-rated health, teeth status, chronic health conditions, symptoms and loneliness. This study compares responses from the 124 adult male PWH with responses from a male general population sample (N = 4849). Analyses used logistic regression, controlling for age and highest completed education. RESULTS Fewer PWH were in the oldest age group (65-84 years). Controlling for age, no significant differences were found regarding cohabitation status or education. Fewer PWH were employed (OR = .48, [.33-.71])-particularly in the 45-64 age group. PWH were less likely to report good health (OR = .49, [.31-.77]). The odds of joint disease was much higher (OR = 13.00, [8.37-20.28]). Also, hypertension (OR = 2.25, [1.13-5.65]) and previous stroke (OR = 2.51, [1.44-3.50]) were more frequent. PWH were more likely to report pain in the arms/hands/legs/hips (OR = 2.94, [1.92-4.52]), but less likely to report pain in the head/neck/shoulder (OR = .66, [.45-.96]). CONCLUSION The disease burden of haemophilia has improved so PWH resembles the general population in areas such as marriage and education. However, even for young PWH, the disease still imposes a significant burden from hemophilia arthropathy and pain in extremities and joints. Middle-aged PWH also have poorer levels of employment than same-aged peers.
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Affiliation(s)
- Christina Schnohr
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ola Ekholm
- National Institute of Public Health, Copenhagen, Denmark
| | | | | | | | - Eva Funding
- Department of Haematology, Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Jakob Bue Bjorner
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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12
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Kirkegaard AM, Kloster S, Davidsen M, Christensen AI, Vestbo J, Nielsen NS, Ersbøll AK, Gunnarsen L. The Association between Perceived Annoyances in the Indoor Home Environment and Respiratory Infections: A Danish Cohort Study with up to 19 Years of Follow-Up. Int J Environ Res Public Health 2023; 20:1911. [PMID: 36767277 PMCID: PMC9915003 DOI: 10.3390/ijerph20031911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/09/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
The increasing prevalence of reported annoyances in the indoor environment threatens public health. This study aimed to investigate the association between perceived annoyances from the home environment and respiratory infections among individuals with and without asthma or chronic obstructive pulmonary disease (COPD). A total of 16,688 individuals from the Danish Health and Morbidity Survey initiated in 2000 were grouped according to their patterns of perceived annoyances. Information on respiratory infections (all causes, bacterial, viral, and those leading to hospital admissions) was obtained from Danish registers up to 19 years after the survey. Poisson regression of incidence rates (IRs) was applied to estimate incidence rate ratios (IRRs). Annoyances significantly increased the IR for respiratory infections of all causes and bacterial respiratory infections in individuals without asthma or COPD, adjusted IRR 1.16 (95% CI: 1.01, 1.34) and 1.15 (95% CI: 1.02, 1.31), respectively. However, no difference was observed for viral respiratory infections nor hospital admissions. Individuals with asthma or COPD and a high level of annoyances had a non-significantly increased IR in all four analyses of respiratory infections. These findings provide support for perceived annoyances as an important risk factor for respiratory infections.
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Affiliation(s)
- Anne Marie Kirkegaard
- Department of the Built Environment, Aalborg University, A.C. Meyers Vaenge 15, 2450 Copenhagen, Denmark
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen, Denmark
| | - Stine Kloster
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen, Denmark
| | - Michael Davidsen
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen, Denmark
| | - Anne Illemann Christensen
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen, Denmark
| | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester M13 9 PL, UK
| | - Niss Skov Nielsen
- Department of the Built Environment, Aalborg University, A.C. Meyers Vaenge 15, 2450 Copenhagen, Denmark
| | - Annette Kjær Ersbøll
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen, Denmark
| | - Lars Gunnarsen
- Department of the Built Environment, Aalborg University, A.C. Meyers Vaenge 15, 2450 Copenhagen, Denmark
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13
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Hempler NF, Fagt C, Olesen K, Wagner S, Rasmussen LB, Laursen DH, Glümer C, Nygaard M, Willaing I. Improving Health and Diabetes Self-Management in Immigrants with Type 2 Diabetes Through a Co-Created Diabetes Self-Management Education and Support Intervention. J Community Health 2023; 48:141-51. [PMID: 36326989 DOI: 10.1007/s10900-022-01151-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
To examine the impact of a co-created culturally sensitive diabetes self-management education and support (DSMES) intervention on the physical and mental health of immigrants with type 2 diabetes (T2D). Pre- and post-test among people with T2D whose primary language was Urdu, Arabic or Turkish (n = 97). Participants were offered a six-week intervention based on a person-centred approach using research-based dialogue tools to facilitate learning and reflection, which was developed in co-creation with immigrants and healthcare professionals. Data were collected at baseline, post-intervention and after 6 months and analysed using paired t-tests, Wilcoxon signed-rank tests, chi-square tests and regression models when appropriate. Several clinical outcomes were improved post-intervention, including HbA1c (P < 0.001), body fat percentage (P = 0.002), self-rated general health (P = 0.05), well-being (P = 0.004) and several self-management behaviours, e.g., physical activity (P < 0.001). Most outcomes remained improved after 6 months, but the effect on HbA1c was no longer statistically significant. Some outcomes were improved only at 6 months, including waist circumference (P < 0.001) and diabetes-related emotional distress (P < 0.001). Fatigue did not change. Attendance at more programme sessions was associated with better outcomes. The DSMES intervention developed in a co-creation process was highly effective in improving the health of immigrants with T2D.
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14
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Brodersen T, Rostgaard K, Lau CJ, Juel K, Erikstrup C, Nielsen KR, Ostrowski SR, Titlestad K, Saekmose SG, Pedersen OBV, Hjalgrim H. The healthy donor effect and survey participation, becoming a donor and donor career. Transfusion 2023; 63:143-155. [PMID: 36479702 PMCID: PMC10107247 DOI: 10.1111/trf.17190] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 09/29/2022] [Accepted: 09/29/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND The healthy donor effect (HDE) is a selection bias caused by the health criteria blood donors must meet. It obscures investigations of beneficial/adverse health effects of blood donation and complicates the generalizability of findings from blood donor cohorts. To further characterize the HDE we investigated how self-reported health and lifestyle are associated with becoming a blood donor, lapsing, and donation intensity. Furthermore, we examined differences in mortality based on donor status. STUDY DESIGN AND METHODS The Danish National Health Survey was linked to the Scandinavian Donations and Transfusions (SCANDAT) database and Danish register data. Logistic- and normal regression was used to compare baseline characteristics and participation. Poisson regression was used to investigate future donation choices. Donation intensity was explored by the Anderson-Gill model and Poisson regression. Mortality was investigated using Poisson regression. RESULTS Blood donors were more likely to participate in the surveys, OR = 2.45 95% confidence interval (2.40-2.49) than non-donors. Among survey participants, better self-reported health and healthier lifestyle were associated with being or becoming a blood donor, donor retention, and to some extent donation intensity, for example, current smoking conveyed lower likelihood of becoming a donor, OR = 0.70 (0.66-0.75). We observed lower mortality for donors and survey participants, respectively, compared with non-participating non-donors. CONCLUSION We provide evidence that blood donation is associated with increased likelihood to participate in health surveys, possibly a manifestation of the HDE. Furthermore, becoming a blood donor, donor retention, and donation intensity was associated with better self-reported health and healthier lifestyles.
