Tor-Ivar Karlsen

• Wevling, Astrid Birgitte; Heen, Cathrine; Hansen, Linda Iren Mihaila; Munday, Judy & Karlsen, Tor-Ivar (2026). Temperature monitoring and hypothermia prevention in Norwegian surgical patients: A retrospective observational study. The Nordic Journal of Nursing Research (NJNR). ISSN 2057-1585. 46, s. 1–9. doi: 10.1177/20571585261468206. Fulltekst i vitenarkiv Vis sammendrag

  Perioperative hypothermia is associated with increased morbidity and mortality. Systematic temperature monitoring is considered important for early detection of hypothermia and timely intervention, yet incidence remains high. This study examined monitoring practices across the perioperative course. We conducted a 1-week retrospective observational study of 1261 patients undergoing surgery lasting more than 30 min. Temperature monitoring data, including hypothermia incidence and the use of monitoring devices, were extracted from electronic records. Only 11.1% of patients had complete temperature documentation across all stages, and hypothermia was frequently recorded. Preoperative temperature measurements were documented in 31.8% of patients with an average 7 h delay between ward measurement and arrival in the operating theatre, potentially limiting clinical utility of these measurements. Intraoperative monitoring occurred in 26.1% of patients and in 29.0% at the post-anesthesia care unit. We found intraoperative hypothermia in 38% of patients. The most commonly used device preoperatively was an infrared aural canal thermometer, and in the operating theatre, the most common device was urinary catheter-based invasive temperature monitoring. These findings indicate suboptimal continuity of temperature monitoring across the perioperative pathway. Our findings highlight opportunities to improve the consistency of perioperative temperature monitoring and warrant further research into factors influencing current practice.

• Bye, Maria Ravnskog; Karlsen, Tor-Ivar & Carlström, Charlotta (2026). “Do You Really Want to Give Up an Eternity in Heaven for a Moment of Carnal Desire?”—Queer Norwegians’ Experiences of Nonaccepting Religious Environments. Sexuality & Culture. ISSN 1095-5143. 30, s. 2068–2085. doi: 10.1007/s12119-026-10554-1. Fulltekst i vitenarkiv Vis sammendrag

  This article examines how queer individuals in Norway navigate tensions between their sexual or gender identities and the expectations of nonaccepting religious environments. Based on ten in-depth interviews analysed using reflexive thematic analysis, the study shows how participants’ religious lifeworlds—shaped by the norms and messages within their faith communities—created deep moral conflict, shame, and fear of divine punishment. These experiences became embodied, often resulting in somatic reactions, internalized stigma, and long-term challenges related to sexuality and intimacy. Many participants encountered explicit or implicit attempts at conversion, which reinforced heteronormative orientations and restricted their imagined life trajectories. The findings demonstrate how religious moral worlds become lived and felt through the body, and how reorientation requires a profound renegotiation of both spiritual meaning and embodied memory. The article contributes valuable insights for professionals in healthcare, counselling, and social work by highlighting the specific challenges faced by queer individuals with religious backgrounds and the need for trauma-informed, faith-aware support.

• Lilleeng-Steimler, Lotte & Karlsen, Tor-Ivar (2026). The effect of hypnotherapy on vulvovaginal pain. A systematic literature review. Sexual & Reproductive HealthCare. ISSN 1877-5756. 48. doi: 10.1016/j.srhc.2026.101203. Fulltekst i vitenarkiv Vis sammendrag

  Background Vulvovaginal pain comprises diagnoses as vulvodynia and vaginismus; chronic pain conditions affecting 10–15% of women globally. The condition presents significant diagnostic and therapeutic challenges due to its multifactorial aetiology, which includes sexual, biological, psychological, and social factors. Objectives This study aimed to evaluate the existing literature on hypnotherapy as a treatment for vulvovaginal pain through systematic searches and quality assessments. Methods: A systematic literature search was conducted January 3rd, 2023, using the Ovid platform to search EMBASE, MEDLINE, and APA PsycInfo databases. The included trials were assessed using the GRADE system. Results: The review identified four studies involving seventy-three participants (64 with vaginismus and nine with vulvar vestibulitis syndrome), originating from Türkiye, Saudi Arabia, and Canada, all suggested positive effects of hypnotherapy on vulvovaginal pain. The participants were predominantly premenopausal, married, and relatively highly educated, limiting generalizability. Study designs included one pragmatic randomized trial, two prospective cohorts, and one case report; all were assessed as ‘very low’ quality on the GRADE scale, with limitations relating to sample size, lack of control groups, and non-validated outcome measures. Despite these methodological issues, all studies suggested potential beneficial effects of hypnotherapy on pain reduction, sexual function, and anxiety. Conclusion: While hypnotherapy shows potential as a treatment for vulvodynia and vaginismus, the current evidence is insufficient to confirm its efficacy. Further research employing innovative study designs that combine qualitative and quantitative data is crucial to advancing understanding and improving care for women affected by these chronic pain conditions.

