Anne Marit Mengshoel

• Allen-Unhammer, Anna Jane; Vøllestad, Nina Køpke & Mengshoel, Anne Marit (2026). Between a rock and a hard place: balancing roles of clinician and co-researcher in a primary health care setting - A qualitative study. Chiropractic & Manual Therapies. 34. doi: 10.1186/s12998-026-00681-9. Full text in Research Archive Show summary

  Background The participation of clinicians in clinical research is necessary, but balancing research and clinical duties can be challenging. We explored chiropractors’ experiences of participating in a clinical trial on spinal manipulation of the neck in primary health care (PHC). Methods A qualitative design was adopted, underpinned by social interactionism. Five virtual focus group interviews were performed between August-November 2023, including 15 chiropractors, who were involved in a clinical trial in PHC. Thematic analysis was applied. Results The interviewees were motivated to participate in the clinical trial to contribute to professional development through investigating the use of spinal manipulation. However, patient recruitment and adherence to the treatment protocol were more difficult than anticipated, especially when patients realised that the treatment would be determined by randomisation and because the chiropractors had to deliver the sham/placebo interventions. The interviewed chiropractors continually negotiated conflicting obligations of clinicians, co-researchers, and breadwinners, shifting loyalties between these roles in response to situational demands. Conclusions The clinicians’ motivations to take part in the trial varied but were in general rooted in a wish to contribute to strengthening the chiropractic profession. The negotiation of multiple roles and shifting loyalties rendered them moral agents. Our findings illustrate the social and relational nature of participating as a co-researcher in a trial conducted in a chiropractic PHC context. Our study also highlights a need for better support systems for research in PHC. This calls for political and organisational will to establish systems that provide necessary support to researchers and clinical co-researchers.

• Borge, Christine Råheim; Eik, Hedda; Wahl, Astrid Klopstad; Bragstad, Line Kildal; Sylwander, Charlotte & Hjorthaug, Kristin [Show all 26 contributors for this article] (2026). Health literacy research in primary healthcare services – A scoping review. Patient Education and Counseling. ISSN 0738-3991. 149, p. 109675–109675. doi: 10.1016/j.pec.2026.109675. Full text in Research Archive Show summary

  Objective To systematically map existing evidence on health literacy among people with non-communicable diseases (NCDs) in primary healthcare. Methods An interdisciplinary research group conducted a scoping review following the Arksey and O’Malley framework, refined by Levac and Peters, and reported according to PRISMA-ScR. The review was registered in OSF and applied the Population–Concept–Context framework to define inclusion criteria. Searches were conducted in Medline, APA PsycInfo, Scopus, and Cochrane for studies published between 2000–2025. Peer-reviewed studies were screened in Rayyan, and data were charted and thematically analyzed through team-based consensus. Results The search identified 7952 studies, of which 106 studies met the inclusion criteria. Participants’ mean age was 59 years; 56% were female. Studies originated from 29 countries, mainly the USA, China, and Canada, with an increase after 2013. Three main themes were identified: (1) health literacy, social status, and ethnicity, (2) health literacy, disease, and health outcomes, and (3) health literacy, NCD knowledge, and self-management. Many studies reported associations between health literacy, and self-management, quality of life, and some clinical outcomes, but findings across designs and outcomes were heterogeneous and not consistently positive. Conclusions Improved communication, greater cultural competence, and tailored health literacy interventions are associated with better self-management and disease outcomes in non-communicable diseases, but most evidence is associative rather than causal, intervention effects are mixed, and research on health literacy experiences remains limited. Practice Implications More rigorously designed intervention studies and broader conceptualization and measurement of health literacy with multidimensional instruments are needed to strengthen the evidence and clarify how health literacy relates to social status, disease outcomes, and self-management in primary healthcare. Training healthcare professionals to assess and address health literacy is essential to promote equity and effective patient engagement.

• Mengshoel, Anne Marit; Aurén-Møkleby, Eva Margareta; Skarbø, Åse & Sallinen, Merja Helena (2026). “This is how we should work” - healthcare professionals’ past uncertainty and present confidence in management of fibromyalgia - Logg inn. International Journal of Qualitative Studies on Health and Well-being. ISSN 1748-2623. 21(1). doi: 10.1080/17482631.2026.2644582. Full text in Research Archive Show summary

  Objective Fibromyalgia is a chronic illness that is poorly understood by healthcare professionals (HCPs), and HCPs may express uncertainty due to limited available knowledge. Our objective was to explore what HCPs tell about their present confidence in delivering self-management programs to patients with fibromyalgia. Methods A narrative research approach was applied, and interviews were conducted with nine HCPs from various professional backgrounds. The HCPs were experienced in the management of fibromyalgia, and one year earlier, they had revised their self-management program to ascertain person-centredness. The interview data were subjected to a narrative analysis of what and how they storied their clinical experiences of delivering the programs. Results The new confidence of the HCPs was grounded in a cohesive, collective platform with an explicit purpose linked to a defined content and an explorative educational approach. This was articulated by a shared clinical mindline emphasizing stress, patients’ experiences of life stress, and facilitating patients to find solutions to repair their disrupted daily lives. The cohesive, collective platform fostered mutual respect and shared responsibility for the wholeness of the program. Further the collective as well as discipline-specific clinical mindlines and skills were bolstered through the team’s engagement and reflective learning on episodes in practice. Conclusions The findings indicate that clinical confidence arises from a shared clinical mindline that articulates a theoretical rationale linked to the actions required and how to deliver the program, together with interdisciplinary collaboration and ongoing reflective practice.

• Feiring, Marte & Mengshoel, Anne Marit (2025). Kjønn og helse på den politiske dagsorden, Kjønn, helse og marginalisering. Cappelen Damm Akademisk. ISSN 9788202869090. p. 161–178. doi: 10.23865/cdf.249.ch9. Full text in Research Archive Show summary

  This chapter explores how knowledge, gender and health are articulated in two policy documents about women’s health from the Sundby Committee (SC) and the Meyer Committee (MC). Such expert reports influence how women’s health is understood in society and the design of healthcare policies and practices. The ways knowledge, gender and health are described in the documents sanctions specific views on gender and health. We examined the content of the two documents, what is emphasized and what is omitted. A practice-oriented, comparative, cultural analysis was conducted. The analysis displayed: First, documents as political tools, where the mandates and committee compositions differed. The SC had a broad mandate about health, working life and welfare, and the committee was headed by a socio-medical expert on gender and health issues, while the MC’s mandate concentrated on health, disease and care throughout the course of a woman’s life, and the work was chaired by an economist and expert in management, strategic changes and innovations. Second, with respect to documents as positioned texts, the SC included both a medical and a sociocultural perspective and approached women's health broadly, while MC applied a combined biological and social lens on women’s health and a biopsychosocial framework. Third, regarding documents as issues, the differences in committee members, mandates, perspectives and approaches led to diverse recommendations, priorities, and policy measures. We conclude that there are contours of a more disease-oriented policy agenda on women’s health in the coming years at the expense of a cultural understanding of gender and health.

• Aurén-Møkleby, Eva Margareta; Aasbø, Gunvor; Mengshoel, Anne Marit; Solbrække, Kari Nyheim & Thoresen, Lisbeth (2025). Kept at a Distance: A Qualitative Study of Bereaved Individuals’ Experiences of How Death Was Addressed When Their Partner Died at Home. Qualitative Health Research. ISSN 1049-7323. doi: 10.1177/10497323251328294. Full text in Research Archive Show summary

  Open awareness and dialogue concerning dying are considered essential for planning and realizing death at home. Moreover, much help and support throughout the dying process and death trajectory are provided by a person’s next of kin, often a spouse or partner. To explore how death was addressed among couples when one of the partners had died at home, we interviewed 14 bereaved individuals. The results were grouped into the following themes: “Idea(l)s and realities of communication,” “Different kinds of talks,” and “Unspoken understandings and showing without talking.” We found that prevailing narratives about how death should be discussed in socially and culturally expected ways affected how the bereaved addressed the imminent death of their partner, both at the time and in their retrospective reflections. In a few cases, death had been talked about directly using words such as “death” and “dying,” although indirect or avoidant discussions about death were more common. The bereaved mentioned unspoken understandings about how it was unnecessary to address death—that is, one just knew. In cases where the couple could not share a silent understanding, the bereaved had experienced loneliness. Death could also be addressed through actions, such as becoming closer or the ill person arranging for an easier subsequent life for their partner. To reduce the expectations that dying people and their partners might have to interact in certain ways at the end of life, it is important to acknowledge that awareness of dying can be expressed and shared in various ways.

• Tangen, Gro Gujord; Engedal, Knut; Persson, Karin Ester Torun; Selbæk, Geir; Dakhil, Shams & McArdle, Riona [Show all 10 contributors for this article] (2025). Validation of Spatial Orientation Screening questionnaire for use in memory clinic patients. Journal of Alzheimer's Disease. ISSN 1387-2877. 103(4), p. 1013–1022. doi: 10.1177/13872877241308877. Full text in Research Archive
• Mengshoel, Anne Marit; Sallinen, Merja Helena; Sim, Julius & Ahlsen, Birgitte (2025). Exercising an individualized process of agency in restoring a self and repairing a daily life disrupted by fibromyalgia: A narrative analysis. SSM - Qualitative Research in Health. 7. doi: 10.1016/j.ssmqr.2025.100538. Full text in Research Archive Show summary

  Objective: Fibromyalgia is a chronic condition that has major impact on people’s lives. This study examines individuals’ illness trajectories, with a particular focus on daily life experiences and self-managing. Methods: Narrative interviews were conducted, asking participants to story their daily life experiences from illness onset to the present, and to reflect on the future. Embedded in their storying were experiences of recently being diagnosed, navigating daily life in the face of illness, and participating in a self-management intervention. The data underwent a narrative analysis. Results: In keeping with the idiographic focus of narrative research, two individuals’ stories were chosen to portray an individualized process of self-managing illness in daily life. The storylines ‘Resuming prior self and life’ and ‘Taking life and self in new direction’ illuminate how individuals with differing illness trajectories and life situations autonomously apply resources available to them in their lives. They make sense of illness by bringing together their own lifeworld experiences of stress and factual knowledge and, through a process of individual agency, discover and try out what is right to do in their own life in the face of chronic illness. Conclusions: These two storylines illustrate that a self-managing process is an individual process nested in the person’s social context. Self-management encompasses an individualized process of agency in remaking daily life and reconstructing a sense of self.

• Aurén-Møkleby, Eva Margareta; Aasbø, Gunvor; Fredheim, Olav Magnus Søndenå; Mengshoel, Anne Marit; Solbrække, Kari Nyheim & Thoresen, Lisbeth (2024). “It turned out right for both of us”: A qualitative study about a preference for home death and actual place of death. Death Studies. ISSN 0748-1187. doi: 10.1080/07481187.2024.2369847. Full text in Research Archive Show summary

  This qualitative study was conducted in Norway to explore couples’ preference for home death when one of the partners was dying from cancer, and what made home death possible or not. We conducted dyad interviews with five couples. After the patients’ death, the spouses participated in individual interviews. The data were interpreted using thematic narrative analysis. One patient died at home, and three died in a healthcare institution. The narratives show how interdependency and mutual care were important when dealing with home death. When care needs were manageable at home, home was perceived a safe place and the preferred place for death. When care needs were experienced to become unmanageable at home, the sense of safety changed and admission to a health care institution was considered the best option. Regardless of place of death, the spouses experienced the end to have turned out right for their partner and themselves.