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Affiliation(s)
- Thorsten Brodersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark.,Department of Science and Environment, Roskilde University, Roskilde, Denmark
| | - Klaus Rostgaard
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.,Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Cathrine Juel Lau
- Centre for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Knud Juel
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Kasper Rene Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Sisse Rye Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kjell Titlestad
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Susanne G Saekmose
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Ole B V Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.,Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Haematology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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15
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Hermans L, Braekman E, Drieskens S, Demarest S. Organizing the health interview survey at the local level: design of a pilot study. Arch Public Health 2022; 80:155. [PMID: 35689255 PMCID: PMC9185910 DOI: 10.1186/s13690-022-00909-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 05/30/2022] [Indexed: 11/10/2022]
Abstract
Background The local Health Interview Study (LHIS) was developed to gain health information at the level of the municipality in Flanders, the northern part of Belgium. It enables municipalities to make evidence-based decisions in their public health policy. To test the feasibility of implementing the LHIS, a pilot study was conducted in Melle, a small Flemish municipality with 11.736 inhabitants. Methods The target sample size was 1000 (≥ 15 years). A systematic sampling technique was applied with substitutes for non-respondents who were matched in terms of statistical sector, age and sex. Selected persons were contacted by post to complete the questionnaire and in case of non-response, a reminder was sent. Questionnaires were collected using a concurrent mixed-mode design: a paper and pencil, and web option. All questions were selected from the Belgian Health Interview Survey relating to health status and determinants of health. Results One thousand twenty-two questionnaires were obtained after inviting 3137 individuals (response rate = 32.6%). Older adults were more likely to participate than younger adults, and women more than men. The final sample resembled the initial sample in terms of sex and statistical sector, but not in terms of age. Younger adults were underrepresented whereas older adults were overrepresented. Lastly, older adults were more likely to fill in the questionnaire on paper than younger adults, and women more than men. Conclusion The LHIS can be successfully implemented in Flemish municipalities. The method, however, does not guarantee that the composition of the final sample reflects the initial sample. Therefore, weights should be added in the analyses to correct for potential deviations in sample composition. Furthermore, implementing a sequential mixed-mode design with a web option preceding a paper and pencil option in future studies could reduce costs and improve data quality. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00909-z.
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Affiliation(s)
- Lize Hermans
- Sciensano, Scientific Direction Public Health and Epidemiology, Juliette Wytsmanstraat 14, B-1050, Brussels, Belgium.
| | - Elise Braekman
- Sciensano, Scientific Direction Public Health and Epidemiology, Juliette Wytsmanstraat 14, B-1050, Brussels, Belgium
| | - Sabine Drieskens
- Sciensano, Scientific Direction Public Health and Epidemiology, Juliette Wytsmanstraat 14, B-1050, Brussels, Belgium
| | - Stefaan Demarest
- Sciensano, Scientific Direction Public Health and Epidemiology, Juliette Wytsmanstraat 14, B-1050, Brussels, Belgium
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16
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Kikkenborg Berg S, Palm P, Nygaard U, Bundgaard H, Petersen MNS, Rosenkilde S, Thorsted AB, Ersbøll AK, Thygesen LC, Nielsen SD, Vinggaard Christensen A. Long COVID symptoms in SARS-CoV-2-positive children aged 0–14 years and matched controls in Denmark (LongCOVIDKidsDK): a national, cross-sectional study. The Lancet Child & Adolescent Health 2022; 6:614-623. [PMID: 35752194 PMCID: PMC9221683 DOI: 10.1016/s2352-4642(22)00154-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 12/16/2022]
Abstract
Background After the acute phase of SARS-CoV-2 infection, children can develop long COVID symptoms. We aimed to investigate the prevalence of long-lasting symptoms, the duration and intensity of symptoms, quality of life, number of sick days and absences from daycare or school, and psychological and social outcomes in children aged 0–14 years who had been infected with SARS-CoV-2 relative to controls with no history of SARS-CoV-2 infection. Methods A nationwide cross-sectional study was conducted including children with a confirmed SARS-CoV-2-positive PCR test (cases) and matched controls from Danish national registers. A survey was sent to mothers (proxy reporting) of children aged 0–14 years who had had a positive SARS-CoV-2 test between Jan 1, 2020, and July 12, 2021, and a control group matched (1:4) by age and sex. The survey included the Pediatric Quality of Life Inventory (PedsQL) and the Children's Somatic Symptoms Inventory-24 (CSSI-24) to capture current overall health and wellbeing, and ancillary questions about the 23 most common long COVID symptoms. Descriptive statistics and logistic regression analysis were used. Clinically relevant differences were defined as those with a Hedges' g score greater than 0·2. This study is registered at ClinicalTrials.gov (NCT04786353). Findings Responses to the survey were received from 10 997 (28·8%) of 38 152 cases and 33 016 (22·4%) of 147 212 controls between July 20, 2021, and Sept 15, 2021. Median age was 10·2 years (IQR 6·6–12·8) in cases and 10·6 years (6·9–12·9) in controls. 5267 (48·2%) cases and 15 777 (48·3%) controls were female, and 5658 (51·8%) cases and 16 870 (51·7%) controls were male. Cases had higher odds of reporting at least one symptom lasting more than 2 months than did controls in the 0–3 years age group (478 [40·0%] of 1194 vs 1049 [27·2%] of 3855; OR 1·78 [95% CI 1·55–2·04], p<0·0001), 4–11 years age group (1912 [38·1%] of 5023 vs 6189 [33·7%] of 18 372; 1·23 [1·15–1·31], p<0·0001), and 12–14 years age group (1313 [46·0%] of 2857 vs 4454 [41·3%] of 10 789; 1·21 [1·11–1·32], p<0·0001). Differences in CSSI-24 symptom scores between cases and controls were statistically significant but not clinically relevant. Small clinically relevant differences in PedsQL quality-of-life scores related to emotional functioning were found in favour of cases in the children aged 4–11 years (median score 80·0 [IQR 65·0–95·0]) in cases vs 75·0 [60·0–85·0] in controls; p<0·0001) and 12–14 years (90·0 [70·0–100·0] vs (85·0 [65·0–95·0], p<0·0001). PedsQL social functioning scores were also higher in cases (100·0 [90·0–100·0] than controls (95·0 [80·0–100·0]) in the 12–14 years age group (p<0·0001; Hedges g>0·2). Interpretation Compared with controls, children aged 0–14 years who had a SARS-CoV-2 infection had more prevalent long-lasting symptoms. There was a tendency towards better quality-of-life scores related to emotional and social functioning in cases than in controls in older children. The burden of symptoms among children in the control group requires attention. Long COVID must be recognised and multi-disciplinary long COVID clinics for children might be beneficial. Funding A P Møller and Chastine Mc-Kinney Møller Foundation.
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Affiliation(s)
- Selina Kikkenborg Berg
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Pernille Palm
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ulrikka Nygaard
- Department of Paediatrics and Adolescents Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henning Bundgaard
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Siri Rosenkilde
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Anne Bonde Thorsted
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Annette Kjær Ersbøll
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lau Casper Thygesen
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Susanne Dam Nielsen
- Department of Infectious Disease, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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17
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Jensen HAR, Lau CJ, Davidsen M, Feveile HB, Christensen AI, Ekholm O. The impact of non-response weighting in health surveys for estimates on primary health care utilization. Eur J Public Health 2022; 32:450-455. [PMID: 35373254 PMCID: PMC9159316 DOI: 10.1093/eurpub/ckac032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Low response rates in health surveys may affect the representativeness and generalizability of results if non-response is systematically related to the indicator of interest. To account for such potential bias, weighting procedures are widely used with an overall aim to obtain less biased estimates. The aim of this study was to assess the impact of applying calibrated weights on prevalence estimates of primary health care utilization among respondents compared to the entire sample of a representative Danish survey of adults aged ≥16 years. Methods Registry-based 1-year prevalence data on health care utilization of chiropractor/physiotherapist, dentist and psychologist in 2016 were linked to the entire sample (n = 312 349), including respondents (n = 183 372), from the Danish National Health Survey in 2017. Calibrated weights, which applied information on e.g. sex, age, ethnic background, education and overall health service use were used to assess their impact on prevalence estimates among respondents. Results Across all included types of health care, weighting for non-response decreased prevalence estimates among respondents, which resulted in less biased estimates. For example, the overall 1-year prevalence of chiropractor/physiotherapist, dentist and psychologist utilization decreased from 19.1% to 16.9%, 68.4% to 62.5% and 1.9% to 1.8%, respectively. The corresponding prevalence in the entire sample was 16.5%, 59.4% and 1.7%. Conclusions Applying calibrated weights to survey data to account for non-response reduces bias in primary health care utilization estimates. Future studies are needed to explore the possible impact of weighting on other health estimates.