• Vatnøy, Torunn Kitty; Karlsen, Tor-Ivar; Skinner, Marianne Sundlisæter & Jeppestøl, Kristin (2025). Use of scoring tools in municipal in-patient acute care services – a cross-sectional study. Sykepleien Forskning. ISSN 1890-2936. 20. doi: 10.4220/sykepleienf.2025.99692en. Fulltekst i vitenarkiv Vis sammendrag

  Background: The clinical assessment and decision-making skills of registered nurses (RNs) face challenges in the encounter with patients with acute care needs referred to municipal in-patient acute care (MIPAC) services. The goal of these services is to provide care for older patients and those with chronic, complex health challenges. The use of decision-making tools is recommended to ensure high-quality treatment. However, knowledge of their practical application is limited. Objective: We wished to explore the degree to which nurses at MIPAC services in Norway use scoring tools in their clinical decision-making processes for early identification of deteriorating somatic condition, risk of falls and risk of undernutrition. Method: Cross-sectional study with a questionnaire distributed to 220 first-line managers in all of Norway’s MIPAC units. Results: A total of 207 first-line managers (91.6 per cent) were included in the study. Some 57 per cent of the units examined used the Early Warning Score (EWS) systematically to identify deteriorating somatic condition at an early stage while 29 per cent of the units did not use this. The sepsis scoring tool recommended when the data were collected was systematically used in 46 per cent of the units, while 32 per cent did not use a sepsis score. The use of these tools was lowest in units in Central and Northern Norway and in MIPAC services co-located with long-stay care units. The scoring tool for identifying fall risk was systematically used in 45 per cent of the units, and the nutritional risk screening tool in 55 per cent of the units, while 34 per cent and 33 per cent respectively did not use the tools. Having a professional development nurse (often referred to in the literature as ‘clinical nurse educator’) attached to the unit was the most important factor in the use of the Early Warning Score and tools to assess nutritional status. Conclusion: The study reveals that there is a considerable potential for increased use of scoring tools in MIPAC services in Norway. The results indicate that this can be achieved by strengthening clinical management through employing professional development nurses in the units.

• Bertelsen, Bård; Hillesund, Odd Kenneth; Olkowska, Alicja; Lindeman, Sari Kaarina; Flon, Halvor de & Karlsen, Tor-Ivar (2025). Relevance and utility of family therapy education. Recommendations for a large-scale survey based on a pilot study among students, therapists and employers. | Research Square. Research Square. ISSN 2693-5015. doi: 10.21203/rs.3.rs-8059525/v1. Fulltekst i vitenarkiv Vis sammendrag

  This article presents a pilot study of family therapy education and practice in Norway, forming the basis for a planned large-scale survey. The pilot examined perceptions among students, practitioners, and employers regarding the relevance and utility of family therapy education. Theoretical perspectives, such as Donald Schön’s concept of «reflection-in-action», guide the survey questions, as do pressing issues in the welfare sector, including multiculturalism, violence, addiction, and sexual health. Key findings highlight diverse educational and professional backgrounds in the field and varying assessments of family therapy competencies across sectors. The pilot study identifies challenges, including low response rates in some target groups and discrepancies in the perceived value of family therapy education. Insights from the pilot will inform the design of a comprehensive survey to further explore family therapy education’s role in meeting evolving professional demands.