• Wigers, Sigrid Hørven; Veierød, Marit Bragelien; Mengshoel, Anne Marit; Forseth, Karin Maria Øien; Dahli, Mina Piiksi & Juel, Niels Gunnar [Show all 7 contributors for this article] (2024). Healthcare experiences of fibromyalgia patients and their associations with satisfaction and pain relief. A patient survey. Scandinavian Journal of Pain. ISSN 1877-8860. 24(1). doi: 10.1515/sjpain-2023-0141. Full text in Research Archive Show summary

  Objectives The etiology of fibromyalgia (FM) is disputed, and there is no established cure. Quantitative data on how this may affect patients’ healthcare experiences are scarce. The present study aims to investigate FM patients’ pain-related healthcare experiences and explore factors associated with high satisfaction and pain relief. Methods An anonymous, online, and patient-administered survey was developed and distributed to members of the Norwegian Fibromyalgia Association. It addressed their pain-related healthcare experiences from both primary and specialist care. Odds ratios for healthcare satisfaction and pain relief were estimated by binary logistic regression. Directed acyclic graphs guided the multivariable analyses. Results The patients (n = 1,626, mean age: 51 years) were primarily women (95%) with a 21.8-year mean pain duration and 12.7 years in pain before diagnosis. One-third did not understand why they had pain, and 56.6% did not know how to get better. More than half had not received satisfactory information on their pain cause from a physician, and guidance on how to improve was reported below medium. Patients regretted a lack of medical specialized competence on muscle pain and reported many unmet needs, including regular follow-up and pain assessment. Physician-mediated pain relief was low, and guideline adherence was deficient. Only 14.8% were satisfied with non-physician health providers evaluating and treating their pain, and 21.5% were satisfied (46.9% dissatisfied) with their global pain-related healthcare. Patients’ knowledge of their condition, physicians’ pain competence and provision of information and guidance, agreement in explanations and advice, and the absence of unmet needs significantly increased the odds of both healthcare satisfaction and pain relief. Conclusions Our survey describes deficiencies in FM patients’ pain-related healthcare and suggests areas for improvement to increase healthcare satisfaction and pain relief. (REC# 2019/845, 09.05.19).

• Krabbe, Silje Helen; Bjorbækmo, Wenche Schrøder; Mengshoel, Anne Marit; Sveen, Unni & Groven, Karen Synne (2024). A suffering body, hidden away from others: The experience of being long-term bedridden with severe myalgic encephalomyelitis/chronic fatigue syndrome in childhood and adolescence. Nursing Inquiry (NI). ISSN 1320-7881. 31(3), p. e12625–e12625. doi: 10.1111/nin.12625. Full text in Research Archive Show summary

  In this article, we present findings from a qualitative study examining how young women experience being long‐term bedridden with myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome (CFS), during childhood and adolescence. The aim is to explore how young women who fell ill with ME/CFS during childhood and adolescence look back on their lived experience of being long‐term bedridden from the vantage point of being fully or partially recovered. Informed by a phenomenological theoretical perspective, the researchers applied a narrative methodological approach involving the analysis of interviews with 13 women, aged 16–29 years at the time of the interview. Attention was particularly paid to how participants structured their narratives and to the events (telling moments) they identified as important. Four major storylines were developed: Ambivalent responses to the presence of others; A body on the edge of life; An eternity in the dark; and Recasting painful memories of being bedridden and alone. Based on our findings, we argue that the experience of being long‐term bedridden with ME/CFS during childhood and adolescence can be understood and communicated as a plot in which individuals find themselves pushed to the extreme limit of suffering and loneliness.

• Vøllestad, Nina Køpke & Mengshoel, Anne Marit (2023). Post-exertional malaise in daily life and experimental exercise models in patients with myalgic encephalomyelitis/chronic fatigue syndrome. Frontiers in Physiology. 14, p. 1257557–1257557. doi: 10.3389/fphys.2023.1257557. Full text in Research Archive Show summary

  Post-exertional malaise (PEM) is commonly recognized as a hallmark of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and is often used as one of several criteria for diagnosing ME/CFS. In this perspective paper we want to reflect on how PEM is understood, assessed, and evaluated in scientific literature, and to identify topics to be addressed in future research. Studies show that patients use a wide variety of words and concepts to label their experience of PEM in everyday life, and they report physical or mental exertions as triggers of PEM. They also report that PEM may have an immediate or delayed onset and may last from a few days to several months. When standardized exercise tests are used to trigger PEM experimentally, the exacerbation of symptoms has a more immediate onset but still shows a wide variability in duration. There are indications of altered muscular metabolism and autonomic nervous responses if exercise is repeated on successive days in patients with ME/CFS. The decreased muscular capacity appears to be maintained over several days following such controlled exercise bouts. These responses may correspond to patients’ experiences of increased exertion. Based on this background we argue that there is a need to look more closely into the processes occurring in the restitution period following exercise, as PEM reaches the peak in this phase.

• Aurén-Møkleby, Eva Margareta; Thoresen, Lisbeth; Mengshoel, Anne Marit; Solbrække, Kari Nyheim & Aasbø, Gunvor (2023). ‘It’s not just about me’: a qualitative study of couples’ narratives about home death when one of the partners is dying of cancer. Palliative Care & Social Practice. 17. doi: 10.1177/26323524231189517. Full text in Research Archive Show summary

  Background: Most cancer patients state a preference for home death. Care and support from primary caregivers are important to enable dying at home. A preference for home death from the perspective of couples has rarely been investigated.<p> <p>Objectives: To explore how a preference for home death is understood and enacted in couples where one of the partners is dying of cancer.<p> <p>Design: A qualitative interview research design with a narrative approach was used.<p> <p>Methods: Five couples participated in dyad interviews. During the analysis, two interviews that particularly illuminated couples’ shared and individual views were chosen as the primary cases.<p> <p>Results: The interviews show, in two highly different ways, how a preference for home death is a significant relational matter. The interviews are presented as two cases: ‘Struggles in an Unknown Terrain’ and ‘Reliance at the Kitchen Table’. They show how a preference for home death can be understood and enacted as a struggle or as reliance based on the couple’s shared biography and the partner’s ability to care for the partner during the end-of-life phase. The analysis highlighted the negotiations that underpin a preference for home death. In these negotiations, the couples drew on idealised understandings of home death. These ideas were supported by cultural values related to autonomy and independence as well as participation and citizenship. Thus, in the negotiations about being cared for and caring, legitimate dependency and the maintenance of a reciprocal relationship were balanced. The presence of healthcare professionals and medical devices in the home had to be balanced with the need to maintain a sense of self and an authentic home.<p> <p>Conclusion: A relational perspective on a preference for home death made us attentive to couples’ negotiations. These negotiations give couples the opportunity to re-evaluate and reconfirm individual and mutual needs in the end-of-life phase.

• Krabbe, Silje Helen; Groven, Karen Synne; Bjorbækmo, Wenche; Sveen, Unni & Mengshoel, Anne Marit (2023). The fragile process of Homecoming - Young women in recovery from severe ME/CFS. International Journal of Qualitative Studies on Health and Well-being. ISSN 1748-2623. 18(1). doi: 10.1080/17482631.2022.2146244. Full text in Research Archive Show summary

  Purpose: To explore the recovery narratives of 13 young women who had fallen ill with severe Myalgic Encephalomyelitis (ME), also known as Chronic Fatigue Syndrome (CFS), during childhood and adolescence, with the focus on what they had to say about their past experiences from the perspective of the present. Method: A qualitative narrative approach, informed by a phenomenological theoretical perspective, was adopted to explore what the women found significant and meaningful in their recovery process. Data analysis of in-depth narrative interviews was performed which are presented to readers through the stories of two particular participants. Results: The first story describes how one participant made a recovery by testing her body’s tolerance and working to create a more confident self. The second story describes a complex exploration of possibilities for action in recovery, along with a struggle to make sense of setbacks and hold on to what has been gained. Conclusion: Recovering from ME/CFS emerges as an inter-personal, contextual, fragile and nonlinear process of homecoming, based on gradually rising bodily based self-knowledge. Illness slowly fades away into the background, and there is the prospect of a healthier tomorrow.

• Mengshoel, Anne Marit (2023). Experiences of shifts in physiotherapy for rheumatoid arthritis over time – an autoethnography. Physiotherapy Theory and Practice. ISSN 0959-3985. doi: 10.1080/09593985.2023.2169061. Full text in Research Archive
• Bakken, Anne Karen; Mengshoel, Anne Marit; Synnes, Oddgeir & Strand, Elin Bolle (2023). Acquiring a new understanding of illness and agency: a narrative study of recovering from chronic fatigue syndrome. International Journal of Qualitative Studies on Health and Well-being. ISSN 1748-2623. 18(1), p. 2223420–2223420. doi: 10.1080/17482631.2023.2223420. Full text in Research Archive Show summary

  Background: The condition known as chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) is poorly understood. Simplified medical models tend to neglect the complexity of illness, contributing to a terrain of uncertainty, dilemmas and predicaments. However, despite pessimistic pictures of no cure and poor prognosis, some patients recover. Purpose: This study’s purpose is to provide insight into people’s experiences of suffering and recovery from very severe CFS/ME and illuminate understanding of how and why changes became possible. Methods: Fourteen former patients were interviewed about their experiences of returning to health. A narrative analysis was undertaken to explore participants’ experiences and understandings. We present the result through one participant’s story. Results: The analysis yielded a common plotline with a distinct turning point. Participants went through a profound narrative shift, change in mindset and subsequent long-time work to actively pursue their own healing. Their narrative understandings of being helpless victims of disease were replaced by a more complex view of causality and illness and a new sense of self-agency developed. Discussion: We discuss the illness narratives in relation to the disease model and its shortcomings, the different voices dominating the stories at different times in a clinically, conceptually, and emotionally challenging area.

• Letén, Helene Myklebust; Karterud, Hilde & Mengshoel, Anne Marit (2023). Individuals’ invisible work continues after epilepsy surgery: A qualitative interview study. Epilepsy Research. ISSN 0920-1211. 199, p. 107281–107281. doi: 10.1016/j.eplepsyres.2023.107281. Full text in Research Archive Show summary

  Objective How do persons with epilepsy (PWE) experience their everyday lives after epilepsy surgery? Methods Qualitative thematic interviews were conducted with eight PWEs (30 to 60 years old). They were recruited when coming for post-operative control 1 to 5 years after epilepsy surgery. The interviews were transcribed. They were analysed by thematic analysis and inspired by Goffman who examines everyday life activities as a theatre play. Results Before surgery, a substantial invisible and hidden work of adjustments was performed to prevent seizures, to secure help from others if seizures occurred, and to protect oneself from others’ gaze during a seizure. This invisible work continued after surgery even for those who became seizure-free; but now for the purpose of protecting oneself from relapse of epilepsy. From the participants perspective there was no or minor change in daily activities among those not becoming seizure-free after surgery. In contrast, those who became seizure-free enjoyed the freedom to participate in social activities without planning or restrictions. Conclusions A striking finding was that daily life after surgery comprises considerably invisible work to protect a social self, and this preventive and protective invisible work continued, although those who became seizure-free were living an ordinary socially healthy life.