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Affiliation(s)
| | - Cathrine Juel Lau
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Denmark
| | - Michael Davidsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | | | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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18
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Braekman E, Demarest S, Charafeddine R, Drieskens S, Berete F, Gisle L, Van der Heyden J, Van Hal G. Unit Response and Costs in Web Versus Face-To-Face Data Collection: Comparison of Two Cross-sectional Health Surveys. J Med Internet Res 2022; 24:e26299. [PMID: 34994701 PMCID: PMC8783289 DOI: 10.2196/26299] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 03/30/2021] [Accepted: 10/05/2021] [Indexed: 12/04/2022] Open
Abstract
Background Potential is seen in web data collection for population health surveys due to its combined cost-effectiveness, implementation ease, and increased internet penetration. Nonetheless, web modes may lead to lower and more selective unit response than traditional modes, and this may increase bias in the measured indicators. Objective This research assesses the unit response and costs of a web study versus face-to-face (F2F) study. Methods Alongside the Belgian Health Interview Survey by F2F edition 2018 (BHISF2F; net sample used: 3316), a web survey (Belgian Health Interview Survey by Web [BHISWEB]; net sample used: 1010) was organized. Sociodemographic data on invited individuals was obtained from the national register and census linkages. Unit response rates considering the different sampling probabilities of both surveys were calculated. Logistic regression analyses examined the association between mode system and sociodemographic characteristics for unit nonresponse. The costs per completed web questionnaire were compared with the costs for a completed F2F questionnaire. Results The unit response rate is lower in BHISWEB (18.0%) versus BHISF2F (43.1%). A lower response rate was observed for the web survey among all sociodemographic groups, but the difference was higher among people aged 65 years and older (15.4% vs 45.1%), lower educated people (10.9% vs 38.0%), people with a non-Belgian European nationality (11.4% vs 40.7%), people with a non-European nationality (7.2% vs 38.0%), people living alone (12.6% vs 40.5%), and people living in the Brussels-Capital (12.2% vs 41.8%) region. The sociodemographic characteristics associated with nonresponse are not the same in the 2 studies. Having another European (OR 1.60, 95% CI 1.20-2.13) or non-European nationality (OR 2.57, 95% CI 1.79-3.70) compared to a Belgian nationality and living in the Brussels-Capital (OR 1.72, 95% CI 1.41-2.10) or Walloon (OR 1.47, 95% CI 1.15-1.87) regions compared to the Flemish region are associated with a higher nonresponse only in the BHISWEB study. In BHISF2F, younger people (OR 1.31, 95% CI 1.11-1.54) are more likely to be nonrespondents than older people, and this was not the case in BHISWEB. In both studies, lower educated people have a higher probability of being nonrespondent, but this effect is more pronounced in BHISWEB (low vs high education level: Web, OR 2.71, 95% CI 2.21-3.39 and F2F OR 1.70, 95% CI 1.48-1.95). The BHISWEB study had a considerable advantage; the cost per completed questionnaire was almost 3 times lower (€41 [US $48]) compared with F2F data collection (€111 [US $131]). Conclusions The F2F unit response rate was generally higher, yet for certain groups the difference between web and F2F was more limited. Web data collection has a considerable cost advantage. It is therefore worth experimenting with adaptive mixed-mode designs to optimize financial resources without increasing selection bias (eg, only inviting sociodemographic groups who are keener to participate online for web surveys while continuing to focus on increasing F2F response rates for other groups).
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Affiliation(s)
- Elise Braekman
- Lifestyle and chronic diseases, Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Stefaan Demarest
- Lifestyle and chronic diseases, Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Rana Charafeddine
- Lifestyle and chronic diseases, Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Sabine Drieskens
- Lifestyle and chronic diseases, Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Finaba Berete
- Lifestyle and chronic diseases, Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Lydia Gisle
- Lifestyle and chronic diseases, Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Johan Van der Heyden
- Lifestyle and chronic diseases, Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Guido Van Hal
- Social Epidemiology and Health Policy, Antwerp University, Antwerp, Belgium
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19
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Kragelund K, Ekholm O, Larsen CVL, Christensen AI. Prevalence and Trends in Problem Gambling in Denmark with Special Focus on Country of Origin: Results from the Danish Health and Morbidity Surveys. J Gambl Stud 2022; 38:1157-1171. [PMID: 34988759 DOI: 10.1007/s10899-021-10093-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2021] [Indexed: 11/29/2022]
Abstract
Belonging to an ethnic minority has been described as a possible risk factor for problem gambling, but the literature is inconclusive whether this association is true or just a proxy for other underlying risk factors. Hence, the aims were to investigate: (1) past year prevalence of problem gambling in the adult Danish population and trends since 2005, (2) past year prevalence of problem gambling in 2017 and trends since 2010 by country of origin, and (3) whether a marginalisation by country of origin or problem gambling, respectively, is seen in various health-related indicators. Data were derived from the Danish Health and Morbidity Surveys in 2005, 2010, 2013, and 2017. The Lie/Bet Questionnaire was used to define problem gamblers. The overall prevalence of past year problem gambling has increased slightly from 2005 (1.0%) to 2017 (1.5%), but a more alarming increase was observed among men with non-western origin (3.1% in 2010 and 7.0% in 2017). A lower prevalence of good self-rated health and a higher prevalence of poor mental health was observed among individuals with a non-western origin compared to those with a Danish origin, although the differences became smaller between 2010 and 2017. The findings indicate a slightly increase in the prevalence of past year problem gambling and that particular attention should be paid to individuals with a non-western origin. The study also highlights the need for better differentiation of risk factors that may variously predispose different ethnic groups to develop gambling problems.
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Affiliation(s)
- Kamilla Kragelund
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark.
| | - Christina V L Larsen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark
| | - Anne I Christensen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark
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Tang LH, Andreasson KH, Thygesen LC, Jepsen R, Møller A, Skou ST. Persistent pain and long-term physical and mental conditions and their association with psychological well-being; data from 10,744 individuals from the Lolland-Falster health study. J Multimorb Comorb 2022; 12:26335565221128712. [PMID: 36386291 PMCID: PMC9659769 DOI: 10.1177/26335565221128712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Persistent pain (PP) and long-term conditions are all associated with psychological well-being. Less is known about their associations with reduced psychological well-being when co-occurring. We investigated how PP and long-term physical and mental conditions relate to psychological well-being when occurring together. METHOD Data collected in the Danish population-based Lolland-Falster Health study were used in this cross-sectional study. Participants aged ≥18 years completing questions concerning PP, long-term conditions and psychological well-being were included. PP and long-term conditions were defined as conditions lasting 6 months or longer. Psychological well-being was assessed by the World Health Organization Well-Being Index (WHO-5). Multiple linear regression investigated combinations of PP and physical and mental long-term conditions and their associations with WHO-5. RESULTS Of 11,711 participants, 10,744 had available data. One third had PP (n = 3250), while 6144 (57%), 213 (2%) and 946 (9%) reported having only physical conditions, only mental conditions or both, respectively. All combinations of PP and long-term conditions were negatively associated with WHO-5. PP in combination with mental (-23.1 (95% CI -28.3 to -17.8)) or both physical and mental conditions (-25.1 (-26.7 to -23.52) yielded the strongest negative associations. Two or more pain sites together with long-term physical and mental conditions was associated with a lower WHO-5 score (-6.2 (-8.9 to -3.5) compared to none or one pain site. CONCLUSION The presence of PP and long-term conditions, in particular mental conditions, were strongly associated with worse psychological well-being. This highlights the importance of assessing psychological well-being in individuals with PP and long-term conditions.
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Affiliation(s)
- Lars H Tang
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
- Department of Regional Health Research, University of Southern Denmark, Denmark
| | - Karen H Andreasson
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
| | - Lau C Thygesen
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Randi Jepsen
- Lolland-Falster Health Study, Centre for Epidemiological Research, Nykøbing Falster Hospital, Nykøbing F., Denmark
| | - Anne Møller
- The Research Unit for General Practice and Section of General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Søren T Skou
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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21
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Lykke C, Sjøgren P, Ekholm O. Losing a child due to a life-limiting diagnosis-parental well-being and quality of life: nationwide survey. BMJ Support Palliat Care 2021:bmjspcare-2021-003251. [PMID: 34969696 DOI: 10.1136/bmjspcare-2021-003251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 12/10/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Losing a child is burdensome with potential long-term impact on the parents' well-being and quality of life. The aim was to investigate parental well-being and quality of life 3-5 years after losing a child due to life-limiting diagnoses and to identify associated factors in order to target future interventions. METHODS All parents, who lost a child (<18 years) due to life-limiting diagnoses in the period 2012-2014 in Denmark, were invited to complete a self-administered questionnaire. A seven-point Visual Digital Scale (VDS) was used to assess issues of well-being and quality of life including physical health, anxiety, depression and sleep quality which were combined into a cumulative symptom index. Associations were assessed by means of ordinal logistic regression models. RESULTS In all, 152 (38%) children were represented by 136 mothers and 57 fathers. Totally, 17.6% of the mothers and 14.0% of the fathers had ≥2 symptoms (assessed by the symptom index). Parents with lower education had 2.11 (95% CI: 1.01 to 4.40) times higher odds of having more symptoms than parents with higher education. Unmarried parents had 2.14 (95% CI: 1.03 to 4.42) times higher odds of having more symptoms than married parents. Ten per cent of the parents reported poor overall quality of life. CONCLUSION According to the VDS, 1 out of 10 parents experienced poor overall quality of life 3-5 years after the loss. Every sixth had two or more symptoms assessed by the symptom index. Associated factors for poor quality of life suggest attention to particularly unmarried parents and parents with lower education.