• Svenningsen, Hege; Stub, Trine; Courtney, Rosalba & Karlsen, Tor-Ivar (2025). Breathing therapy for patients with medically unexplained physical symptoms and dysfunctional breathing: A pilot and feasibility trial. PLOS ONE. 20(7). doi: 10.1371/journal.pone.0325951. Fulltekst i vitenarkiv Vis sammendrag

  Medically unexplained physical symptoms (MUPS) are symptoms without an identifiable organic cause that lead to functional impairment. MUPS is highly prevalent in general practice consultations. This pilot trial aimed to investigate the effectiveness and feasibility of a 5-week breathing retraining program focusing on basic anatomy and physiology, breathing awareness, nasal breathing and resonance (coherent) breathing for patients meeting the criteria for MUPS. The trial used a quantitative design with pre- and post-intervention measurements. Fifteen participants with MUPS and dysfunctional breathing (assessed by the Nijmegen Questionnaire) were recruited from two general practitioner offices. The intervention consisted of 5 weekly sessions including education on breathing physiology and weekly breathing exercises focused on nasal breathing and resonance breathing techniques. One week post intervention, improvements were observed in dysfunctional breathing scores, lower symptom severity, higher general well-being, and reduced musculoskeletal pain complaints. At 3 months post-intervention, sustained improvements were seen in dysfunctional breathing, general well-being, musculoskeletal pain, and additionally lower pseudoneurological, gastrointestinal, and allergy complaints, as well as lower overall symptom burden and improved end-tidal CO2 levels. The trial concluded that the 5-week breathing program showed promising results for improving multiple patient-reported outcomes in MUPS. Recruitment, adherence, and acceptability of the program were satisfactory. A randomized controlled trial is recommended to further evaluate the efficacy of this breathing intervention for MUPS patients.

• Vatnøy, Torunn Kitty; Karlsen, Tor-Ivar; Skinner, Marianne Sundlisæter & Jeppestøl, Kristin (2025). Bruk av skåringsverktøy ved kommunale akutte døgnplasser – en tverrsnittsstudie. Sykepleien Forskning. ISSN 1890-2936. 20. doi: 10.4220/Sykepleienf.2025.99692. Fulltekst i vitenarkiv Vis sammendrag

  Bakgrunn: Sykepleieres kliniske vurderings- og beslutningskompetanse utfordres i møte med pasienter som henvises til kommunale akutte døgnplasser med akutt behov for helsehjelp. Denne tjenesten har som mål å ivareta eldre og pasienter med kroniske, komplekse helseutfordringer. For å sikre høy kvalitet i behandlingen anbefales det å benytte beslutningsstøtteverktøy. Kunnskapen om praktisk anvendelse av disse verktøyene er imidlertid begrenset. Hensikt: Vi ønsket å undersøke i hvilken grad sykepleiere ved kommunale akutte døgnplasser i Norge benytter skåringsverktøy for tidlig påvisning av forverret somatisk tilstand, fallrisiko og risiko for underernæring i sine kliniske beslutningsprosesser. Metode: Tverrsnittsstudie med et spørreskjema som ble distribuert til 220 førstelinjeledere i alle landets kommunale akutte døgnplasser. Resultat: Det var 207 førstelinjeledere (91,6 prosent) som ble inkludert i studien. Av de undersøkte enhetene brukte 57 prosent skåringsverktøy systematisk for tidlig identifisering av forverret somatisk tilstand, Early Warning Score, men 29 prosent av enhetene brukte ikke dette. Verktøy for sepsisskår som var anbefalt da dataene ble samlet inn, ble systematisk brukt i 46 prosent av enhetene, mens 32 prosent ikke brukte sepsisskår. Bruken av disse verktøyene var lavest i enheter som var lokalisert i Midt- og Nord-Norge, samt i kommunale akutte døgnplasser som var organisert sammen med langtidsenheter. Skåringsverktøy for å identifisere fallrisiko ble systematisk brukt i 45 prosent av enhetene og for ernæringsstatus i 55 prosent av enhetene, mens henholdsvis 34 prosent og 33 prosent ikke brukte verktøyene. Det å ha en fagutviklingssykepleier tilknyttet enheten var den viktigste faktoren for om Early Warning Score og verktøy for å vurdere ernæringstilstand ble brukt. Konklusjon: Studien avslører at det er et betydelig potensial for økt bruk av skåringsverktøy i kommunale akutte døgnplasser i Norge. Resultatene indikerer at dette potensialet kan realiseres ved å styrke den faglige ledelsen ved å ansette fagutviklingssykepleiere i enhetene.