• Krabbe, Silje Helen; Mengshoel, Anne Marit; Bjorbærkmo, Wenche Schrøder; Sveen, Unni & Groven, Karen Synne (2022). Bodies in lockdown: Young women's narratives of falling severely ill with ME/CFS during childhood and adolescence. Health Care for Women International. ISSN 0739-9332. doi: 10.1080/07399332.2022.2043862. Full text in Research Archive
• Sim, Julius & Mengshoel, Anne Marit (2022). Metasynthesis: issues of empirical and theoretical context. Quality & Quantity: International Journal of Methodology. ISSN 0033-5177. 56. doi: 10.1007/s11135-022-01502-w. Full text in Research Archive Show summary

  Abstract Metasynthesis is an approach to synthesizing primary qualitative research, and may take either an aggregative or an interpretive approach. In either case, the resulting synthesis inevitably occurs at a remove from both the empirical and the theoretical contexts of the original research. We argue that seeking to retain these contexts in the synthesis poses specific challenges. Thus, the empirical context of an original study and the individuality of participants’ first-order accounts will be incompletely and selectively represented in a published study, and will be further out of reach at the level of synthesis. Syntheses should therefore be faithful to, but not seek to reproduce, the empirical context of the primary studies. As regards theoretical context, accommodating the concepts and the broader theoretical frameworks of primary studies may require potentially divergent philosophical assumptions to be reconciled with each other and with the theoretical standpoint of the synthesist. Selecting studies where these assumptions are compatible, at the level of both theory and methodology, may lessen this challenge. Some metasyntheses seek to integrate not just concepts but also theories (metatheorizing), but here the challenges of philosophical and theoretical compatibility are more acute, and the means of achieving such integration appear to be underdeveloped.

• Larsen, Marie Hamilton; Mengshoel, Anne Marit; Andersen, Marit Helen; Borge, Christine Råheim; Ahlsen, Birgitte & Dahl, Kari Gire [Show all 15 contributors for this article] (2022). “A bit of everything”: Health literacy interventions in chronic conditions – a systematic review. Patient Education and Counseling. ISSN 0738-3991. 105(10), p. 2999–3016. doi: 10.1016/j.pec.2022.05.008. Full text in Research Archive Show summary

  Objective: To systematically evaluate health literacy (HL) interventions in chronic conditions by exploring theoretical perspectives, intervention content and effectiveness. Method: We searched MEDLINE, Cochrane, CINAHL, EMBASE, ERIC, Web of Science and PsycINFO. Standardised systematic review methods were used, and sequences informing our research question were extracted and analysed. The study includes a descriptive summary of the included papers. Results: We included 39 unique interventions, with diabetes and heart disease as the most targeted chronic conditions. Fifty-four percent of papers included a definition of HL, but the studies showed significant heterogeneity of theoretical underpinnings, modes, measures and content. We identified 23 HL measures, mostly assessing functional HL. The HL interventions were often more complex than the measures indicated. A significant change in HL was found in 28 studies. Study quality was generally poor. Conclusions: Interventions optimizing HL appear important to improve health outcomes in chronic conditions. To ensure cumulative knowledge development of this field we need theory-based interventions, consistency in methods and more tailored and comprehensive measures to capture the interventions’ complexity. Practice implications: A more valid understanding of HL interventions and measurements is needed to reach an agreed understanding of their components and intentions.

• Ahlsen, Birgitte; Mengshoel, Anne Marit & Engebretsen, Eivind (2022). Legitimacy in clinical practice: How patients with chronic muscle pain position themselves in the physiotherapy encounter. Journal of Evaluation In Clinical Practice. ISSN 1356-1294. p. 1–8. doi: 10.1111/jep.13768. Full text in Research Archive Show summary

  Rationale, Aims & Objective Patients who seek healthcare for long-lasting pain and symptoms without a detectable disease must put in extra work to be taken seriously and gain recognition as a patient. However, little is known about how patients' help-seeking is performed in clinical practice. The aim of the current study was to gain knowledge about the ways in which patients with chronic muscle pain position themselves as help-seekers during their first physiotherapy encounter. Method The material consisted of observation of 10 therapist-patient clinical interviews in primary care clinics and was analyzed using perspectives from discourse theory and the concept of positioning. Results The study highlights how the patients positioned themselves in continually shift between two discourses: that of disease (considering the patient as an object under study) and that of illness (positioning the patient as an active and participating but also troubled individual). This shifting of position was negotiated in interaction with the therapist: patients' opportunities to position themselves within the discourse of illness were limited by therapists' focus on facts and causal relationships within the discourse of disease. Conclusion Patients with chronic muscle pain seek to establish their legitimacy through the positivistic discourse of medicine and also through their compliance with the moral discourse of the patient as someone active, willing to take responsibility for their own health—and therefore worthy of treatment.

• Bjorbækmo, Wenche Schrøder; Mengshoel, Anne Marit & Robinson, Hilde Stendal (2022). Bridging troubled water - exploring improvement and patients' experiences using patient-reported outcome measures in physiotherapy: A mixed-method study. Health Science Reports. 5(2). doi: 10.1002/hsr2.530. Full text in Research Archive Show summary

  Background and Aims Increased use of patient-reported outcomes in health care has been emphasized. Our aim was to use the Patient-Specific Functional Scale (PSFS) to examine improvement in neck pain patients' activity limitations during physiotherapy treatment, with the purpose to explore the patients' experiences of using PSFS. The study illuminates whether and how PSFS can be useful in clinical physiotherapy. Methods Six patients participated. A mixed-method study design was applied, triangulating ontological perspectives of realism and phenomenology, quantitative and qualitative methods. Single Subject Experimental Design with PSFS as outcome measure examined changes over time and phenomenological interviews examined its meaningfulness for patients. Patients defined their personal activity limitations due to neck pain and scored difficulties several times, during the physiotherapy treatment period, using PSFS. We used visual analyses of the quantitative data and thematic analyses of the qualitative data. Integration and combination of the results from the two designs are presented in the discussion. Results In the quantitative analyses, PSFS showed improvement in most activity limitations during treatment. The qualitative analyses revealed that using PSFS required the patient to engage in different bodily awareness processes and handle the dilemma of a possible double function of scoring chosen activities. The mixed findings revealed improved functionality and that the context and the interaction between patient and therapist have a significant influence on the assessment process. Conclusions To be able to improve the utilization of PSFS, communication between patients and physiotherapists is of vital importance. When using PSFS, physiotherapists should direct their attention to the importance of interaction as always present and vital in assessments.

• Mengshoel, Anne Marit (2022). A long, winding trajectory of suffering with no definite start and uncertain future prospects – narratives of individuals recently diagnosed with fibromyalgia. International Journal of Qualitative Studies on Health and Well-being. ISSN 1748-2623. doi: 10.1080/17482631.2022.2056956. Full text in Research Archive Show summary

  Purpose Fibromyalgia is a contested illness with unknown aetiology and poorly understood development. The present aim is to explore the pre-diagnostic illness trajectory narrated by individuals recently diagnosed with fibromyalgia (FM). Methods Individual interviews about the course of the illness were conducted with seven women and three men (age from early 20s to 50s) who had recently been diagnosed with FM. A narrative analysis of what the interviewees told and how the stories were narrated was conducted. Results The findings are expressed by three storylines. “Strenuous life and alerted body preluding illness” displays a difficult, unsupported life and bodily sensitivity to stimuli. “Recurrent pains unfolding to become a lasting and complex illness” describes individuals pushing themselves to meet social obligations until they come to a full stop. “Diagnosed but still uncertain presence and future” portrays satisfaction with finally being diagnosed with FM and being supported by others, but still there are no solutions as to do about it. Conclusions The three storylines portray a long, winding trajectory of suffering starting before the onset of illness, and unfolding illness gradually becoming persistent and overwhelming. Finally, a diagnosis of FM is arrived at, but how the situation will evolve is uncertain.

• Bjorbækmo, Wenche & Mengshoel, Anne Marit (2022). A critical phenomenological investigation in the use of touch as “know how” in practical physiotherapy in primary care with children and adults. Frontiers in Rehabilitation Sciences. 3. doi: 10.3389/fresc.2022.1008969. Full text in Research Archive Show summary

  In this article, we examine the interactions between physiotherapists and patients in actual situations, focusing on how touch is expressed, what it may mean and how physiotherapists know (or do not know) when and how to touch. The empirical material is obtained from two Norwegian research projects. In both of them, the first author observed physiotherapeutic practice and conducted interviews with patients (children and adults) and physiotherapists. A phenomenological research approach was applied, and analysis of the empirical data was guided by the concept of bridling, implying adopting a questioning attitude and being open to that which presents itself and exploring its possibilities. Three processed excerpts from the empirical data are presented to illustrate how, in different ways, physiotherapists' expert knowledge about how to relate to and interact with individual patients is put into play and expressed in real physiotherapy encounters. Each excerpt is presented individually, followed by analysis. Our findings reveal aspects of the epistemology of physiotherapeutic practice to be intercorporal and illuminated by the concept and phenomenon of letting the other be.

• Mengshoel, Anne Marit; Skarbø, Åse; Hasselknippe, Elisabeth; Pettersson, Tamara; Brandsar, Nina Linnea & Askmann, Ellen [Show all 8 contributors for this article] (2021). Enabling personal recovery from fibromyalgia - theoretical rationale, content and meaning of a person-centred recovery-oriented programme. BMC Health Services Research. 21(1), p. 339–339. doi: 10.1186/s12913-021-06295-6. Full text in Research Archive Show summary

  Background Fibromyalgia (FM) is a contested, chronic widespread pain syndrome on which recommended therapies have short-lasting, moderate effects. Nevertheless, some patients become symptom-free, and their recovery experiences inspired us to develop a patient-centred recovery-oriented programme (PROP) delivered in a group format. Presently, we describe the theoretical rationale, purpose and content of the PROP, and its meanings for clinicians and patients. Methods A multidisciplinary clinical team, a leader of a rehabilitation unit, and two researchers coproduced the PROP. Five full-day seminars were arranged to bridge research and clinical experiences. Qualitative studies about patients’ illness and recovery experiences and questions by researchers facilitated reflections on clinical experiences. The meaning of the PROP was examined using focus group and individual interviews with patients and clinicians immediately after completing the course and after 1–1.5 years. Results The biopsychosocial model displays the research evidence across biological, mental and social impacts of FM, justifying that life stress can be an illness-maintaining factor in FM. The content addresses enabling patients to heal their own life and self by modifying life stress. Patients engage in making sense of the relationship between FM, themselves, and life through exploring, discovering and creating appropriate solutions for their daily social life. The PROP reduced uncertainties and brought a positive attitude and hope to the groups. After 1 year, patients are still engaged in recovery work, experience more good days, and maintain hope for further recovery. By sharing and reflecting on clinical experiences, a unified clinical team was established that continues to develop their competency. Conclusion To our knowledge, the PROP is the first programme for patients with FM that results from a process of coproducing knowledge, is based on explicit theoretical rationale, and facilitates a personal experiential recovery process. PROP is found to be meaningful and to work by patients and clinicians.