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Affiliation(s)
- Camilla Lykke
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
- Department of Oncology and Palliative Care, Nordsjællands Hospital, Hillerod, Denmark
| | - Per Sjøgren
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Region Hovedstaden, Denmark
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22
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Jensen HAR, Ekholm O. Therapy-dependent inconsistencies in self-reported use of complementary and alternative medicine in the general population: findings from a longitudinal study. BMJ Open 2021; 11:e051647. [PMID: 34836900 PMCID: PMC8628339 DOI: 10.1136/bmjopen-2021-051647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Information on the use of complementary and alternative medicine (CAM) in the general population is often collected by means of surveys, causing the reliability of data to rely on the memory accuracy of the respondent. The objective of this study was to examine the consistency in self-reported CAM use using data from two survey waves 4 years apart. DESIGN Longitudinal study. SETTING/PARTICIPANTS Data were obtained from the Danish Health and Morbidity Surveys. A nationally representative subsample of the individuals invited in 2013 was reinvited in 2017. In all, 2297 individuals (≥16 years) completed the self-administered questionnaire in both waves, including questions on for example, CAM use. MAIN OUTCOME MEASURES The use of six different CAM therapies (acupuncture; craniosacral therapy; faith healing and/or clairvoyance; nutritional counselling; massage; osteopathy or other manipulative therapies; reflexology) was assessed by the response categories 'Yes, within the past 12 months', 'Yes, but previously than within the past 12 months' and 'No'. For each CAM therapy, an inconsistent response was defined as either the response combination (1) 'Yes, within the past 12 months' in 2013 and 'No' in 2017, or (2) 'Yes, within the past 12 months' or 'Yes, but previously than within the past 12 months' in 2013 and 'No' in 2017. RESULTS The inconsistency percentages varied across CAM therapies. The highest levels of inconsistency for CAM use within the past 12 months were observed for nutritional counselling (64.9 %) and faith healing and/or clairvoyance (36.4 %). The lowest proportion of inconsistent responses was observed for acupuncture (18.3%). Overall, the same pattern was observed for lifetime CAM use. CONCLUSIONS The results highlight the difficulty in obtaining reliable prevalence estimates on the use of CAM in the general population. Future studies should take these findings into account when interpreting similar analyses.
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Affiliation(s)
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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23
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Nygaard SS, Srivarathan A, Mathisen J, Kristiansen M, Christensen U, Kvorning MF, Lund R. Challenges and lessons learnt from conducting a health survey in an ethnically diverse population. Scand J Public Health 2021; 50:995-1006. [PMID: 34711102 DOI: 10.1177/14034948211054663] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim: To document the challenges of developing and executing an interviewer-driven survey questionnaire in an ethnically diverse and deprived social housing area undergoing reconstruction in Denmark. Methods: The survey was initially planned to be conducted in three waves (before, during and after reconstruction of the housing area), based on a questionnaire covering health, wellbeing and social relations. The first two waves took place in 2018 and 2019 (invited n=~600 per wave) and the third wave will be conducted once the reconstruction is finalised. The approach to the third wave is under revision by the research team. The questionnaire was translated from Danish into the seven most common languages in the housing area. A bilingual interview team went door to door interviewing residents. Field notes were collected systematically during each wave to document the process. Results: The response rates were 35% (n=209) and 22% (n=132) for waves 1 and 2, respectively. There was an overall decrease in response rates between waves 1 and 2 for all language groups, but particularly for Arabic and Turkish-speaking men. The most frequently stated reasons for non-participation included illness and language barriers. The key lessons learnt were that overcoming linguistic and cultural barriers to conducting research among residents in this social housing area requires time and resources. Conclusions: Several challenges are associated with conducting a survey in ethnically diverse and deprived social housing areas. Documenting the challenges and learning from experience are both important, in order to include this hard-to-reach population in health research.
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Affiliation(s)
- Siv Steffen Nygaard
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Denmark
| | - Abirami Srivarathan
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Denmark
| | - Jimmi Mathisen
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Denmark
| | - Maria Kristiansen
- Center for Healthy Aging, University of Copenhagen, Denmark.,Department of Public Health, Section for Health Services Research, University of Copenhagen, Denmark
| | - Ulla Christensen
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Denmark
| | | | - Rikke Lund
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Denmark
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24
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Petersen PE, Davidsen M, Rosendahl Jensen H, Ekholm O, Illemann Christensen A. Trends in dentate status and preventive dental visits of the adult population in Denmark over 30 years (1987-2017). Eur J Oral Sci 2021; 129:e12809. [PMID: 34218468 DOI: 10.1111/eos.12809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 05/10/2021] [Accepted: 05/10/2021] [Indexed: 01/23/2023]
Abstract
This study analyzed the trend in self-reported dentate status over 30 years (1987-2017) among Danish adults, the self-reported frequencies of preventive dental visits undertaken annually during the period 1987-2013, and the self-reported use of the 2016 recall scheme for preventive dental check-ups. The impact of social determinants (education, employment, civil status, and ethnic background) on these dental outcome variables in 2017 was explored. Questionnaire data were obtained from the Danish Health and Morbidity Surveys conducted from 1987-2017, and they were analyzed by tri-variate frequency distributions and multivariate analyses. The prevalence of complete tooth loss was 17.7% in 1987 but 3.4% in 2017. The frequency of adults having 20 or more teeth grew markedly from 1987 (65.9%) to 2017 (85.1%). Educational inequality in dentate status persisted over the period. The frequency of preventive dental visits at least annually increased from 1987 to 2013, although visits were less frequent for young people. In 2017, preventive dental check-ups were reported in intervals: less than 12 months (56.4%), 12-18 months (18.9%), 19-24 months (4.8%), and more than 24 months (5.2%). In 2017, dentate status and preventive dental check-ups varied profoundly by social determinants. In conclusion, social policies should be implemented to tackle the persistent inequities in dentate status and public health policies should target Universal Health Coverage.
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Affiliation(s)
| | - Michael Davidsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Heidi Rosendahl Jensen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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25
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Rosendahl Jensen HA, Thygesen LC, Møller SP, Dahl Nielsen MB, Ersbøll AK, Ekholm O. The Danish Health and Wellbeing Survey: Study design, response proportion and respondent characteristics. Scand J Public Health 2021; 50:959-967. [PMID: 34162289 DOI: 10.1177/14034948211022429] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS This study aimed to describe the study design and respondent characteristics (including non-response analyses) of the Danish Health and Wellbeing Surveys in 2015 and 2019 and a follow-up survey that was carried out during the COVID-19 pandemic in 2020. METHODS The Danish Health and Wellbeing Survey is the Danish part of the European Health Interview Survey (EHIS). The samples in 2015 (N=12,000) and 2019 (N=14,000) were both based on a simple random selection of individuals aged ⩾15 years from the Danish Civil Registration System. All individuals from the sample in 2019 who were still alive and living in Denmark were reinvited for a follow-up survey in 2020 (N=13,474). Data in all surveys were collected via self-administered questionnaires (web or paper based). The questionnaires in 2015 and 2019 included the EHIS model questionnaire as well as national questions, whereas the questionnaire in 2020 mainly focused on physical and mental health, employment and working lives, and health behaviour. RESULTS The overall response proportion declined slightly between 2015 (48.4%) and 2019 (47.4%) but went up to 49.8% in the follow-up survey in 2020. Unit non-response was associated with, for example, male sex, younger age, being unmarried and lower educational level but not with degree of urbanisation. In all, 5000 individuals completed the questionnaire in both 2019 and 2020. CONCLUSIONS The results are in line with most previous research on non-response in health surveys. However, an association between degree of urbanisation and non-response has been suggested in previous studies. This association was not found in our study.