• Almås, Elsa Mari; Bolstad, Silje-Håvard; Benestad, Esben Esther Pirelli; Karlsen, Tor-Ivar & Giami, Alain (2025). Gender identities and affirmation pathways among transgender individuals in Norway. Sexual and Relationship Therapy. ISSN 1468-1994. 40(2), s. 412–429. doi: 10.1080/14681994.2025.2464651. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: To identify subgroups of the Transgender and Gender Diverse (TGD) population and investigate if they follow similar or different affirmation pathways according to their self-reported gender identity. Method: A questionnaire used in France and Brazil was adapted to the Norwegian context and used for this study. Participants were recruited through therapists, TGD organizations, and social media. The data were analyzed based on seven categories -man, woman, trans man, trans woman, nonbinary, agender and undefined - which were derived from a content analysis of the self-reported definitions. Results: In total, 538 individuals responded the questionnaire, of which 336 participants provided a self-reported definition of their gender identity. The groups differed systematically along the binary – nonbinary continuum regarding changes in legal status, planning and obtaining health care, and overall satisfaction regarding their pathway. Conclusions: The results indicate that health care must be adapted according to gender self-identification and accommodate the different needs that are expressed by the participants. Lay Summary The study aimed to describe experiences of individuals who identify as Transgender and Gender Diverse (TGD) in Norway. Researchers wanted to explore whether TGD individuals follow similar or different paths when affirming their gender identity. A questionnaire originally developed in France, was adapted to fit the Norwegian context. Participants were reached out to through therapists, TGD organizations, and social media. A total of 538 people answered the questionnaire, and 336 of them provided a description of their gender identity. The responses were categorized into seven groups based on how the participants described their gender identity: man, woman, trans man, trans woman, nonbinary, agender, and undefined. The study found that these groups had different experiences when it came to legally changing their gender, accessing healthcare, and how satisfied they were with their journey of gender affirmation: People who identified as nonbinary or agender reported different needs and experiences compared to those who identified within binary male or female categories. The conclusion of the study was that healthcare services need to be more flexible and responsive to the individual needs of TGD people. This means recognizing and respecting each person’s self-identified gender identity and provide support that is tailored to the individual experiences and challenges.

• Torjesen, Dag Olaf; Torsteinsen, Harald Henning; Saxi, Hans Petter; Kiland, Charlotte & Karlsen, Tor-Ivar (2024). The Contemporary Norwegian Municipal CEO. I Hlynsdóttir, Eva Marín; Hansen, Morten Balle; Cregård, Anna; Torjesen, Dag Olaf & Sandberg, Siv (Red.), Managing Nordic Local Governments: Paradoxes and Challenges of the Municipal Chief Executive Officer. Palgrave Macmillan. ISSN 9783031600692. s. 161–188. doi: 10.1007/978-3-031-60069-2_7. Fulltekst i vitenarkiv Vis sammendrag

  This chapter describes the evolution of the Norwegian municipal chief executive officer (MCEO) from 1980 to 1992 and 2018, when the position was weakened politically but strengthened administratively. Today, the Norwegian MCEO corresponds to Mouritzen and Svara’s council–manager model, making it one of the most powerful in the Nordic region, second only to the Finish MCEO. Despite multiple significant contextual changes in the last two to three decades, the essential role of the Norwegian MCEO has remained remarkably stable, demonstrated in survey data from 1997 to 2017. Nevertheless, the data also show that the biographical characteristics of the MCEO have undergone considerable change during this period, most notably the increase in the proportion of female MCEOs from 7% to 30%. Further, today’s MCEOs are older and more highly educated, especially in disciplines such as economics, administration, and public management, reflecting the strong emphasis on economic management and performance in Norwegian municipalities. Finally, MCEOs are met with increasing expectations to combine innovation and management, cooperate internally and externally, and govern municipal affairs through complex, hybrid networks.

• Almås, Elsa Mari; Benestad, Esben Esther Pirelli; Bolstad, Silje-Håvard; Karlsen, Tor-Ivar & Giami, Alain (2024). Gender Identity Orientation and Sexual Activity—A Survey among Transgender and Gender-Diverse (TGD) Individuals in Norway. Healthcare. 12(4). doi: 10.3390/healthcare12040482. Fulltekst i vitenarkiv
• Kiland, Charlotte; Karlsen, Tor-Ivar & Kvåle, Gro (2024). Organisational Conditions for Boundary Spanning in Public Health. Scandinavian Journal of Public Administration (SPJA). ISSN 2001-7405. 28(1), s. 43–59. doi: 10.58235/sjpa.2023.12541. Fulltekst i vitenarkiv Vis sammendrag

