- 10.00: Trial lecture
- 12.00: Public defence
The ordinary opponents are:
- First opponent: Professor Jonas Block Thorlund, University of Southern Denmark
- Second opponent: PhD, Researcher, Post Doc Mariëtte de Rooij, Amsterdam Rehabilitation Research Centre, The Netherlands
- Leader of the evaluation committee: Professor Margreth Grotle, OsloMet
The leader of the public defense is Head of Department Mari Klokkerud, OsloMet.
The main supervisor is Professor II Ida K. Bos-Haugen, Diakonhjemmet Hospital.
The co-supervisors are Resident Physician Pernille S. Pettersen, Diakonhjemmet Hospital and Professor Ingvild Kjeken, OsloMet.
Thesis abstract
Hand osteoarthritis (OA) is a common joint disease that may entail various symptoms. Although pain is the most important symptom, less is known about how and why individuals with hand OA may vary in their pain.
Also, whether people with hand OA experience extreme tiredness (fatigue) remains unclear as well as which features that may be linked to this fatigue. Increased knowledge about these aspects may assist in our progress towards more tailored treatment approaches.
The aim of this thesis was to explore the interplay between pain, sleep, and fatigue in people with hand OA.
Method and findings
This thesis used observational data collected in 300 participants with hand OA included in the hospital-based Nor-Hand study. Our results show that sleep problems such as feelings of not sleeping good or long enough were commonly reported in hand OA.
Participants with more sleep problems also reported more intense pain in their hands and the overall body than participants with normal sleep, both at the present time and 3.5 years later. We also found that people with hand OA may belong to one of four unique pain profiles. Factors such as pain intensity, sleep problems, fatigue, and psychological and mental factors were largely sufficient to identify these profiles and characterize them. Markers of changed pain sensitivity were less important.
The probability of belonging to the same profile after 3.5 years differed depending on which profile an individual belonged to at the beginning of the study. Around 80 percent of all participants did not change their profile. Among those who did, approximately two thirds changed to a profile characterized by less pain.
Participants who changed to another profile were characterized by larger changes in pain and psychosocial factors than those who did not change profile. We also found that fatigue represents a significant burden in hand OA. Pain, sleep problems, and psychological factors were strongly linked to fatigue. Radiographic hand OA severity and other biological features were less important.
The generalizability of these findings may be limited, and no causal links have been shown. However, the results provide new insight into the complex puzzle of how hand OA symptoms may be affected or vary across individuals, indicating that factors beyond the disease may also be important.
Including more biopsychosocial factors into hand OA assessments may improve illness understanding and reveal additional treatment targets that better accommodate individual needs.