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Affiliation(s)
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Sanne Pagh Møller
- National Institute of Public Health, University of Southern Denmark, Denmark
| | | | | | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Denmark
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26
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Boyle E, Folkestad L, Frafjord E, Koes BW, Skou ST, Hartvigsen J. The Danish Diabetes Musculoskeletal Cohort: Non-Responder Analysis of an Electronic Survey Using Registry Data. Clin Epidemiol 2021; 13:397-405. [PMID: 34103998 PMCID: PMC8180289 DOI: 10.2147/clep.s293186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/29/2021] [Indexed: 01/01/2023] Open
Abstract
Purpose To conduct a non-responder analysis on a musculoskeletal (MSK) electronic questionnaire. Methods Individuals aged 18 years and older, diagnosed with diabetes mellitus (DM), and attended an ambulatory DM clinic formed the sample frame. They were invited to complete an electronic musculoskeletal (MSK) conditions and symptoms questionnaire booklet using a secured electronic email system. Individuals whose secured email box was not active at the time were discarded. Using the Central Person Registry number, a unique number assigned to all Danish residents, we linked the sample frame to different registries to learn more about non-responders. Non-responders were either individuals who did not respond to a single question and those who responded “No” to the first question about willing to participate. We calculated descriptive statistics for each characteristic. Univariate logistic regression models were conducted to determine the relationship between each characteristic and non-responder status. Results The response rate was 36% (n = 3812). Individuals with type 2 DM (OR 2.0 (95% CI 1.8–2.2)), secondary DM (1.9 (1.3–2.8)) or unspecified DM (2.1 (1.8–2.4)) were more likely to be non-responders than individuals with Type 1 DM. Also, individuals aged 70–79 (1.3 (1.1–1.6)) and 80 years and older (5.9 (4.5–7.7)) were more likely to be non-responders than 18–29 years old individuals. However, individuals aged 40–49 (1.5 (1.2–1.8)), 50–59 (1.5 (1.3–1.8)) or 60–69 (1.4 (1.1–1.6)) were more likely to be responders than 18–29 years old individuals. Individuals with Charlson Comorbidity Index (CCI) of 1 (2.0 (1.3.2.9) or CCI of 2 (1.7 (1.1–2.5) were more likely to be responders than individuals with a CCI of 0. Lastly, individuals who were currently outside of the workforce (1.6 (2.4–2.9) or had unknown/missing socioeconomic status (3.9 (2.8–5.3) were more likely to be non-responders than individuals who were working. Conclusion Although we did find a non-response bias, this cohort will be an important source to determine the prevalence and consequences of MSK conditions in a secondary care DM population.
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Affiliation(s)
- Eleanor Boyle
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lars Folkestad
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.,Department of Internal Medicine, Hospital of South West Denmark, Esbjerg, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Open Patient Exploratory Network, University of Southern Denmark, Odense, Denmark
| | | | - Bart W Koes
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Department of General Practice, Erasmus MC, Rotterdam, the Netherlands
| | - Soren Thorgaard Skou
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Jan Hartvigsen
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Chiropractic Knowledge Hub, Odense, Denmark
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27
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Joshi VL, Tang LH, Borregaard B, Zinckernagel L, Mikkelsen TB, Taylor RS, Christiansen SR, Nielsen JF, Zwisler AD. Long-term physical and psychological outcomes after out-of-hospital cardiac arrest-protocol for a national cross-sectional survey of survivors and their relatives (the DANCAS survey). BMJ Open 2021; 11:e045668. [PMID: 33811056 PMCID: PMC8023731 DOI: 10.1136/bmjopen-2020-045668] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION The number of out-of-hospital cardiac arrest (OHCA) survivors is increasing. However, there remains limited knowledge on the long-term physical and psychological problems suffered by survivors and their relatives. The aims of the DANCAS (DANish cardiac arrest survivorship) survey are to describe the prevalence of physical and psychological problems, identify predictors associated with suffering them and to determine unmet rehabilitation needs in order to make recommendations on the timing and content of future rehabilitation interventions. METHODS AND ANALYSIS The DANCAS survey has a cross-sectional design involving a survey of OHCA survivors and their relatives. OHCA survivors will be identified through the Danish Cardiac Arrest Registry as having suffered an OHCA between 1 January 2016 and 31 December 2019. Each survivor will be asked to identify their closest relative to complete the relatives' survey. Contents of survivor survey: EQ-5D-5Level, Hospital Anxiety and Depression Scale, Two Simple Questions, Modified Fatigue Impact Scale, 12-item WHO Disability Assessment Scale 2.0, plus questions on unmet rehabilitation and information needs. Contents of relatives' survey: World Health Organisation-Five Well-Being Index, Hospital Anxiety and Depression Scale, Informant Questionnaire on Cognitive Decline in the Elderly-Cardiac Arrest and the Modified Caregiver Strain Index. Self-report outcome data collected through the surveys will be enriched by data from Danish national registries including demographic characteristics, circumstances of cardiac arrest and comorbidities. The survey will be completed either electronically or by post December 2020-February 2021. ETHICS AND DISSEMINATION The study will be conducted in accordance with the Declaration of Helsinki. Surveys and registry-based research studies do not normally require ethical approval in Denmark. This has been confirmed for this study by the Region of Southern Denmark ethics committee (20192000-19). Results of the study will be disseminated via several peer-reviewed publications and will be presented at national and international conferences.
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Affiliation(s)
- Vicky L Joshi
- REHPA, Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Odense, Denmark
| | - Lars H Tang
- Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Britt Borregaard
- Department of Cardiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Line Zinckernagel
- REHPA, Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Odense, Denmark
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Tina Broby Mikkelsen
- REHPA, Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Odense, Denmark
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Well Being, University of Glasgow, Glasgow, UK
- College of Medicine and Health, University of Exeter, Exeter, Devon, UK
| | - Sofie Raahauge Christiansen
- REHPA, Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Odense, Denmark
| | - Jørgen Feldbæk Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Midtjylland, Denmark
| | - Ann Dorthe Zwisler
- REHPA, Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Odense, Denmark
- Department of Cardiology, Odense University Hospital, Odense, Denmark
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Molsted S, Eidemak I, Aadahl M. Sex Difference in the Association between Physical Activity and All-Cause Mortality in Ambulatory Patients with Chronic Kidney Disease. Int J Environ Res Public Health 2021; 18:3698. [PMID: 33916240 DOI: 10.3390/ijerph18073698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 02/06/2023]
Abstract
(1) Background: The purpose of this article was to investigate the association between self-reported physical activity (PA) and all-cause mortality in ambulatory patients with chronic kidney disease (CKD), stage 4–5 including maintenance dialysis. (2) Methods: Ambulatory patients with CKD (eGFR < 30 mL/min/1.73 m2) with conservative treatment or chronic dialysis were included. PA was assessed using the Saltin–Grimby Physical Activity Level Scale. A Cox proportional hazards regression model––adjusted for age, sex, plasma–albumin, body mass index, socioeconomic status, and treatment––was applied. (3) Results: Participants (n = 374) were followed 39 ± 15 months from entry to death or censoring. Throughout the study period of 39 months, 156 deaths (42%) were registered. Regarding physical activity, 128 (34%) of the participants were inactive, 212 (57%) were moderately active, and 34 (9%) were highly or vigorously active. Moderate PA was associated with a decreased mortality risk in women (n = 150) compared to inactivity (HR 0.27 (0.15; 0.51), p < 0.001), whereas a high/vigorous level of PA was not significantly associated with mortality risk compared to inactivity. In men (n = 224), the associations between PA levels and mortality risk were not significant. (4) Conclusions: Moderate PA was associated with reduced all-cause mortality in ambulatory women with stage 4–5 CKD with or without maintenance dialysis treatment. Physical activity was not significantly associated with mortality in men.