  In this study, we examine how organisational conditions impact boundary spanning in public health to handle complex tasks. This policy field is characterised by extensive pressure for collaborative governance and boundary-spanning activities. Data from a 2019 web-based survey of all Norwegian public health coordinators (n = 428; response rate 60%) demonstrated the importance of boundary spanning “by architecture” for completing complex transboundary tasks, such as local government health overviews. Combinations of organisational conditions; organisational size, position size, position in the organisational hierarchy and formalised network arrangements, affected degrees of boundary-spanning and the ability to complete health overviews. The most important indirect organisational condition seemed to be position size. Organisational size is an important organisational predictor for position size, position in the organisational hierarchy and collaborative partners’ contact pattern. Large municipalities had higher coordination capacity, higher degrees of boundary spanning and more formalised structures for intersectoral collaboration. Organisational size correlated significantly with contact frequency between boundary spanners and internal and external professional expertise. Overall, boundary spanning is not influential per se, but different degrees of boundary spanning affected the completion of complicated transboundary task in public health.

• Vatnøy, Torunn Kitty; Dale, Bjørg; Skinner, Marianne Sundlisæter & Karlsen, Tor-Ivar (2022). Associations between nurse managers’ leadership styles, team culture and competence planning in Norwegian municipal in-patient acute care services: A cross-sectional study. Scandinavian Journal of Caring Sciences. ISSN 0283-9318. 36(2), s. 482–492. doi: 10.1111/scs.13064. Fulltekst i vitenarkiv Vis sammendrag

  Background Increased complexity in the primary healthcare services has followed in the wake of health reforms and reveals the need for competence enhancement in the nursing services. Effective and visionary leadership, sufficiently qualified staff and cooperation among professionals are considered as key measures to safeguard quality in the services. Aims To identify which leadership styles characterise first-line nurse managers in Norwegian municipal in-patient acute care (MipAC) units and to investigate how first-line nurse managers’ leadership styles are associated with team culture and documented nursing competence planning. Methods A cross-sectional survey was distributed to all the first-line nurse managers in Norwegian MipAC units (n = 229). Data were collected between March and June 2019. The response rate was 80.5% (n = 182). First-line managers’ background information and data about their focus on team culture and competence planning were recorded. Furthermore, we noted organisational structural characteristics, and managers’ transformational (relational) leadership and transactional (task-oriented) leadership styles. Results The managers exhibited a high degree of transformational leadership behaviour, which was significantly associated with team culture. No significant associations between leadership behaviours and documented competence planning were found. Notably, we found a significant correlation between transformational and transactional leadership styles, indicating that the managers adapt their leadership behaviours to actual requirements and situations. Organisational structural factors: the share of registered nurses (RNs) on the staff and having a position for a professional development nurse were positively associated with competence planning. Conclusion A relational leadership style promotes team culture and both factors may empower the professional nursing environment. However, first-line nurse managers need to acknowledge nursing competence planning as a central part of effective leadership. Having a professional development nurse position seems to complement leadership and ease the manager's responsibilities regarding team culture and competence planning.

• Karlsen, Tor-Ivar; Kiland, Charlotte; Kvåle, Gro & Torjesen, Dag Olaf (2022). ‘Health in All Policies’ and the Urge for Coordination: The Work of Public Health Coordinators and Their Impact and Influence in Local Public Health Policies: A Cross-Sectional Study. Societies. 12(1). doi: 10.3390/soc12010011. Fulltekst i vitenarkiv Vis sammendrag

  : Building heavily on the Health in All Policies (HiAP) approach, Norway implemented the Public Health Act in 2012 to reduce social inequalities in health. Local public health coordinators (PHCs) at municipal levels were seen as tools to provide local intersectoral public health work. In this study, we examine factors related to intersectoral agency and if intersectoral work is understood as relevant to securing social justice in local policy outcomes. A national web-based survey in 2019 of all Norwegian PHCs (n = 428) was conducted with a response rate of 60%. Data were analysed through multiple linear regression, hierarchical regression modelling and structural equation modelling. Neither factors relating to community contexts nor individual characteristics were associated with intersectoral agency. Organisational factors, especially position size, being organised at the top level and having a job description, were significantly associated with perceptions of intersectoral agency. PHCs seeing themselves as intersectoral agents also found themselves able to affect annual budgets and policy outcomes. We conclude that municipal PHC positions can be important HiAP tools in local public health policies. However, organisational factors affect how PHCs perceive their influence and role in the municipal organisation and thereby their possibilities to influence local policymaking through intersectoral agency