• Mengshoel, Anne Marit; Svarstad, Anne; Blegen, Gunhild; Elveseter, Arvid; Ildstad, Ragnhild & Vehus, Tiril [Show all 8 contributors for this article] (2021). Fysioterapi ved revmatiske betennelsessykdommer - på veg til en kunnskapsplattform for klinisk praksis. Fysioterapeuten. ISSN 0016-3384. 88(6), p. 28–33. Full text in Research Archive Show summary

  Hensikt: Å tydeliggjøre teoretisk forståelse som ligger til grunn for fysioterapipraksis ved revmatiske inflammatoriske sykdommer. Metode: Fysioterapeuter ved Revmatismesykehuset A/S Lillehammer og forsker samarbeidet om å tydeliggjøre revmafysioterapipraksis på sykehuset. Vitenskapelige studier relatert til revmafysioterapi ble lest og brukt til å fremme refleksjon om egen praksis. Samtalene ble tatt opp på bånd og analysert etter hvert møte. Foreløpige analyser dannet grunnlag for å stille nye spørsmål og velge ut artikler for videre utforskning. Resultat: Tidligere var fokus på symptomlindring, forebygge og redusere sykdomsrelaterte funksjonsbegrensninger, men de siste 20 årene er fysioterapeuter også opptatt av å fremme pasienters deltagelse i arbeidslivet og trening for å øke fysisk kapasitet, forebygge inaktivitet og livsstilssykdommer. Fysioterapeutene vektlegger betydning av «hendene som instrument» i undersøkelse og behandling. To ulike mulige måter å forstå kropp, bevegelse og funksjon kan dermed begrunne klinisk fysioterapipraksis; den ene relatert til sykdom og funksjonskapasitet og den andre til pasienters kroppslige sykdomserfaringer og tilhørighet i egen kropp og liv. Konklusjon: En objektiv og en subjektiv forståelse av kropp og fungering ligger til grunn for hva revmafysioterapi kan handle om. Nøkkelord: Fysioterapi – revmatologi – revmatiske sykdommer - rehabilitering – teoretiske perspektiv.

• Mengshoel, Anne Marit (2021). Tid for å tenke nytt om fysioterapi til pasienter med fibromyalgi. Fysioterapeuten. ISSN 0016-3384. 88(6), p. 34–40. Full text in Research Archive Show summary

  Hensikt: Det er mye usikkerhet knyttet til diagnostisering og behandling av pasienter med fibromyalgi (FM). I denne studien kartlegges hvilke medisinske spesialister som utreder pasienter for diagnose, hvilke yrkesgrupper oppsøkes for behandling, og pasienters utbytte av behandling. Metoder: Deltagerne ble inkludert fortløpende etter hvert de ble henvist til et pasientundervisningsopplegg innen spesialisthelsetjenesten. Pasientene fylte ut et strukturert spørreskjema om hvilke medisinske spesialister og faggrupper de hadde vært hos og utbytte av behandling. Alvorlighetsgrad av FM ble målt med Fibromyalgia Survey Questionnaire. Resultater: I studien deltok 130 pasienter (84% kvinner), 44% var fullt/delvis yrkesaktive, og 95% hadde alvorlig eller svært alvorlig grad av FM. Tidligere hadde pasientene i gjennomsnitt (standardavvik) blitt utredet hos medisinske spesialister innen 2 (2) ulike områder og hadde blitt behandlet hos 4 (2) ulike yrkesgrupper. Flest hadde vært hos fastlege (98%) og fysioterapeut (87%) i primærhelsetjenesten. Pasientene anga lite utbytte av behandlingene de hadde fått. Konklusjon: Flere av pasientene var storforbrukere av helsetjenester, og pasientene mente at de hadde hatt begrenset utbytte av behandling. Ettersom primærhelsetjenesten har ansvar for behandling av pasienter med FM, trengs det å tenke nytt om fysioterapi og samarbeid med fastleger i primærhelsetjenesten.

• Mengshoel, Anne Marit; Brandsar, Nina Linnea; Natvig, Bård & Fors, Egil Andreas (2021). Concordance between clinician- and 2016 criteria-based diagnoses of fibromyalgia. Scandinavian Journal of Pain. ISSN 1877-8860. 22(1), p. 59–66. doi: 10.1515/sjpain-2021-0087. Full text in Research Archive Show summary

  Objectives The Fibromyalgia Survey Diagnostic Criteria-2016 (FSD-2016 criteria) were recently recommended for both clinical and research purposes. The present study aims to examine whether there is concordance between clinician-based and FSD-2016 criteria-based diagnoses of FM, and secondly, to examine how the illness severity and physical function relate to the criteria-based diagnosis among patients referred to a rheumatism hospital. Methods Participants with a clinician-based diagnosis of FM were included consecutively when referred to a patient education programme for patients with FM. Illness severity was assessed with the Fibromyalgia Survey Questionnaire (FSQ). Based on the FSQ, the fulfilment of the FSD-2016 criteria was evaluated. Physical function was assessed using the Fibromyalgia Impact Questionnaire (FIQ) function scale and self-reported employment status. Results The sample included 130 patients (84% women) from 20 to 66 years of age. Eighty-nine per cent met the FSD-2016 criteria, and 44% of the patients were fully or partially employed. Great variability in illness severity was seen irrespective of employment status. There was an association between illness severity and physical function (r=0.4, p<0.001). For 95% of the patients, the FSQ illness severity scores classify as severe or very severe, and even for those not fulfilling the diagnostic criteria the scores were moderate and severe. Conclusions There was relatively high agreement between clinician- and criteria-based diagnoses. The illness severity overlapped irrespective of different employment status and fulfilment of FSD-2016 criteria.

• Nacul, Luis; Authier, Francois Jerome; Scheibenbogen, Carmen; Lorusso, Lorenzo; Helland, Ingrid B & Alegre, Jose [Show all 27 contributors for this article] (2021). European Network on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (EUROMENE): Expert consensus on the diagnosis, service provision, and care of people with ME/CFS in Europe. Medicina. ISSN 1010-660X. 57(5). doi: 10.3390/medicina57050510. Full text in Research Archive Show summary

  Designed by a group of ME/CFS researchers and health professionals, the European Network on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (EUROMENE) has received funding from the European Cooperation in Science and Technology (COST)—COST action 15111—from 2016 to 2020. The main goal of the Cost Action was to assess the existing knowledge and experience on health care delivery for people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) in European countries, and to enhance coordinated research and health care provision in this field. We report our findings and make recommendations for clinical diagnosis, health services and care for people with ME/CFS in Europe, as prepared by the group of clinicians and researchers from 22 countries and 55 European health professionals and researchers, who have been informed by people with ME/CFS.

• Mengshoel, Anne Marit; Helland, Ingrid B; Meeus, Mira; Castro-Marrero, Jesus; Pheby, Derek & Strand, Elin Bolle (2020). Patients’ experiences and effects of non-pharmacological treatment for myalgic encephalomyelitis/chronic fatigue syndrome – a scoping mixed methods review. International Journal of Qualitative Studies on Health and Well-being. ISSN 1748-2623. 15(1). doi: 10.1080/17482631.2020.1764830. Full text in Research Archive Show summary

  Purpose The EU COST Action 15111 collaboration on myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) aims to assess current research and identify knowledge gaps in Europe. Presently, our purpose is to map the effects of non-pharmacological therapies (NPTs) for ME/CFS, and what patients find important in the treatment process. Methods A scoping mixed methods literature review of European studies identified 16 papers fulfiling our inclusion criteria. The quantitative and qualitative studies were synthesized separately in tables. Additionally, extracts from the qualitative studies were subjected to translational analysis. Results Effect studies addressed cognitive behavioural therapy (CBT, n = 4), multimodal rehabilitation (n = 2) and activity-pacing (n = 2). CBT reduced fatigue scores more than usual care or waiting list controls. The effects of rehabilitation and activity-pacing were inconsistent. The contents, assessment methods and effects of rehabilitation and activity pacing studies varied. For patients, health professionals’ recognition of ME/CFS and support were crucial, but they expressed ambiguous experiences of what the NPTs entail. Conclusions Methodological differences make comparisons across NPTs impossible, and from a patient perspective the relevance of the specific contents of NPTs are unclear. Future well-designed studies should focus on developing NPTs tailored to patients’ concerns and evaluation tools reflecting what is essential for patients.

• Holmen, Heidi; Larsen, Marie Hamilton; Sallinen, Merja Helena; Thoresen, Lisbeth; Ahlsen, Birgitte & Andersen, Marit Helen [Show all 10 contributors for this article] (2020). En balansegang: helsepersonells erfaringer med mennesker med kronisk sykdom - en oversiktsartikkel av kvalitative studier. BestPractice nordic. Full text in Research Archive
• Mengshoel, Anne Marit & Feiring, Marte (2020). Rethinking recovery. In Nicholls, David; Groven, Karen Synne; Anjum, Rani Lill & Kinsella, Anne Elisabeth (Ed.), Mobilizing Knowledge in Physiotherapy Critical Reflections on Foundations and Practices. Routledge. ISSN 9780367428181. doi: 10.4324/9780367855338. Full text in Research Archive Show summary

  In this chapter, we explore recovery as knowledge and practices. In health sciences, clinical practice and public debates, the understanding of recovery relates to various interpretations of disease, illness and health. Our analytical perspective is inspired by theories of knowledge production; in particular, Jasanoff’s work on co-production of knowledge. In the present chapter, we unpack two ideal-typical understandings of recovery. According to the first understanding, recovery is disease-oriented and relates to the treatment’s curative effects (recovery as outcome), and knowledge production is separated from the persons and situations involved. The second, meanwhile, sees recovery in terms of a personal experiential process focusing on illness experience and the process of overcoming or coming to terms with illness in real-life situations (recovery as experience). Here, knowledge production integrates persons, contexts and culture. Recovery as outcome concerns health professionals’ responsibility to choose the most effective treatment for patients, informed by quantitative effect studies. Recovery as experience embraces the process undertaken and valued by the individual person in the act of living that can be informed by qualitative interview studies. In the third section, we elaborate on how these two understandings of recovery are integrated into contemporary clinical practice (recovery as coproduction).