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29
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Molsted S, Wendelboe S, Flege MM, Eidemak I. The impact of marital and socioeconomic status on quality of life and physical activity in patients with chronic kidney disease. Int Urol Nephrol 2021; 53:2577-2582. [PMID: 33674948 DOI: 10.1007/s11255-021-02826-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 02/24/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Quality of life (QOL) and physical activity (PA) is reduced in patients with chronic kidney disease (CKD). The aim was to investigate the impact of marital status and educational level on QOL and PA in patients with CKD including dialysis treatment. METHODS This cross-sectional study included ambulatory adult patients undergoing dialysis or CKD stage 4-5. Data for marital status, educational level and PA were obtained using the Danish health and Morbidity Survey. QOL was assessed using the Physical Component Scale and the Mental Component Scale scores from the Kidney Disease Quality of Life Instrument. RESULTS Five hundred twelve participants were included: 316 (62%) were married/had a permanent partner, 119 (23%) had a low level of education, 327 (67%) were physically active. After confounder adjustments (age, sex, treatment), having a permanent partner was associated with greater scores in Mental Component Scale, β 2.88 [CI 95% 0.99; 4.77], p = 0.003, and being physically active in women OR 2.237 [1.231; 4.066], p = 0.008. A high vs low educational level was associated with greater scores in Physical Component Scale (3.79 [1.01; 6.58], p = 0.008) and in Mental Component Scale (3.55 [0.82; 6.28], p = 0.011). CONCLUSION In ambulatory patients with CKD stage 4-5, being married or having a permanent partner and a high educational level had positive impacts on mental QOL. Higher educational level was also associated with better physical QOL. The presented inequality in QOL should be considered in communications, care and treatments in clinical practice.
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Affiliation(s)
- Stig Molsted
- Department of Clinical Research, Nordsjællands Hospital, Dyrehavevej 29, 3400, Hillerød, Denmark.
| | - Sofie Wendelboe
- Department of Medicine, Zealand University Hospital Roskilde, Nykøbing F. Hospital, Nykøbing Falster, Denmark
| | - Marius M Flege
- Department of Medicine, Amager Hospital, Copenhagen, Denmark
| | - Inge Eidemak
- Department of Oncology, Section of Palliative Medicine, Rigshospitalet, Copenhagen, Denmark
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30
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Pisinger VSC, Thorsted A, Jezek AH, Jørgensen A, Christensen AI, Tolstrup JS, Thygesen LC. The Danish National Youth Study 2019: study design and participant characteristics. Scand J Public Health 2021; 50:323-332. [PMID: 33620000 DOI: 10.1177/1403494821993724] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM To present the study design, study population and questionnaire content of the Danish National Youth Study 2019, and to describe the differences between participants and non-participants regarding demographic and socioeconomic characteristics. METHOD The Danish National Youth Study 2019 is a nationwide web-survey among high school students in Denmark. Data was collected from January to April 2019 through a self-administered questionnaire in the classroom. The questionnaire included 120 questions on, for example, physical and mental health, health behaviour and well-being. Data collection took place at 50 general high schools, 32 preparatory high schools, 15 commercial high school and 19 technical high schools. RESULTS A total of 29,086 students participated (20,287 general high school students, 2,113 preparatory higher school students, 4027 commercial high school students and 2659 technical high school students) corresponding to 66% of the students in the 88 participating schools (31% of invited schools). Among students, 55% were female and the mean age was 17.8 years. Participants were more likely to be female, to be younger, to be of Danish origin, and have family disposable income in the highest quartile compared to non-participants. CONCLUSIONS The Danish National Youth Study 2019 contributes to knowledge on high school students' health, health behaviour and well-being that can support health planning and prioritizing, through identification of specific risk groups at both local and national level. The study also offers great opportunities for future research as it provides possibility of linkage to various Danish national registers.
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Affiliation(s)
| | - Anne Thorsted
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Andrea Huber Jezek
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Andreas Jørgensen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | | | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Olesen SS, Mortensen LH, Zinck E, Becker U, Drewes AM, Nøjgaard C, Novovic S, Yadav D, Tolstrup JS. Time trends in incidence and prevalence of chronic pancreatitis: A 25-year population-based nationwide study. United European Gastroenterol J 2021; 9:82-90. [PMID: 33176616 PMCID: PMC8259237 DOI: 10.1177/2050640620966513] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/17/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Updated population-based estimates on incidence and prevalence of chronic pancreatitis are scarce. METHODS We used nationwide healthcare registries to identify all Danish patients diagnosed with chronic pancreatitis and computed crude and standardised incidence rates and prevalence estimates in 1994-2018. Incidence and prevalence were evaluated in relation to patients age and gender, aetiology (alcoholic vs. non-alcoholic) and smoking and alcohol consumption in the general Danish population. RESULTS The mean incidence rate of chronic pancreatitis during the study period was 12.6 per 100,000 person years for the total population, for women it was 8.6 per 100,000 person years and for men it was 16.7 per 100,000 person years. The standardised incidence rate was stable from 1994 to 2018, remaining at 12.5 per 100,000 person years in the last observation period (2014-2018). The point prevalence of chronic pancreatitis in 2016 was 153.9 per 100,000 persons. A gradual increase in standardised prevalence estimates was observed during the study period from 126.6 in 1996 to 153.9 in 2016. The mean age at chronic pancreatitis diagnosis increased from 52.1 to 60.0 years during the study period. CONCLUSION The prevalence of chronic pancreatitis is increasing in the Danish population despite a stable incidence level. Improved management strategies and changes in the underlying patient population may explain these observations.
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Affiliation(s)
- Søren S Olesen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
| | - Laust H Mortensen
- Data Science Lab, Methods and Analysis, Statistics Denmark, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth Zinck
- Data Science Lab, Methods and Analysis, Statistics Denmark, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ulrik Becker
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Asbjørn M Drewes
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
| | | | - Srdan Novovic
- Gastro Unit, Hvidovre University Hospital, Hvidovre, Denmark
| | - Dhiraj Yadav
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Janne S Tolstrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Hansen J, Molsted S, Ekholm O, Hansen H. Pain Prevalence, Localization, and Intensity in Adults with and without COPD: Results from the Danish Health and Morbidity Survey (a Self-reported Survey). Int J Chron Obstruct Pulmon Dis 2020; 15:3303-3311. [PMID: 33335391 PMCID: PMC7737012 DOI: 10.2147/copd.s275234] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/06/2020] [Indexed: 12/17/2022] Open
Abstract
Introduction Pain is a clinical complication to chronic obstructive pulmonary disease (COPD) that interferes negatively with physical activity level (PAL), quality of life (QOL) and pulmonary interventions. Yet, research in pain characteristics including prevalence, localization, and intensity in people with COPD are sparsely researched. Aim To investigate self-reported pain prevalence, localization and intensity of pain in people with and without COPD, and to investigate the association between pain intensity and PAL among participants with COPD. Methods Data were derived from the Danish Health and Morbidity Survey in 2017. The study population was restricted to individuals aged ≥35 years. Data included pain intensity assessed on the Numeric Rating Scale (NRS) and localization, PAL, QoL, sleep disturbance, comorbidities, sociodemographic and behavioral factors. Results In all, 528 participants with COPD and 8184 participants without COPD (51% females, mean ±SD age 67.1±11.4 years) were analyzed. Pain prevalence within the past 14 days was significantly higher in participants with COPD vs nonCOPD (72.7% vs 57.7%, p<0.001) and mainly located in the limbs, thorax, and lower back. COPD was associated with the prevalence of chronic pain (≥6 months) (OR: 2.78, 95%CI: 2.32; 3.34, p<0.001). Participants with COPD reported a higher pain intensity compared to those with nonCOPD with a mean difference of 1.04 points (95%CI: 0.75; 1.32, p<0.001) on the NRS. In the adjusted multiple logistic regression analysis, pain intensity was negatively associated with odds of being physical active (OR: 0.72, 95%CI: 0.61; 0.85, p<0.001). Conclusion Pain is more prevalent in people with self-reported COPD. After adjustment for age and gender, COPD was associated with an elevated pain intensity. Sleep disturbance and multimorbidity had the most pronounced impacts on pain intensity in the multiple linear regression model. In participants with COPD, increased pain intensity was negatively associated with being physically active.