• Torjesen, Dag Olaf; Karlsen, Tor-Ivar; Kiland, Charlotte & Hansen, Morten Balle (2021). Public service motivation among Danish and Norwegian local government administrative managers. I Pinheiro, Romulo & Trondal, Jarle (Red.), Organizing and Governing Governmental Institutions. Fagbokforlaget. ISSN 9788245035322. s. 88–107. Fulltekst i vitenarkiv
• Arntsen, Bjørnulf; Torjesen, Dag Olaf & Karlsen, Tor-Ivar (2021). Asymmetry in inter-municipal cooperation in health services – how does it affect service quality and autonomy? Social Science and Medicine. ISSN 0277-9536. 273. doi: 10.1016/j.socscimed.2021.113744. Fulltekst i vitenarkiv Vis sammendrag

  Throughout Europe, local health services are increasingly being provided through various forms of inter-municipal cooperation (IMC). One of the most common forms of IMC is when small municipalities delegate the operational responsibility for providing health services to a larger host municipality. However, despite the size asymmetry usually inherent in this type of IMC, this aspect has largely been neglected in the existing literature, which mainly focuses on the size of individual municipalities. Based on data from 97 partner municipalities and 25 host municipalities in Norway, this study examines how varying degrees of size asymmetry between them affect the perceived service quality and loss of autonomy resulting from IMC in health services. From the perspective of the relatively smaller partner municipalities, the results suggest that these are likely to benefit greatly from size asymmetry in terms of improved service quality, although this would appear to be at the expense of losing decision-making autonomy to their host. However, from the perspective of the relatively larger hosts municipalities, this type of asymmetry is likely to affect service quality negatively while having no effect on decision-making autonomy.

• Nordstrand, Sebjørg Elizabeth Hesla; Juvodden, Hilde Therese; Viste, Rannveig; Rootwelt-Revheim, Terje; Karlsen, Tor-Ivar & Thorsby, Per Medbøe [Vis alle 10 forfattere av denne artikkelen] (2020). Obesity and other medical comorbidities among NT1 patients after the Norwegian H1N1 influenza epidemic and vaccination campaign. Sleep. ISSN 0161-8105. 43(5). doi: 10.1093/sleep/zsz277. Fulltekst i vitenarkiv
• Vatnøy, Torunn Kitty; Skinner, Marianne Sundlisæter; Karlsen, Tor-Ivar & Dale, Bjørg (2020). Nursing competence in municipal in-patient acute care in Norway: a cross-sectional study. BMC Nursing. 19. doi: 10.1186/s12912-020-00463-5. Fulltekst i vitenarkiv Vis sammendrag

  Background The primary health care services are becoming increasingly complex, which presents challenges for the municipal nursing services. In Norway, municipal in-patient acute care (MipAC) has been introduced in all municipalities, and the competence at the services has been questioned. Few studies have examined the nursing services in the units. This study aims to get an overview of the nursing competence in those units across geographical regions, and different groups of organisation and localisation. Methods A cross-sectional study was conducted, and an ad hoc questionnaire was distributed to first-line leaders in all the MipAC units in Norway. Data were collected in the period between 6 March 2019 to 6 June 2019. Measures to get an overview of the nursing competence were ratio of registered nurses (RNs) in staff, count of shifts with only one RN on duty and count of RNs with master’s degrees/specialisation. Descriptive comparative statistics were used. Results Of all 226 first-line leaders invited to participate, 207 (91.6%) responded to the questionnaire. Overall a considerable variance across the sample was revealed. The median ratio of RNs in staff was 56 (IQR = 40–70), the count of shifts with only one RN on duty median 28 (IQR = 5–49), and the count of RNs with a master’s degree or specialisation median 3 (IQR = 0–5). The regions of Northern and Central Norway, MipACs located in nursing home and MipACs organised at long-term care units, showed significantly lower nursing competence in staff compared to the remaining institution and organisations. Conclusion This study generates knowledge that can inform planning, priorities and interventions that may be initiated at all organisational and political levels concerning the MipAC services. An overall conclusion is that advanced nursing competence is lacking. The study also highlights the most urgent direction for improvements regarding nursing competence in the services. It seemed to be MipACs in Northern and Central Norway, and those located at nursing homes organised together with long-term care units, that needed improvements the most.