• Holmen, Heidi; Larsen, Marie Hamilton; Sallinen, Merja Helena; Thoresen, Lisbeth; Ahlsen, Birgitte & Andersen, Marit Helen [Show all 10 contributors for this article] (2020). Working with patients suffering from chronic diseases can be a balancing act for health care professionals - a meta-synthesis of qualitative studies. BMC Health Services Research. doi: 10.1186/s12913-019-4826-2. Full text in Research Archive Show summary

  Background: The number of patients with long-term chronic diseases is increasing. These patients place a strain on health care systems and health care professionals (HCPs). Presently, we aimed to systematically review the literature on HCPs’ experiences working with patients with long-term chronic diseases such as type 2 diabetes, chronic obstructive pulmonary disease (COPD), and chronic kidney disease (CKD). Method: A systematic search of papers published between 2002 and July 2019 was conducted in the Embase, AMED, PsycINFO, MEDLINE, CINAHL, and COCHRANE databases to identify studies reporting qualitative interviews addressing HCPs’ experiences working with adults with COPD, CKD or type 2 diabetes. An interdisciplinary research group were involved in all phases of the study. With the help of NVivo, extracts of each paper were coded, and codes were compared across papers and refined using translational analysis. Further codes were clustered in categories that in turn formed overarching themes. Results: Our comprehensive search identified 4170 citations. Of these, 20 papers met our inclusion criteria. Regarding HCPs’ experiences working with patients with COPD, CKD, or type 2 diabetes, we developed 10 subcategories that formed three overarching main themes of work experiences: 1) individualizing one’s professional approach within the clinical encounter; 2) managing one’s emotions over time; 3) working to maintain professionalism. Overall these three themes suggest that HCPs’ work is a complex balancing act depending on the interaction between patient and professional, reality and professional ideals, and contextual support and managing one’s own emotions. Conclusion: Few qualitative studies highlighted HCPs’ general working experiences, as they mainly focused on the patients’ experiences or HCPs’ experiences of using particular clinical procedures. This study brings new insights about the complexity embedded in HCPs’ work in terms of weighing different, often contrasting aspects, in order to deliver appropriate practice. Acknowledging, discussing and supporting this complexity can empower HCPs to avoid burning out. Leaders, health organizations, and educational institutions have a particular responsibility to provide HCPs with thorough professional knowledge and systematic support. Trial registration: PROSPERO number: CRD42019119052.

• Strand, Elin Bolle; Castro-Marrero, Jesus; Helland, Ingrid B; Alegre, Jose & Mengshoel, Anne Marit (2020). Pain and depression are associated with more anxiety in ME/CFS: A cross-sectional cohort study between Norway and Spain. Clinical Medicine Insights: Psychiatry. 11, p. 1–8. doi: 10.1177/1179557320941478. Full text in Research Archive Show summary

  Objectives: Lasting, unexplained and high levels of pain may cause anxiety in patients with chronic fatigue syndrome. The objectives of the current study were to test assumptions of the association between pain and anxiety in patients diagnosed with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and to clarify the role of depression in this relationship. Methods: Data were collected from 664 participants (age 18-65 years) with 133 ME/CFS patients and 201 healthy controls from Norway and 330 CFS patients from Spain. Binary logistic regression model was applied to test relationships between the included variables in the samples. Results: Both pain and depression made significant direct contributions to the level of anxiety. The strongest risk for higher levels of anxiety was the combination of high levels of depression and high levels of pain in the overall sample (OR=49.70; P < 0.001), not so much in the Spanish cohort (OR=11.99; P < 0.0001) and most of all in the Norwegian cohort (OR=88.21; P < 0.001) sample. Conclusions: It was the combination of high pain levels and high levels of depression that to the greatest extent increased the risk of anxiety in patients with CFS/ME. Whatever diagnostic criterion that is applied, anxiety and depression should be mandatory to assess in the clinical assessments performed for diagnosing the ME/CFS. Approaches addressing anxiety-related pain and treatment of depression should be warranted.

• Eik, Hedda; Kirkevold, Marit; Solbrække, Kari Nyheim & Mengshoel, Anne Marit (2020). Rebuilding a tolerable life: narratives of women recovered from fibromyalgia. Physiotherapy Theory and Practice. ISSN 0959-3985. p. 1–11. doi: 10.1080/09593985.2020.1830454. Full text in Research Archive
• Mengshoel, Anne Marit; Bjorbærkmo, Wenche Schrøder; Sallinen, Merja Helena & Wahl, Astrid Klopstad (2019). 'It takes time, but recovering makes it worthwhile' - A qualitative study of long-term users' experiences of physiotherapy in primary health care. Physiotherapy Theory and Practice. ISSN 0959-3985. p. 1–12. doi: 10.1080/09593985.2019.1616343. Full text in Research Archive Show summary

  In several European countries, patients with chronic pain conditions are high consumers of physicians’ and physiotherapists’ health services in primary health care. This study aimed to explore how patients in a Norwegian context make sense of their long-term use of physiotherapy. Narrative interviews were conducted with six long-term users. The data material was subjected to a narrative analysis with a focus on the stories’ content and how health professionals and informants were inscribed in the stories. The stories provide rich and varied information about the informants’ experiences with prior and present health services inscribed in their experiences of illness and recovery. The narrative’s introduction portrays a shared illness narrative, centered around negative experiences as illustrated by the theme ‘A long time searching for explanations and solutions to recover’. The narrative’s plot describes a gradually ascending story of recovery where abilities overshadowed disabilities, as the informants are ‘Learning their own meaningful ways to proceed’. The narrative has no definite ending, but instead depicts an ‘Uncertainty about future and own ability to reverse relapse’. The shared narrative’s storyline is that ‘It takes time, but recovering makes it worthwhile’.

• Møkleby, Eva Margareta & Mengshoel, Anne Marit (2019). Devoted or negotiated routes of adherence: Narratives of patients with obstructive sleep apnoea using a continuous airway pressure device. Nursing Open. 6(3), p. 1237–1244. doi: 10.1002/nop2.325. Full text in Research Archive Show summary

  Aims To explore the narratives of patients about receiving a diagnosis of obstructive sleep apnoea and using a continuous positive airway pressure device. Design A qualitative design with a narrative approach. Methods Participants with personal experience of using a continuous positive airway pressure device were recruited through purposive sampling. Two women and five men were interviewed in 2017. The data material was subjected to a narrative analysis. Results Two storylines portraying two different trajectories of continuous positive airway pressure use were identified: “A route of devotion” reflects patients experiencing immediate health benefits, which lead to committed use. “A route of negotiations” is characterized by more irregular use, and the perceived benefits were less evident than for those displaying a devoted route. Individuals adjust to a continuous positive airway pressure device differently based on their prior and present life situation and whether use of the device is experienced as an opportunity to regain ordinary life or as an obstacle to maintaining ordinary life.

• Strand, Elin Bolle; Nacul, Luis; Mengshoel, Anne Marit; Helland, Ingrid B; Grabowski, Patricia & Krumina, Angelika [Show all 13 contributors for this article] (2019). Myalgic encephalomyelitis/chronic fatigue Syndrome (ME/CFS): Investigating care practices pointed out to disparities in diagnosis and treatment across European Union. PLOS ONE. 14(12), p. 1–12. doi: 10.1371/journal.pone.0225995. Full text in Research Archive Show summary

  ME/CFS is a chronic, complex, multisystem disease that often limits the health and functioning of the affected patients. Diagnosing patients with ME/CFS is a challenge, and many different case definitions exist and are used in clinical practice and research. Even after diagnosis, medical treatment is very challenging. Symptom relief and coping may affect how patients live with their disease and their quality of life. There is no consensus on which diagnostic criteria should be used and which treatment strategies can be recommended for patients. The purpose of the current project was to map the landscape of the Euromene countries in respect of national guidelines and recommendations for case definition, diagnosis and clinical approaches for ME/CFS patients. A 23 items questionnaire was sent out by email to the members of Euromene. The form contained questions on existing guidelines for case definitions, treatment/management of the disease, tests and questionnaires applied, and the prioritization of information for data sampling in research. We obtained information from 17 countries. Five countries reported having national guidelines for diagnosis, and five countries reported having guidelines for clinical approaches. For diagnostic purposes, the Fukuda criteria were most often recommended, and also the Canadian Consensus criteria, the International Consensus Criteria and the Oxford criteria were used. A mix of diagnostic criteria was applied within those countries having no guidelines. Many different questionnaires and tests were used for symptom registration and diagnostic investigation. For symptom relief, pain and anti-depressive medication were most often recommended. Cognitive Behavioral Therapy and Graded Exercise treatment were often recommended as disease management and rehabilitative/palliative strategies. The lack of consistency in recommendations across European countries urges the development of regulations, guidance and standards. The results of this study will contribute to the harmonization of diagnostic criteria and treatment for ME/CFS in Europe.

• Mengshoel, Anne Marit & Sallinen, Merja Helena (2019). Bringing qualitative research into rehabilitation - a worked example of developing a rehabilitation program for patients with fibromyalgia. In Hayre*, Christopher* & Muller, Dave* (Ed.), Enhancing healthcare and rehabilitation. The impact of qualitative research. Taylor & Francis Group. ISSN 9781351116824. p. 223–241. Full text in Research Archive Show summary

  Researchers and a multidisciplinary clinical team collaborated on the development of a rehabilitation programme for patients with fibromyalgia (FM). In this chapter, we describe the process of developing the programme, which involved reflecting across evidence, patientcenteredness, and clinical experiences. Pulling the different knowledges together, we applied condition-oriented evidence and a biopsychosocial model to demonstrate the complexity of FM and determine the target of the programme. The programme’s patient-centred approach was supported by patient-oriented evidence, theories of suffering and personal recovery, and clinical experiences, which fit together into a personal resource-oriented recovery model. Our experience was that applying a qualitative explorative approach and incorporating evidence from qualitative studies enhanced our reflexivity. Moreover, a ‘bottom-up’ working process resulted in a broad understanding about FM, what FM is like to live with and what a personal recovery process implies for a patient.

• Sallinen, Merja Helena; Mengshoel, Anne Marit & Solbrække, Kari Nyheim (2019). “I can’t have it; I am a man. A young man!” – men, fibromyalgia and masculinity in a Nordic context. International Journal of Qualitative Studies on Health and Well-being. ISSN 1748-2623. 14(1), p. 1676974–1676974. doi: 10.1080/17482631.2019.1676974. Full text in Research Archive Show summary

  Purpose: Research shows that gender has a substantial impact on the health behaviour such as expression of physical symptoms like persistent pains and aches. However, there is yet little knowledge about the gendered aspect of pain by men who suffer from typical female diseases like fibromyalgia. The purpose of the study was to elucidate the interplay between illness and gender by exploring life-stories of men who suffer from fibromyalgia. Methods: The data were collected through life-story interviews of eight men suffering from fibromyalgia. A narrative methodology for analysis was applied to explore the storytelling and the linguistic and performative aspects of the life-stories. Results: The masculine identity of the participants was re-negotiated by comparisons to other men and life before symptom onset, and by discussing expectations and beliefs of how men should act in contemporary societies. The transition from experiencing a strong, active and reliable body to experiencing a painful, vulnerable and helpless body was perceived as fundamental. Conclusions: Self-management and rehabilitation of fibromyalgia it is not only about learning to manage the symptoms but also about the struggle to find coherence in life through re-constructing gender identity that is acceptable both for the individual and for the community.