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Affiliation(s)
- Jeanette Hansen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Stig Molsted
- Department of Clinical Research, North Zealand Hospital, Hillerød, Denmark
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Henrik Hansen
- Respiratory Research Unit, Department of Respiratory Medicine, University Hospital Hvidovre, Hvidovre, Denmark
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Callhoff J, Jacobs H, Albrecht K, Saam J, Zink A, Hoffmann F. Factors Associated with Survey Non-Response in a Cross-Sectional Survey of Persons with an Axial Spondyloarthritis or Osteoarthritis Claims Diagnosis. Int J Environ Res Public Health 2020; 17:E9186. [PMID: 33316981 DOI: 10.3390/ijerph17249186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/06/2020] [Accepted: 12/07/2020] [Indexed: 02/06/2023]
Abstract
Non-response in surveys can lead to bias, which is often difficult to investigate. The aim of this analysis was to compare factors available from claims data associated with survey non-response and to compare them among two samples. A stratified sample of 4471 persons with a diagnosis of axial spondyloarthritis (axSpA) and a sample of 8995 persons with an osteoarthritis (OA) diagnosis from a German statutory health insurance were randomly selected and sent a postal survey. The association of age, sex, medical prescriptions, specialist physician contact, influenza vaccination, hospitalization, and Elixhauser comorbidity index with the survey response was assessed. Multiple logistic regression models were used with response as the outcome. A total of 47% of the axSpA sample and 40% of the OA sample responded to the survey. In both samples, the response was highest in the 70-79-year-olds. Women in all age groups responded more often, except for the 70-79-year-olds. Rheumatologist/orthopedist contact, physical therapy prescription, and influenza vaccination were more frequent among responders. In the logistic regression models, rheumatologist/orthopedist treatment, influenza vaccination, and physical therapy were associated with a higher odds ratio for response in both samples. The prescription of biologic drugs was associated with higher response in axSpA. A high Elixhauser comorbidity index and opioid use were not relevantly associated with response. Being reimbursed for long-term care was associated with lower response-this was only significant in the OA sample. The number of quarters with a diagnosis in the survey year was associated with higher response. Similar factors were associated with non-response in the two samples. The results can help other investigators to plan sample sizes of their surveys in similar settings.
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Birkeland SF, Haakonsson AK, Pedersen SS, Rottmann N, Barry MJ, Möller S. Sociodemographic Representativeness in a Nationwide Web-Based Survey of the View of Men on Involvement in Health Care Decision-Making: Cross-Sectional Questionnaire Study. J Med Internet Res 2020; 22:e19517. [PMID: 32663149 PMCID: PMC7495257 DOI: 10.2196/19517] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/25/2020] [Indexed: 02/06/2023] Open
Abstract
Background Being able to generalize research findings to a broader population outside of the study sample is an important goal in surveys on the internet. We conducted a nationwide, cross-sectional, web-based survey with vignettes illustrating different levels of patient involvement to investigate men’s preferences regarding participation in health care decision-making. Following randomization into vignette variants, we distributed the survey among men aged 45 to 70 years through the state-authorized digital mailbox provided by the Danish authorities for secure communication with citizens. Objective This study aimed to investigate the sociodemographic representativeness of our sample of men obtained in a nationwide web-based survey using the digital mailbox. Methods Response rate estimates were established, and comparisons were made between responders and nonresponders in terms of age profiles (eg, average age) and municipality-level information on sociodemographic characteristics. Results Among 22,288 men invited during two waves, a total of 6756 (30.31%) participants responded to the survey. In adjusted analyses, responders’ characteristics mostly resembled those of nonresponders. Response rates, however, were significantly higher in older men (odds ratio [OR] 2.83 for responses among those aged 65-70 years compared with those aged 45-49 years, 95% CI 2.58-3.11; P<.001) and in rural areas (OR 1.10 compared with urban areas, 95% CI 1.03-1.18; P=.005). Furthermore, response rates appeared lower in areas with a higher tax base (OR 0.89 in the highest tertile, 95% CI 0.81-0.98; P=.02). Conclusions Overall, the general population of men aged 45 to 70 years was represented very well by the responders to our web-based survey. However, the imbalances identified highlight the importance of supplementing survey findings with studies of the representativeness of other characteristics of the sample like trait and preference features, so that proper statistical corrections can be made in upcoming analyses of survey responses whenever needed.
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Affiliation(s)
- Søren F Birkeland
- Open Patient Data Explorative Network (OPEN), Odense University Hospital and Department of Clinical Medicine, University of Southern Denmark, Odense, Denmark
| | - Anders K Haakonsson
- Open Patient Data Explorative Network (OPEN), Odense University Hospital and Department of Clinical Medicine, University of Southern Denmark, Odense, Denmark
| | - Susanne S Pedersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Nina Rottmann
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and Department of Clinical Medicine, University of Southern Denmark, Nyborg, Denmark
| | - Michael J Barry
- MGH Division of General Internal Medicine, Harvard Medical School, Boston, MA, United States
| | - Sören Möller
- Open Patient Data Explorative Network (OPEN), Odense University Hospital and Department of Clinical Medicine, University of Southern Denmark, Odense, Denmark
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35
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Baumbach L, Roos EM, Lykkegaard J, Thomsen KS, Kristensen PL, Christensen AI, Thorlund JB. Patients with osteoarthritis are least likely to receive lifestyle advice compared with patients with diabetes and hypertension: A national health survey study from Denmark. Osteoarthritis and Cartilage Open 2020; 2:100067. [DOI: 10.1016/j.ocarto.2020.100067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 04/09/2020] [Indexed: 01/01/2023] Open
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Melhus M, Eliassen BM, Broderstad AR. From rural to urban living - migration from Sami core areas to cities in Norway. Study design and sample characteristics. Int J Circumpolar Health 2020; 79:1794456. [PMID: 32692277 PMCID: PMC7480478 DOI: 10.1080/22423982.2020.1794456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
The Indigenous Sami population have inhabited rural northern areas of Norway, Sweden, Finland and the Kola Peninsula in Russia for thousands of years. Today, many Sami live in cities. No large quantitative studies have investigated the health and life of urban Sami in Norway. As a basis for further research, this paper describes the background, methods, participation and sample characteristics of the survey From Rural to Urban Living, conducted in 2014. The unique sampling design is based on internal migration records. Those invited were everyone born 1950-1975 who had relocated from preselected rural Sami core areas to cities in Norway. Their children above the age of 18 were also invited. The paper is descriptive with some basic statistical tests. In total, 2058 (response rate 34%) first-generation and 1168 (response rate 19%) second-generation migrants responded. The response rate was lowest in the younger age groups and among men. One out of three reported Sami background. The education level was in general high. From Rural to Urban Living enables numerous research possibilities within health and social sciences, and may contribute to new insight into the health, culture and identity of the growing Sami population in urban areas of Norway.
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Affiliation(s)
- Marita Melhus
- Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway , Tromsø, Norway
| | | | - Ann Ragnhild Broderstad
- Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway , Tromsø, Norway
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Haastrup PF, Jarbøl DE, Balasubramaniam K, Sætre LMS, Søndergaard J, Rasmussen S. Predictive values of lung cancer alarm symptoms in the general population: a nationwide cohort study. NPJ Prim Care Respir Med 2020; 30:15. [PMID: 32265450 DOI: 10.1038/s41533-020-0173-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 03/12/2020] [Indexed: 11/30/2022] Open
Abstract
We aimed to firstly determine the 1-year predictive values of lung cancer alarm symptoms in the general population and to analyse the proportion of alarm symptoms reported prior to diagnosis, and secondly analyse how smoking status and reported contact with general practitioners (GPs) regarding lung cancer alarm symptoms influence the predictive values. The study was a nationwide prospective cohort study of 69,060 individuals aged ≥40 years, randomly selected from the Danish population. Using information gathered in a survey regarding symptoms, lifestyle and healthcare-seeking together with registry information on lung cancer diagnoses in the subsequent year, we calculated the predictive values and likelihood ratios of symptoms that might be indicative of lung cancer. Furthermore, we analysed how smoking status and reported contact with GPs regarding the alarm symptoms affected the predictive values. We found that less than half of the patients had reported an alarm symptom six months prior to lung cancer diagnosis. The positive predictive values of the symptoms were generally very low, even for patients reporting GP contact regarding an alarm symptom. The highest predictive values were found for dyspnoea, hoarseness, loss of appetite and for current heavy smokers. The negative predictive values were high, all close to 100%. Given the low positive predictive values, our findings emphasise that diagnostic strategies should not focus on single, specific alarm symptoms, but should perhaps focus on different clusters of symptoms. For patients not experiencing alarm symptoms, the risk of overlooking lung cancer is very low.
