Inger Ahlstrand

Senior Lecturer Health and Care Sciences
Department of Rehabilitation , School of Health and Welfare
Doctor of Philosophy

Over the last 20 years, therapy strategies in RA have been dramatically reformed. Routines for early diagnosis, early aggressive medication is established and disease activity decreased. Although disability for persons treated with new medicines is reduced, the impact of disease on daily activities and participation is described as too high. Even if the disability has decreased, poorer general health is reported, which increases the needs and requirements of participation. Persons with RA are working to a greater extent, have less disability and a greater need to be able to make their own priorities. Despite a well-structured care early so continue many people with RA to report a high pain intensity. Pain has been highlighted by persons with RA as one of the most restrictive symptoms in RA.  

Different methodological approach are used in this thesis in order to provide a more comprehensive understanding of the pain and participation in valued activities in persons with RA. International recommendations highlight that research should be based on the experience of those who are living with RA and the person with RA is in focus in standards of care for treatment (including rehabilitation) of RA. The personal perspective is therefore important but such descriptions of pain and perceptions of how it affects people’s everyday life are still missing in research. Patient Reported Outcome Measures (PROM) and focus group discussions are therefore used as data collection in this thesis. Participants in the studies in this thesis are both women and men depending on the previously found gender differences in RA. To what degree pain and participation have been reduced or still exist after the access to biological drugs has not been studied in detail. Consequently, there is a need to study pain and the relationship between pain and participation in daily activities to identify unmet needs for multi professional interventions in rehabilitation directed to the different needs and demands expressed by the women and men with RA today. Which means that there is a need to develop knowledge and methods in rehabilitation. The knowledge this thesis generate will provide a basis for that.

The studies are carried out in collaboration with the rheumatology units in the counties of Jönköping, Kalmar and Östergötland. Patient participation in research is undertaken here through cooperation with the Swedish Rheumatism Association trained research partners. successfully defended her dissertation The dissertation Pain and its relation to participation in valued activities in rheumatoid arthritis, was succesfully defended in september, 2015.

Article

Lindmark, U. Ahlstrand, I. Ekman, A. Berg, L. Hedén, L. Källstrand, J. , ... Larsson I. (2020). Health-promoting factors in higher education for a sustainable working life – protocol for a multicenter longitudinal study BMC Public Health, 20(1), 1-8.
Wagman, P. Johansson, A. Jansson, I. Lygnegård, F. Edström, E. Björklund Carlstedt, A. , ... Fristedt S. (2020). Making sustainability in occupational therapy visible by relating to the Agenda 2030 goals – A case description of a Swedish university World Federation of Occupational Therapists Bulletin, 76(1), 7-14.
Wagman, P., Ahlstrand, I., Björk, M., Håkansson, C. (2020). Occupational balance and its association with life satisfaction in men and women with rheumatoid arthritis Musculoskeletal Care, 18(2), 187-194.
Ahlstrand, I., Wagman, P., Hakansson, C., Bjork, M. (2018). Occupational balance and its relation to performance of valued life activities in persons with rheumatoid arthritis in working age Annals of the Rheumatic Diseases, 77(Suppl. 2), 186.
Ahlstrand, I., Vaz, S., Falkmer, T., Thyberg, I., Björk, M. (2017). Self-efficacy and pain acceptance as mediators of the relationship between pain and performance of valued life activities in women and men with rheumatoid arthritis Clinical Rehabilitation, 31(6), 824-834.
Bergström, M., Ahlstrand, I., Thyberg, I., Falkmer, T., Börsbo, B., Björk, M. (2017). ‘Like the worst toothache you’ve had’ – How people with rheumatoid arthritis describe and manage pain Scandinavian Journal of Occupational Therapy, 24(6), 468-476.
Ahlstrand, I., Thyberg, I., Falkmer, T., Dahlström, Ö., Björk, M. (2015). Pain and activity limitations in women and men with contemporary treated early RA compared to 10 years ago: the Swedish TIRA project Scandinavian Journal of Rheumatology, 44(4), 259-264.
Ahlstrand, I., Björk, M., Thyberg, I., Falkmer, T. (2015). Pain and difficulties performing valued life activities in women and men with rheumatoid arthritis Clinical Rheumatology, 34(8), 1353-1362.
Ahlstrand, I., Björk, M., Thyberg, I., Börsbo, B., Falkmer, T. (2012). Pain and Daily Activities in Rheumatoid Arthritis Disability and Rehabilitation, 34(15), 1245-1253.
Ahlstrand, I., Bränholm, I. (1998). Activity performance, life satisfaction and locus of control in young women on sick leave Work: A journal of Prevention, Assessment and rehabilitation, 11(2), 131-136.

Article, review/survey

Lindmark, U. Bülow, P. Mårtensson, J. Rönning, H. Ahlstrand, I. Broström, A. , ... Sandgren A. (2019). The use of the concept of transition in different disciplines within health and social welfare: An integrative literature review.

Book chapter

Ahlstrand, I. (2006). Att vara ung kvinna och långtidssjukskriven påverkar hela livssituationen. In: Vågor på HaVet: tio texter om arbete och funktionshinder Jönköping: Hälsohögskolan

Conference paper

Ahlstrand, I., Thyberg, I., Falkmer, T., Dahlström, Ö., Björk, M. (2014). Less pain and activity limitations in today's early RA patients compared with patients diagnosed 10 years earlier (the swedish TIRA-project). EULAR conference, Paris June 2014.
Ahlstrand, I., Björk, M., Thyberg, I. (2013). Low levels of pain impact on valued life activities in women and men with Rheumatoid Arthritis. EULAR 2013 Congress, Madrid.
Ahlstrand, I., Björk, M., Thyberg, I., Börsbo, B., Falkmer, T. (2011). Smärta och dagliga aktiviteter vid Reumatoid artrit ur ett patientperspektiv. AT-forum.

Doctoral thesis

Ahlstrand, I. (2015). Pain and its relation to participation in valued activities in rheumatoid arthritis (Doctoral thesis, Jönköping: Jönköping University, School of Health and Welfare).