• Sallinen, Merja Helena & Mengshoel, Anne Marit (2019). 'I just want my life back' - Men's narratives about living With fibromyalgia. Disability and Rehabilitation. ISSN 0963-8288. 41(4), p. 422–429. doi: 10.1080/09638288.2017.1395085. Full text in Research Archive
• Ahlsen, Birgitte; Engebretsen, Eivind; Nicholls, David & Mengshoel, Anne Marit (2019). The singular patient in patient-centred care: Physiotherapists' accounts of treatment of patients with chronic muscle pain. Medical Humanities. ISSN 1468-215X. p. 1–8. doi: 10.1136/medhum-2018-011603. Full text in Research Archive Show summary

  A patient-centered approach has gained increasing interest in medicine and other health sciences. Whereas there are discussions about the meaning of a patientcentered approach and what the concept entails, little is known about how the patient as a person is understood in patient-centered care. This mticle investigates understandings of the patient as a self in patient-centered care through physiotherapy of patients with chronic muscle pain. The material consists of interviews with five Norwegian physiotherapists working in a rehabilitation clinic. Drawing on Kristeva's discussion of subjectivity in medical discourse, the study highlights two different treatment storylines that were closely entwined. One storyline focuses on open singular healing processes in which the treatment was based on openness to a search for meaning and sharing. In this storyline, the "person" at the center of care was not essentialized in terms of \ i biological mechanisms, but rather considered as a vulnerable, in-ational and moving self. By contrast, the second storyline focused on goal-oriented interventions aimed at restoring the patient to health. Here, the person in the center of the treatment was shaped according to model narratives about "the successful patient"; the empowered, rational, choosing and self-managing individual. As such, the findings revealed two conflicting concepts of the individual patient inherent in patientcentered care. On the one hand, the patient is seen as being a person in constant movement, and on the other, they are captured by more standardized te1ms designed to focus on more stable notion of outcome of illness. Therefore, our study suggests that the therapists' will to recognize the individual in patient-centered care had a counterpmt involving a marginalization of the singular.

• Tollefsrud, Inger Elisabeth & Mengshoel, Anne Marit (2019). A fragile normality - illness experiences of working-age individuals with osteoarthritis in knees and hips. Disability and Rehabilitation. ISSN 0963-8288. doi: 10.1080/09638288.2019.1573930. Full text in Research Archive
• Linberg, Berit Hagemoen & Mengshoel, Anne Marit (2018). Effect of a thin customized insole on pain and walking ability in rheumatoid arthritis, a randomised study. Musculoskeletal Care. ISSN 1478-2189. 16(1), p. 32–38. doi: 10.1002/msc.1199. Full text in Research Archive Show summary

  Objective The aim of the study was to investigate the immediate effects of a thin, easily customizable insole on pain and walking ability in patients with rheumatoid arthritis (RA) who have forefoot pain, and to determine whether the insoles were in use 1 year afterwards. Design An experimental, assessor-blinded design was applied to compare the immediate effects when walking with or without insoles in random order. After 1 year, a structured telephone interview was conducted. Participants Twenty-one subjects with RA and foot pain in at least one forefoot when walking and in response to the Gänslen test were recruited consecutively from the outpatient clinic and the inpatient ward at a hospital for people with rheumatic disease. Intervention Each subject was given a 4-mm thin individually customized insole of a malleable plastic material (CI-Core®) with synthetic textile material on the upper side. Main outcome measures The 6-min walk test (6MWT) was used to assess the ability to walk, and a 10-cm visual analogue scale to measure the intensity of foot pain induced by walking with and without the insole. A standardized questionnaire with five items was used to determine the use of, and degree of satisfaction with, insoles after 1 year. Results The median (interquartile range) foot pain intensity was 19 (15) with and 36 (27) without insoles (p < 0.001; effect size = 0.6). No statistically significant differences in 6MWT were found between the presence or absence of insoles (p = 0.07). After 1 year, 90% of the participants were still using the insoles. Conclusions The use of thin, easily customizable insoles resulted in immediate clinically relevant relief in walking-induced forefoot pain. Most of the patients were still using the insoles after 1 year.

• Njølstad, Berit Widerøe; Mengshoel, Anne Marit & Sveen, Unni (2018). "It's like being a slave to your own body in a way": a qualitative study of adolescents With chronic fatigue syndrome. Scandinavian Journal of Occupational Therapy. ISSN 1103-8128. 26(7), p. 505–514. doi: 10.1080/11038128.2018.1455895. Full text in Research Archive Show summary

  Background: Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a relatively common disabling illness in adolescents that may limit participation in daily life. Aim: This study explored interactions between the illness experiences of adolescents with CFS/ME, their occupational lives and expectations for the future. Methods: Seven adolescents with CFS/ME were interviewed. The interviews were analysed using thematic analysis. Results: Three themes were developed. ‘Being ruled by an unfamiliar and inexplicable body’, which illustrated that altered and strange bodies seemed to separate and disrupt the participants from their former occupational lives. ‘On the sideline of life with peers’, which demonstrated that the informants spent time at home, doing undemanding activities instead of participating in activities with peers. ‘A coherent connection between present and future life’, which was reflected by how the participants eventually accepted their situation and rebuilt a meaningful occupational life and value of self. Conclusion: CFS/ME made the body unfamiliar and disconnected informants from participating in their usual daily occupations. A coherent interaction between body, occupational life and social self was achieved by taking their new body into account and adjusting their occupations accordingly. This practice enabled the participants to hope for a better future life.

• Wahl, Astrid Klopstad; Opseth, Gro; Nolte, Sandra; Osborne, Richard H; Bjørke, Gustav & Mengshoel, Anne Marit (2018). Is regular use of physiotherapy treatment associated with health locus of control and self-management competency? A study of patients with musculoskeletal disorders undergoing physiotherapy in primary health care. Musculoskeletal Science and Practice. ISSN 2468-8630. 36, p. 43–47. doi: 10.1016/j.msksp.2018.04.008. Full text in Research Archive
• Mengshoel, Anne Marit; Sim, Julius; Ahlsen, Birgitte & Madden, Sue (2018). Diagnostic experience of patients With fibromyalgia - A meta-ethnography. Chronic Illness. ISSN 1742-3953. 14(3), p. 194–211. doi: 10.1177/1742395317718035. Full text in Research Archive Show summary

  Objective To examine how individuals experience the process and consequences of receiving a diagnosis of fibromyalgia syndrome. Methods A systematic literature search of qualitative studies up to May 2016 was performed. Twenty-eight reports including information on patients’ diagnostic experiences were subjected to an interpretive analysis in accordance with the principles of meta-ethnography. Results Years were normally spent consulting specialists in an attempt to confirm the reality of symptoms and make sense of the illness. Great relief was felt at finally achieving the fibromyalgia syndrome diagnosis. However, relief waned when therapies proved ineffective. Health professionals and others questioned whether individuals were genuinely ill, that the illness had a psychological nature, and whether they were doing their best to recover. The diagnosis did not provide a meaningful explanation of individuals’ suffering and had limited power to legitimate illness. Patients felt blamed for their failure to recover, threatening their personal credibility and moral identity. Conclusion The fibromyalgia syndrome diagnosis has limitations in validating and making sense of patients’ illness experiences and in providing social legitimation of their illness. Social relationships are strained during the diagnostic process and in the course of ineffective therapies.

• Opseth, Gro; Wahl, Astrid Klopstad; Bjørke, Gustav & Mengshoel, Anne Marit (2018). Negative perceptions of illness and health are associated with frequent use of physiotherapy in primary healthcare. Musculoskeletal Care. ISSN 1478-2189. 16(1), p. 133–138. doi: 10.1002/msc.1224. Full text in Research Archive Show summary

  Background: There is growing concern that an ageing population and increasing number of patients with chronic illnesses in the future will foster a need for health services beyond the resources available in society. Patients with chronic illnesses are reported to be frequent users of physicians' services in the primary health sector. Therapies for patients with chronic musculoskeletal illnesses are delivered by physiotherapists in this sector. However, we know little about the use of physiotherapy services and the factors that may explain their use. Purpose: The aim of the present study was to examine the association between the regular/non‐regular use of physiotherapy services, impacts of illness, and perceptions of illness and health. Methods: A cross‐sectional survey included patients between 18 and 70 years of age who visited a physiotherapy outpatient clinic in Oslo during one randomly chosen week. Patient characteristics and use of physiotherapy were mapped. The Brief Illness Perception Questionnaire (BIPQ), a single item of the Short Form Health Survey (SF‐12) and the Ørebro Musculoskeletal Pain Questionnaire (ØMPQ) were used to assess perceptions of illness and health, and impacts of illness. Data were analysed using independent sample t‐tests and logistic regression analysis. Results: A total of 507 patients with a mean age of 46 (standard deviation 12) years participated, of whom 54% were regular users of physiotherapy. BIPQ (p = 0.02; β = 0.03) and the single‐item on general health perception (p = 0.001; β = 0.44,) were the only significant variables in the final equation associated with regular use of physiotherapy. Conclusion: About half of the participants were regular, high consumers of physiotherapy, and negative perceptions of illness and health were associated with this regular use. The final version of this research has been published in Musculoskeletal Care. © 2017 Wiley

• Strand, Elin Bolle; Mengshoel, Anne Marit; Sandvik, Leiv; Helland, Ingrid B; Abraham, Semhar & Nes, Lise Solberg (2018). Pain is associated with reduced quality of life and functional status in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Scandinavian Journal of Pain. ISSN 1877-8860. 19(7), p. 505–514. doi: 10.1515/sjpain-2018-0095. Full text in Research Archive
• Ahlsen, Birgitte; Mengshoel, Anne Marit; Bondevik, Hilde & Engebretsen, Eivind (2018). Physiotherapists as detectives: Investigating clues and plots in the clinical encounter. Medical Humanities. ISSN 1468-215X. 44(1), p. 40–45. doi: 10.1136/medhum-2017-011229. Full text in Research Archive
• Sallinen, Merja Helena & Mengshoel, Anne Marit (2018). Memory gaps, lost words and crucial mistakes – men’s experiences of cognitive difficulties in fibromyalgia. Chronic Illness. ISSN 1742-3953. doi: 10.1177/1742395318815947. Full text in Research Archive Show summary

  Objectives The purpose of the study was to explore the impact of perceived cognitive problems on daily life in men with fibromyalgia. Method The data were collected through life-story interviews of eight men with fibromyalgia. Narrative analysis was conducted to create model narratives that comprise the content and storylines across the data. Results Three model narratives are presented in the findings to describe the scope and severity of the cognitive problems. The participants’ experiences of cognitive problems varied from occasional concentration problems to severe and complex difficulties in memory, problem solving and verbal fluency. The impact of these problems on daily life was substantial and overshadowed the participants’ domestic life, social relations and work performance. In some cases, maintaining a role in working life was perceived as challenging. Discussion These patients are usually examined and treated in primary health care settings and the assessment tools and interventions should be applicable in these settings. More research is needed to develop effective interventions that address not only memory but also individual’s ability to solve complex problems and to work under pressure as well as the level of verbal fluency, which all are relevant issues in terms of work ability in contemporary society.