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Molsted S, Eidemak I. Musculoskeletal pain reported by mobile patients with chronic kidney disease. Clin Kidney J 2020; 13:813-820. [PMID: 33123357 PMCID: PMC7577771 DOI: 10.1093/ckj/sfz196] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 12/11/2019] [Indexed: 11/17/2022] Open
Abstract
Background Musculoskeletal pain has been reported as a clinical problem in patients with chronic kidney disease (CKD). The purpose of this study was to compare the frequency of musculoskeletal pain in patients with CKD and no mobility problems with a general population and to investigate the impact of pain on quality of life (QOL), physical activity and physical function. Methods Patients with CKD Stages 4 and 5 with or without a dialysis treatment and no mobility problems were included. Musculoskeletal pain in the shoulder/neck, back/low back and limbs and level of physical activity were measured using the Danish Health and Morbidity Survey and coded into dichotomous answers. QOL and physical function were measured using the kidney disease QOL questionnaire and the 30-s chair stand test, respectively. Data for the general population were collected in national registers and adjusted for age, gender and region. Results The patients (n = 539) had a mean age of 66 [95% confidence interval (CI) 65–67] years, 62% were men and they were treated with haemodialysis (HD) (n = 281), peritoneal dialysis (n = 62) or without dialysis (n = 196). The frequency of reported musculoskeletal pain in the patients did not exceed pain reported by the general population [e.g. pain in the limbs in patients undergoing HD versus a matched general population, 61% versus 63% (P = 0.533), respectively]. Pain in all measured body sites was associated with reduced QOL [e.g. pain in the limbs associated with a physical component scale β of −8.2 (95% CI −10.3 to −6.0), P < 0.001]. Pain in the limbs was associated with a reduced number of repetitions in the 30-s chair stand test [mean −1.7 (95% CI −3.0 to −0.4), P = 0.009]. Pain in the shoulder/neck was associated with reduced odds of being physically active [odds ratio 0.6 (95% CI 0.4 to 0.9); P = 0.022]. Conclusions Musculoskeletal pain was not more frequently reported by patients with CKD and no mobility problems compared with the general population. However, as musculoskeletal pain was reported by up to two-thirds of the patient sample, healthcare professionals should remember to focus on this issue. The patients’ pain was associated with negative impacts on QOL, level of physical activity and physical function.
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Affiliation(s)
- Stig Molsted
- Department of Clinical Research, Nordsjællands Hospital, Hillerød, Denmark
| | - Inge Eidemak
- Department of Oncology, Section of Palliative Medicine, Rigshospitalet, Denmark
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Braekman E, Drieskens S, Charafeddine R, Demarest S, Berete F, Gisle L, Tafforeau J, Van der Heyden J, Van Hal G. Mixing mixed-mode designs in a national health interview survey: a pilot study to assess the impact on the self-administered questionnaire non-response. BMC Med Res Methodol 2019; 19:212. [PMID: 31752714 PMCID: PMC6868753 DOI: 10.1186/s12874-019-0860-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 10/31/2019] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Many population health surveys consist of a mixed-mode design that includes a face-to-face (F2F) interview followed by a paper-and-pencil (P&P) self-administered questionnaire (SAQ) for the sensitive topics. In order to alleviate the burden of a supplementary P&P questioning after the interview, a mixed-mode SAQ design including a web and P&P option was tested for the Belgian health interview survey. METHODS A pilot study (n = 266, age 15+) was organized using a mixed-mode SAQ design following the F2F interview. Respondents were invited to complete a web SAQ either immediately after the interview or at a later time. The P&P option was offered in case respondents refused or had previously declared having no computer access, no internet connection or no recent usage of computers. The unit response rate for the web SAQ and the overall unit response rate for the SAQ independent of the mode were evaluated. A logistic regression analysis was conducted to explore the association of socio-demographic characteristics and interviewer effects with the completed SAQ mode. Furthermore, a logistic regression analysis assessed the differential user-friendliness of the SAQ modes. Finally, a logistic multilevel model was used to evaluate the item non-response in the two SAQ modes while controlling for respondents' characteristics. RESULTS Of the eligible F2F respondents in this study, 76% (107/140) agreed to complete the web SAQ. Yet among those, only 78.5% (84/107) actually did. At the end, the overall (web and P&P) SAQ unit response rate reached 73.5%. In this study older people were less likely to complete the web SAQ. Indications for an interviewer effect were observed as regard the number of web respondents, P&P respondents and respondents who refused to complete the SAQ. The web SAQ scored better in terms of user-friendliness and presented higher item response than the P&P SAQ. CONCLUSIONS The web SAQ performed better regarding user-friendliness and item response than the P&P SAQ but the overall SAQ unit response rate was low. Therefore, future research is recommended to further assess which type of SAQ design implemented after a F2F interview is the most beneficial to obtain high unit and item response rates.
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Affiliation(s)
- Elise Braekman
- Scientific Direction Epidemiology and public health, Sciensano, Rue Juliette Wytsmanstraat 14, 1050, Brussels, Belgium. .,Unit of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium.
| | - Sabine Drieskens
- Scientific Direction Epidemiology and public health, Sciensano, Rue Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Rana Charafeddine
- Scientific Direction Epidemiology and public health, Sciensano, Rue Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Stefaan Demarest
- Scientific Direction Epidemiology and public health, Sciensano, Rue Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Finaba Berete
- Scientific Direction Epidemiology and public health, Sciensano, Rue Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Lydia Gisle
- Scientific Direction Epidemiology and public health, Sciensano, Rue Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Jean Tafforeau
- Scientific Direction Epidemiology and public health, Sciensano, Rue Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Johan Van der Heyden
- Scientific Direction Epidemiology and public health, Sciensano, Rue Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Guido Van Hal
- Unit of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium
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Jensen HAR, Rasmussen B, Ekholm O. Neighbour noise annoyance is associated with various mental and physical health symptoms: results from a nationwide study among individuals living in multi-storey housing. BMC Public Health 2019; 19:1508. [PMID: 31718590 PMCID: PMC6849169 DOI: 10.1186/s12889-019-7893-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 11/01/2019] [Indexed: 12/03/2022] Open
Abstract
Background Noise exposure is considered a stressor that may potentially exert negative health effects among the exposed individuals. On a population basis, the most prevalent and immediate response to noise is annoyance, which is an individually experienced phenomenon that may activate physiological stress-responses and result in both physical and mental symptoms. Health implications of traffic noise have been investigated thoroughly, but not of neighbour noise. The aim of the present study was to examine the associations between neighbour noise annoyance and eight different physical and mental health symptoms. Methods Cross-sectional data from the Danish Health and Morbidity Survey 2017 were used. The present study included a random sample of 3893 adults living in multi-storey housing. Information on neighbour noise annoyance and various health symptoms (e.g. pain in various body parts, headache, sleeping problems, depression, and anxiety) during the past two weeks was obtained by self-administered questionnaires. The question on neighbour noise annoyance and health symptoms, respectively, had three possible response options: ‘Yes, very annoyed/bothered’, ‘Yes, slightly annoyed/bothered’, ‘No’. The associations between neighbour noise annoyance and very bothering physical and mental health symptoms were investigated using multiple logistic regression models. Results Being very annoyed by neighbour noise was significantly associated with higher odds of being very bothered by all eight health symptoms (adjusted OR = 1.73–3.32, all p-values < 0.05) compared to individuals not annoyed by noise from neighbours. Statistically significant interactions were observed between sex and two of the eight health symptoms. Among women, a strong association was observed between neighbour noise annoyance and being very bothered by pain or discomfort in the shoulder or neck, and in the arms, hands, legs, knees, hips or joints. Among men, no associations were observed. Conclusions Based on the findings from this study, neighbour noise annoyance is strongly associated with eight different physical and mental health symptoms. Future studies are encouraged to 1) determine the direction of causality using a longitudinal design, 2) explore the biological mechanisms explaining the sex-specific impact of neighbour noise annoyance on symptoms of musculoskeletal pain or discomfort and the other outcomes as well.
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Affiliation(s)
- Heidi A R Jensen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Birgit Rasmussen
- Danish Building Research Institute, Aalborg University, A.C. Meyers Vænge 15, 2450, Copenhagen, Denmark
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark.
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Jensen HAR, Davidsen M, Christensen AI, Ekholm O. Inconsistencies in self-reported health conditions: results of a nationwide panel study. Int J Public Health 2019; 64:1243-1246. [PMID: 31422436 DOI: 10.1007/s00038-019-01287-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/27/2019] [Accepted: 08/12/2019] [Indexed: 11/28/2022] Open
Affiliation(s)
| | - Michael Davidsen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark
| | - Anne Illemann Christensen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark.
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