• Mengshoel, Anne Marit & Grape, Hedda Eik (2017). Rethinking physiotherapy for patients With fibromyalgia - lessons learnt from qualitative studies. Physical Therapy Reviews. ISSN 1083-3196. 22(5-6). doi: 10.1080/10833196.217.1377975. Full text in Research Archive Show summary

  Background: Fibromyalgia (FM) is characterized by chronic, widespread musculoskeletal pain, extensive fatigue and an array of other symptoms. Cure is not expected, and patients have to learn to live with the illness. During the last years several studies have examined how it is like to live with FM from a patient’s point of view. These findings may help physiotherapists to better understand the challenges faced by patients. Objective: To describe what it is like for patients to live with FM and discuss how this may inform physiotherapy practice. Design: A systematic literature search of qualitative studies up till May 2016 was conducted, and 93 papers were read. The focus was on patients’ experiences of symptoms and how they managed everyday life. Results: Incomprehensible, unpredictable symptoms of FM intrude and disturb everyday life. The body is constantly monitored by patients on a day-to-day basis according to fluctuations in pain and energy levels, and habits and routines of daily life are adapted to these shifts. With other words, the connection between body, self and daily life is ruptured. In contrast, those having recovered from FM had found out what they could tolerate during a day and spent long time in rebuiding a life worth living. Conclusion: The present paper presents an argument that living with FM calls for a rather complex personal healing process that should be recognized and supported by physiotherapists. The final version of this research has been published in Physical Therapy Reviews. © 2017 Taylor & Francis

• Mengshoel, Anne Marit & Skarbø, Åse (2017). Rehabilitation needs approached by health professionals at a rheumatism hospital. Musculoskeletal Care. ISSN 1478-2189. 15(3), p. 210–217. doi: 10.1002/msc.1162. Full text in Research Archive Show summary

  Objective The aim of the present study was to examine the characteristics of patients referred to occupational therapists (OTs), physiotherapists (PTs) and social workers (SWs) at a rehabilitation unit in a hospital specializing in rheumatology, and the rehabilitation needs that clinicians and patients agreed should be addressed in the encounters with the particular health professional groups. Methods Consecutive hospitalized patients at a rheumatism hospital were recruited by the health professionals. Questions about patient characteristics and rehabilitation needs were posed. Free-text responses to questions about rehabilitation needs were coded by the International Classification of Functioning, Disability, and Health (ICF). Results The patients varied considerably in age distribution, disease duration, disability level and diagnoses, and several patients had comorbidities. The rehabilitation needs classified under the component Body Function fell into the chapters: Sensory Functions and Pain (PTs), Functions of Cardiovascular System (PTs), Neuromusculoskeletal and Movement-Related Functions (OTs, PTs); under the Activity and Participation component, these were: General Tasks and Demands (OTs), Mobility (OTs), Self-Care (PTs), Interpersonal Interactions and Relationships (SWs) and Major Life Stress (SWs); and under the Environmental Factors component these were: Products and Technology (OTs) and Services, Systems and Politics (SWs). Conclusions The patients were fairly heterogeneous. The needs identified in the encounters with the different professional groups fell into all three components of the ICF, and there was only a minor overlap between the health professionals at the chapter level of the ICF.

• Grape, Hedda; Solbrække, Kari Nyheim; Kirkevold, Marit & Mengshoel, Anne Marit (2017). Tiredness and fatigue during processes of illness and recovery: A qualitative study of women recovered from fibromyalgia syndrome. Physiotherapy Theory and Practice. ISSN 0959-3985. 33(1), p. 31–40. doi: 10.1080/09593985.2016.1247933. Full text in Research Archive Show summary

  Fibromyalgia syndrome (FMS), a chronic musculoskeletal pain condition, is often accompanied by fatigue. In this study, inspired by narrative approaches to health and illness, we explore how women who have regained their health after FMS describe tiredness along a storyline from before they fell ill, through their illness, recovery process, and present-day health. The data derive from qualitative interviews with eight Norwegian women who previously suffered from FMS but who no longer had the condition at the time of interview. We undertook a narrative analysis to understand the complexity of the stories about tiredness and fatigue and on this basis identified a storyline based on four sub-narratives: 1) Alarming but ignored tiredness (before illness); 2) paralyzing fatigue (during illness); 3) making sense of fatigue (recovery process); and 4) integrating tiredness into life (today). The findings highlight participants’ different understandings and meanings of tiredness and fatigue and the ways in which these link past, present, and future. Significantly, a clear distinction between tiredness and fatigue was not always found. Overall, the storyline that emerges from the narratives is about balancing tiredness/fatigue with everyday life, and how this unfolds in different ways across the span of FMS, from falling ill to recovering and regaining health.

• Tangen, Gro Gujord; Bergland, Astrid; Engedal, Knut & Mengshoel, Anne Marit (2017). The importance of parkinsonian signs for gait and balance in patients with Alzheimer's disease of mild degree. Gait & Posture. ISSN 0966-6362. 51, p. 159–161. doi: 10.1016/j.gaitpost.2016.10.009. Full text in Research Archive Show summary

  Parkinsonian signs are common in patients with Alzheimer’s disease (AD) of mild degree and predict functional decline, but their relationship with gait speed and balance is unclear. The aims of this study were to describe characteristics of patients with parkinsonian signs among 98 patients with AD of mild degree (with no comorbid Parkinson’s disease), and to examine associations between parkinsonian signs with gait speed and balance. A cross sectional study at a memory clinic was conducted. Presence of each parkinsonian sign (bradykinesia, rigidity and tremor) was derived from the UPDRS, regular gait speed was recorded over 10 m and balance were assessed using the Mini-Balance Evaluation Systems Test (Mini-BESTest). Bradykinesia was present in 30.6% of the sample, rigidity in 13.3% and tremor only in one patient. Patients with bradykinesia were older, had worse cognitive impairment and worse gait and balance performance than those without bradykinesia. More men than women had rigidity. Bradykinesia was significantly associated with mini-BESTest after adjusting for demographic factors (p < 0.001, explaining 13.3% of the variance), but was not significantly associated with gait speed. Rigidity was not associated with either gait speed or balance. We conclude that assessment of bradykinesia should be included in examination of balance control in patients with AD of mild degree.

• Bjorbærkmo, Wenche Schrøder & Mengshoel, Anne Marit (2016). “A Touch of Physiotherapy” – the significance and meaning of touch in the practice of physiotherapy. Physiotherapy Theory and Practice. ISSN 0959-3985. 32(1), p. 10–19. doi: 10.3109/09593985.2015.1071449. Full text in Research Archive
• Wahl, Astrid Klopstad; Osborne, Richard H; Langeland, Eva; Wentzel-Larsen, Tore; Mengshoel, Anne Marit & Ribu, Lis [Show all 9 contributors for this article] (2016). Making robust decisions about the impact of health education programs: Psychometric evaluation of the Health Education Impact Questionnaire (heiQ) in diverse patient groups in Norway. Patient Education and Counseling. ISSN 0738-3991. 99(10), p. 1733–1738. doi: 10.1016/j.pec.2016.05.001. Full text in Research Archive
• Borge, Christine Råheim; Mengshoel, Anne Marit; Moum, Torbjørn Åge & Wahl, Astrid Klopstad (2016). Fluctuating patterns in quality of life outcomes among patients with moderate and severe stages of chronic obstructive pulmonary disease. Quality of Life Research. ISSN 0962-9343. 25, p. 2041–2051. doi: 10.1007/s11136-016-1227-4. Full text in Research Archive
• Tangen, Gro Gujord; Engedal, Knut; Bergland, Astrid; Moger, Tron Anders; Hansson, Oskar & Mengshoel, Anne Marit (2015). Spatial navigation measured by the Floor Maze Test in patients with subjective cognitive impairment, mild cognitive impairment, and mild Alzheimer's disease. International Psychogeriatrics. ISSN 1041-6102. 27(8), p. 1401–1409. doi: 10.1017/S1041610215000022. Full text in Research Archive Show summary

  Background: Impaired spatial navigation is an early sign of Alzheimer's disease (AD), but this can be difficult to assess in clinical practice. We examined how the performance on the Floor Maze Test (FMT), which combines navigation with walking, differed between patients with subjective cognitive impairment (SCI), mild cognitive impairment (MCI), and mild AD. We also explored if there was a significant relationship between the FMT and the cognitive tests or sociodemographic factors. Methods: The study included 128 patients from a memory clinic classified as having SCI (n = 19), MCI (n = 20), and mild AD (n = 89). Spatial navigation was assessed by having the patients walk through the FMT, a two-dimensional maze. Both timed measures and number of errors were recorded. Cognitive function was assessed by the Word List Memory test, the Clock Drawing test, the Trail Making tests (TMT) A and B, and the Mini Mental Status Examination (MMSE). Results: The patients with MCI were slower than those with SCI, while the patients with mild AD more frequently completed the FMT with errors or gave up than the patients with MCI. Performance on the FMT was significantly associated with executive function (measured by TMT-B). Conclusions: The performances on the FMT worsened with increasing severity of cognitive impairment, and the FMT was primarily associated with executive function. The explained variance was relatively low, which may indicate that the standard cognitive test battery does not capture impairments of spatial navigation.

• Grape, Hedda; Solbrække, Kari Nyheim; Kirkevold, Marit & Mengshoel, Anne Marit (2015). Staying Healthy From Fibromyalgia Is Ongoing Hard Work. Qualitative Health Research. ISSN 1049-7323. 25(5), p. 679–688. doi: 10.1177/1049732314557333. Full text in Research Archive
• Bruun-Olsen, Vigdis; Wahl, Astrid Klopstad; Heggen, Kristin; Heiberg, Kristi E. & Mengshoel, Anne Marit (2015). On the inside of a walking skill programme for patients who have undergone total hip or knee arthroplasty: A qualitative study. European Journal of Physiotherapy. ISSN 2167-9169. 17(4), p. 159–165. doi: 10.3109/21679169.2015.1061052. Full text in Research Archive
• Borge, Christine Råheim; Mengshoel, Anne Marit; Omenaas, Ernst; Moum, Torbjørn Åge; Ekman, Inger & Lein, Martha Pauline [Show all 8 contributors for this article] (2015). Effect of guided deep breathing on breathlessness and the breathing pattern in chronic obstructive pulmonary disease: A double-blind randomized control trial. Patient Education and Counseling. ISSN 0738-3991. 98(2), p. 182–190. doi: 10.1016/j.pec.2014.10.017. Full text in Research Archive
• Eilertsen, Grethe; Ormstad, Heidi Kristin; Kirkevold, Marit; Mengshoel, Anne Marit; Söderberg, Siv & Olsson, Malin (2015). Similarities and differences in the experience of fatigue among People living with fibromyalgia, multiple sclerosis, ankylosing spondylitis and stroke. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 24(13-14), p. 2023–2034. doi: 10.1111/jocn.12774. Full text in Research Archive Show summary

  Aims and objectives To elucidate the experience of fatigue across several long-term illnesses, focusing on the similarities and differences. Background Fatigue is common to many long-term illnesses, but it has been studied mainly within the context of a single illness; qualitative studies comparing the experience and its impact on daily life across different long-term illnesses are lacking. Design Qualitative design. Methods A secondary analysis was conducted of five original interview studies involving 95 persons with ankylosing spondylitis, fibromyalgia, multiple sclerosis or stroke. Results Similarities and differences concerning experiences of fatigue were found across the studied long-term illnesses. All patients expressed the perception of having an unfamiliar body. Fatigue was also commonly expressed as unpredictable, uncontrollable and invisible to others. Differences were related to a constant versus a varying condition, a sudden and an uncontrollable sleepiness, a mutual reinforcement with pain and increased stress sensitivity. A lack of energy and a need for sleep and rest were common experiences, as was the impact on social relationships. There were also similarities regarding how the patients managed their daily life. The search for practical solutions and attitude adjustment differed with the fatigue characteristics. All patients felt a lack of understanding and disbelief from others. Conclusion and relevance to clinical practice Fatigue is commonly expressed by patients with long-term illnesses. Variations in experience are related to the type of diagnosis. The disparity between experiences influences how patients managed and adjusted to the conditions of everyday life. The illness-specific characteristics of fatigue warrant increased clinical awareness and may allow professionals to offer adequate information and establish effective methods of managing the condition. The

• Borge, Christine Råheim; Hagen, Kåre Birger; Mengshoel, Anne Marit; Omenaas, Ernst; Moum, Torbjørn Åge & Wahl, Astrid Klopstad (2014). Effects of controlled breathing exercises and respiratory muscle training in people with chronic obstructive pulmonary disease: results from evaluating the quality of evidence in systematic reviews. BMC Pulmonary Medicine. 14:184. doi: 10.1186/1471-2466-14-184. Full text in Research Archive Show summary

  Background This paper reviews evidence and quality of Systematic Reviews (SRs) on the effects of breathing control exercises (BCEs) and respiratory muscle training (RMT) on breathlessness/dyspnea and other symptoms, and quality of life (QOL) for individuals with chronic obstructive pulmonary disease (COPD). Methods A search for BCE and RMT literature in COPD published between January 1, 2002 and December 31, 2013 was performed in the following databases: PubMed, Ovid, CINAHL, PsycINFO, AMED, Cochrane and PEDro. The AMSTAR criteria were used to evaluate quality. Results After reviewing 642 reports, seven SRs were identified on RMT and BCEs. Three SRs were of high quality, three were of moderate quality, and one was of low quality. Two high-quality SRs reported significantly beneficial effects of RMT on dyspnea, and one reported significant effects on disease-specific QOL and fatigue. In these SRs, pooled data analyses were performed with three to fourteen single randomised control trials (RCTs) included in the analysis. In one of the SRs the quality of the single RCTs were rated by the authors to be between 5–7 (with10 best) and in the other one the quality of the single RCTs were rated to be between 30-83% of the maximum score. One high-quality SR found a significant positive effect of BCE based on pooled data analysis with two single RCTs in regard to pursed-lip breathing (PLB) on breathlessness. In this SR, one single RCT on diaphragmatic breathing (DB) and another one on yoga breathing (YB) showed effect on disease-specific QOL. The single RCTs included in the SR were rated by the authors in the SRs to be of low and moderate quality. Conclusions Based on three high-quality SRs performing pooled data analyses, there is evidence that RMT has effect on breathlessness, fatigue and disease-specific QOL and PLB on breathlessness. There is also evidence that single studies on DB and YB has effect on disease-specific QOL. Few RCTs are available and the variable quality of the single RCTs in the SRs, seem to require more RCTs in particular for BCEs, but also RMT before conclusions regarding effects and high quality SRs can be written.

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• Feiring, Marte & Mengshoel, Anne Marit (2024). KJØNN OG HELSE PÅ DEN POLITISKE DAGSORDEN En sammenlignende analyse av to politikkdokumenter. Full text in Research Archive
• Ingebritsen, Julia Renate & Mengshoel, Anne Marit (2024). Fibromyalgi - smerte hele døgnet. [Journal]. VG : Verdens gang. Full text in Research Archive
• Sollund, Adrian & Mengshoel, Anne Marit (2024). Dette bør du unngå. [Journal]. Dagbladet. Full text in Research Archive
• Thorsen, Ingeborg Marie Hegland; Linberg, Berit Hagemoen & Mengshoel, Anne Marit (2024). Utvikling av epikrisemal for utveksling av informasjon mellom fysioterapeuter i primærhelse-og spesialisthelsetjeneste. En systematisk samproduksjonsprosess. Fysioterapeuten. ISSN 0016-3384. p. 120–126. Full text in Research Archive
• Mengshoel, Anne Marit (2024). Fibromyalgi er forklarlig og mulig å gjøre noe med. Utposten. ISSN 0800-5680. 53(6), p. 13–15. Full text in Research Archive
• Opedal, Sondre & Mengshoel, Anne Marit (2023). Fibromyalgi-studie: Advarer mot feilbehandling. [Journal]. Dagbladet. Full text in Research Archive
• Mengshoel, Anne Marit (2023). Kunnskapsbasert praksis, makt og helsepolitikk. Fysioterapeuten. ISSN 0016-3384. p. 6–9. Full text in Research Archive
• Lein, Marte & Mengshoel, Anne Marit (2023). Fibromyalgi - er det mulig å bli frisk? [Internet]. NHI. Full text in Research Archive
• Mengshoel, Anne Marit (2023). Forskere: - Dette er den beste behandlingen for fibromyalgi. [Internet]. Lommelegen. Full text in Research Archive
• Mengshoel, Anne Marit (2023). Kan du bli betydelig bedre eller frisk av fibromyalgi? Medisinbloggen. Full text in Research Archive
• Mengshoel, Anne Marit (2022). Vær i forkant med å utvikle fremtidens fysioterapitjenester. p. 82–83. Full text in Research Archive
• Mengshoel, Anne Marit (2022). Kunnskap for å forklare og for å forstå - møte mellom ulike kunnskapssyn i diskusjon om psykomotorisk fysioterapi. Fysioterapeuten. ISSN 2246-7270. p. 72–75. Full text in Research Archive
• Wahl, Astrid Klopstad; Ahlsen, Birgitte & Mengshoel, Anne Marit (2022). Forstrukket og skvist- fysioterapi og kunnskap i møtet med pasienter med langvarige muskel og skjelettplager. Full text in Research Archive
• Bakken, Anne Karen; Mengshoel, Anne Marit; Synnes, Oddgeir & Strand, Elin Bolle (2022). Narratives of change in recovery from severe fatigue - a qualitative study on stories of healing from severe chronic fatigue syndrome/myalgic encephalomyelitis. Journal of Psychosomatic Research. ISSN 0022-3999. 157. Full text in Research Archive
• Mengshoel, Anne Marit (2022). Fibromyalgi – diagnostikk og pasientveiledning. BestPractice nordic. Full text in Research Archive
• Mengshoel, Anne Marit & Ahlsen, Birgitte (2022). Å skape mening sammen- en narrativ intervensjon i fysioterapi. Full text in Research Archive
• Storrøsten, Kaja & Mengshoel, Anne Marit (2021). Professorens metode: Bedre liv med fibromyalgi. [Journal]. Dagbladet. Full text in Research Archive
• Mengshoel, Anne Marit (2021). Nedstenging og normalitet. Full text in Research Archive
• Petterson, Tamara; Mengshoel, Anne Marit & Tollefsrud, Inger Elisabeth (2021). Hvordan skal helsepersonell møte pasienter med usikre diagnoser? Fontene. ISSN 0805-5432. Full text in Research Archive
• Mengshoel, Anne Marit & Woodhouse, Astrid (2021). Folk med fibromyalgi føler ofte de ikke blir trodd, i følge norsk forsker. [Internet]. forskning.no. Full text in Research Archive
• Holmen, Heidi; Mengshoel, Anne Marit; Thoresen, Lisbeth; Larsen, Marie Hamilton; Eik, Hedda & Borge, Christine Råheim (2021). En ubetydelig brikke. Full text in Research Archive
• Feiring, Marte & Mengshoel, Anne Marit (2021). Co-production of recovery. Full text in Research Archive
• Aurén-Møkleby, Eva Margareta (2019). Patients´ experience of living with obstructive sleep apnea and use of CPAP. Full text in Research Archive
• Mengshoel, Anne Marit (2019). Bedring som effekt av behandling og som personlig tilhelingserfaring. Revmatologi BestPractice. Full text in Research Archive
• Mengshoel, Anne Marit (2019). Nytt rehabiliteringstilbud til pasienter med fibromyalgi. Revmatologi BestPractice. 10(39), p. 8–10. Full text in Research Archive
• Mengshoel, Anne Marit (2019). Langvarige muskelskjelettplager: Bedring som personlig tilhelingsarbeid. Fysioterapeuten. ISSN 0016-3384. p. 16–20. Full text in Research Archive
• Tangen, Gro Gujord; Bergland, Astrid; Engedal, Knut & Mengshoel, Anne Marit (2018). Author response to the letter “The association of bradykinesia and balance control in patients with Alzheimer’s disease?”. Gait & Posture. ISSN 0966-6362. 60, p. 48–49. doi: 10.1016/j.gaitpost.2017.11.013. Full text in Research Archive
• Eik, Hedda; Solbrække, Kari Nyheim; Kirkevold, Marit & Mengshoel, Anne Marit (2018). Å gjennvinne et akseptabelt liv- tilfriskningsprosesser fra fibromyalgi. Full text in Research Archive
• Tangen, Gro Gujord; Knapskog, Anne Brita; Mengshoel, Anne Marit & Selbæk, Geir (2018). Romlig orienteringsevne hos personer med kognitiv svikt - betydning for fysisk funksjon og aktivitet. Full text in Research Archive
• Mengshoel, Anne Marit (2017). Fibromyalgidiagnose og diagnostisering sett fra pasienters ståsted - resultater fra en metasyntese av kvalitative studier. Revmatologi BestPractice. 8, p. 18–21. Full text in Research Archive
• Mengshoel, Anne Marit (2017). Noen tanker om å skrive prosjektsøknader. Fysioterapeuten. ISSN 0016-3384. p. 36–38. Full text in Research Archive
• Leistad, Elin Andresen; Skarbø, Åse; Rønningen, Aud & Mengshoel, Anne Marit (2016). Aktivitetsprioritering i gruppe - aktivitet gjennom bevisste valg. Ergoterapeuten. ISSN 0800-3475. p. 24–29. Full text in Research Archive
• Borge, Christine Råheim; Mengshoel, Anne Marit; Omenaas, Ernst; Moum, Torbjørn Åge; Ekman, Inger & Lein, Martha Pauline [Show all 8 contributors for this article] (2016). Effektn på tung pust ved hjelp av pusteveiledning av pasienter med moderat og alvorlig kols -en dobbelblindet, randomisert kontrollstudie. BestPractice. Lungemedisin. Full text in Research Archive
• Ottesen, Alette & Mengshoel, Anne Marit (2016). (U)synlig og (u)forståelig - avhengig av hva man retter blikket mot. Fysioterapeuten. ISSN 0016-3384. p. 30–33. Full text in Research Archive
• Mengshoel, Anne Marit (2016). Sykt trett eller bare vanlig trett? Revmatologi BestPractice. 7(26), p. 32–34. Full text in Research Archive
• Mengshoel, Anne Marit (2015). Unormal form for tretthet ved Sjøgrens syndrom. Fysioterapeuten. ISSN 0016-3384. Full text in Research Archive
• Mengshoel, Anne Marit (2015). Artrose, smerte og fysisk funksjon etter innsatt totalprotese i hoften. Full text in Research Archive

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