• Lorentzen, Jolanta Halabowska; Medhus, Asle Wilhelm; Hertel, Jens Kristoffer; Borgeraas, Heidi; Karlsen, Tor-Ivar & Kolotkin, Ronette Loganzo [Vis alle 12 forfattere av denne artikkelen] (2020). Erosive Esophagitis and Symptoms of Gastroesophageal Reflux Disease in Patients with Morbid Obesity with and without Type 2 Diabetes: a Cross-sectional Study. Obesity Surgery. ISSN 0960-8923. 30, s. 2667–2675. doi: 10.1007/s11695-020-04545-w. Fulltekst i vitenarkiv Vis sammendrag

  Background Type 2 diabetes (T2DM) is associated with gastroesophageal reflux disease (GERD) in the general population, but the relationship between these conditions in candidates for bariatric surgery is uncertain. We compared the prevalence of GERD and the association between GERD symptoms and esophagitis among bariatric candidates with and without T2DM. Methods Cross-sectional study of baseline data from the Oseberg study in Norway. Both groups underwent gastroduodenoscopy and completed validated questionnaires: Gastrointestinal Symptom Rating Scale and Gastroesophageal Reflux Disease Questionnaire. Participants with T2DM underwent 24-h pH-metry. Results A total of 124 patients with T2DM, 81 women, mean (SD) age 48.6 (9.4) years and BMI 42.3 (5.5) kg/m2, and 64 patients without T2DM, 46 women, age 43.0 (11.0) years and BMI 43.0 (5.0) kg/m2, were included. The proportions of patients reporting GERD-symptoms were low (< 29%) and did not differ significantly between groups, while the proportions of patients with esophagitis were high both in the T2DM and non-T2DM group, 58% versus 47%, p = 0.16. The majority of patients with esophagitis did not have GERD-symptoms (68–80%). Further, 55% of the patients with T2DM had pathologic acid reflux. Among these, 71% also had erosive esophagitis, whereof 67% were asymptomatic. Conclusions The prevalence of GERD was similar in bariatric patients with or without T2DM, and the proportion of patients with asymptomatic GERD was high independent of the presence or absence of T2DM. Accordingly, GERD may be underdiagnosed in patients not undergoing a preoperative endoscopy or acid reflux assessment

• Arntsen, Bjørnulf; Torjesen, Dag Olaf & Karlsen, Tor-Ivar (2020). Associations between structures, processes and outcomes in inter-municipal cooperation in out-of-hours services in Norway: A survey study. Social Science and Medicine. ISSN 0277-9536. 258. doi: 10.1016/j.socscimed.2020.113067. Fulltekst i vitenarkiv Vis sammendrag

  Inter-municipal cooperation (IMC) has gained widespread recognition as a beneficial strategy for improving efficiency and quality in the provision of out-of-hours emergency care services (OOH services). Little attention, however, has been given to the additional costs of cooperation and the relational processes through which benefits and costs are likely to result. Based on survey data from 266 (77%) Norwegian municipalities involved in IMC in OOH services in 2015, this study aimed to investigate how the structure (governance form, complexity and stability) and quality (trust and consensus) of cooperation processes interact to influence the perceived outcomes (benefits and costs) of IMC in OOH services. Using Structural equation modeling, we found trust and consensus fully mediated the association between the structure and outcomes of IMC. More specifically, the results suggest that cooperation structures characterized by centralized governance, stability over time, and reduced complexity were likely to enhance the benefits and reduce the costs of IMC through trust and consensus.

• Borgeraas, Heidi; Hjelmesæth, Jøran; Birkeland, Kåre I.; Fatima, Farhat; Grimnes, John Olav & Gulseth, Hanne Løvdal [Vis alle 22 forfattere av denne artikkelen] (2019). Single-centre, triple-blinded, randomised, 1-year, parallel-group, superiority study to compare the effects of Roux-en-Y gastric bypass and sleeve gastrectomy on remission of type 2 diabetes and β-cell function in subjects with morbid obesity: a protocol for the Obesity surgery in Tønsberg (Oseberg) study. BMJ Open. 9(6). doi: 10.1136/bmjopen-2018-024573. Fulltekst i vitenarkiv Vis sammendrag

  Introduction Bariatric surgery is increasingly recognised as an effective treatment option for subjects with type 2 diabetes and obesity; however, there is no conclusive evidence on the superiority of Roux-en-Y gastric bypass or sleeve gastrectomy. The Oseberg study was designed to compare the effects of gastric bypass and sleeve gastrectomy on remission of type 2 diabetes and β-cell function. Methods and analysis Single-centre, randomised, triple-blinded, two-armed superiority trial carried out at the Morbid Obesity Centre at Vestfold Hospital Trust in Norway. Eligible patients with type 2 diabetes and obesity were randomly allocated in a 1:1 ratio to either gastric bypass or sleeve gastrectomy. The primary outcome measures are (1) the proportion of participants with complete remission of type 2 diabetes (HbA1c≤6.0% in the absence of blood glucose-lowering pharmacologic therapy) and (2) β-cell function expressed by the disposition index (calculated using the frequently sampled intravenous glucose tolerance test with minimal model analysis) 1 year after surgery. Ethics and dissemination The protocol of the current study was reviewed and approved by the regional ethics committee on 12 September 2012 (ref: 2012/1427/REK sør-øst B). The results will be disseminated to academic and health professional audiences and the public via publications in international peer-reviewed journals and conferences. Participants will receive a summary of the main findings. Trial registration number NCT01778738;Pre-results. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial

• Benestad, Beate; Karlsen, Tor-Ivar; Småstuen, Milada Cvancarova; Lekhal, Samira; Hertel, Jens Kristoffer & Steinsbekk, Silje [Vis alle 9 forfattere av denne artikkelen] (2019). Health-related quality of life after camp-based family obesity treatment: an RCT. BMJ Paediatrics Open. 3(1). doi: 10.1136/bmjpo-2018-000413. Fulltekst i vitenarkiv Vis sammendrag

  Objective To compare the effects of a 2-year camp-based immersion family treatment for obesity with an outpatient family-based treatment for obesity on health-related quality of life (HRQoL) in two generations. Design Randomised controlled trial. Setting Rehabilitation clinic, tertiary care hospital and primary care. Patients Families with at least one child (7–12 years) and one parent, both with obesity. Interventions Summer camp for 2 weeks, with four repetition weekends, or lifestyle school, including four outpatient days over 4 weeks. Behavioural techniques to promote a healthier lifestyle. Main outcome measures Children’s and parents’ HRQoL were assessed using generic and obesity-specific measures. Outcomes were analysed using linear mixed models according to intention to treat, and multiple imputations were used for missing data. Results Ninety children (50% girls) with a mean (SD) age of 9.7 (1.2) years and body mass index 28.7 (3.9) kg/m2 were included in the analyses. Summer camp children had an estimated mean (95% CI) of 5.3 (0.4 to 10.1) points greater improvement in adiposity-specific HRQoL score at 2 years compared with the lifestyle school children, and this improvement was even larger in the parent proxy-report, where mean difference was 7.3 (95% CI 2.3 to 12.2). Corresponding effect sizes were 0.33 and 0.44. Generic HRQoL questionnaires revealed no significant differences between treatment groups in either children or parents from baseline to 2 years. Conclusions A 2-year family camp-based immersion obesity treatment programme had significantly larger effects on obesity-specific HRQoL in children’s self-report and parent proxy-reports in children with obesity compared with an outpatient family-based treatment programme.

• Vatnøy, Torunn Kitty; Karlsen, Tor-Ivar & Dale, Bjørg (2019). Exploring nursing competence to care for older patients in municipal in-patient acute care: a qualitative study. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 28. doi: 10.1111/jocn.14914. Fulltekst i vitenarkiv Vis sammendrag

  Aim: To identify critical aspects of nursing competence to care for older patients in the context of municipal in‐patient acute care. Background: An increasingly complex and advanced primary healthcare system re ‐quires attention to the extent of nursing competence in municipal services. However, competence in complex and advanced care settings must be explored using perspec‐tives which acknowledge the complexity of nurses' performance

• Vatnøy, Torunn Kitty; Karlsen, Tor-Ivar & Dale, Bjørg (2019). Exploring nursing competence to care for older patients in municipal in‐patient acute care: A qualitative study. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 28(17-18), s. 3339–3352. doi: 10.1111/jocn.14914. Fulltekst i vitenarkiv
• Nordstrand, Sebjørg Elizabeth Hesla; Hansen, Berit M Hjelde; Rootwelt-Revheim, Terje; Karlsen, Tor-Ivar; Swanson, David & Nilsen, Kristian Bernhard [Vis alle 7 forfattere av denne artikkelen] (2019). Psychiatric symptoms in patients with post-H1N1 narcolepsy type 1 in Norway. Sleep. ISSN 0161-8105. 42(4), s. 1–9. doi: 10.1093/sleep/zsz008. Fulltekst i vitenarkiv Vis sammendrag

  Study Objectives Several studies have reported psychiatric comorbidity in patients with narcolepsy type 1 (NC1). The primary aim of this study was to explore the extent of psychiatric symptoms in a cohort of Norwegian NC1 patients, most of whom were H1N1-vaccinated. We also wanted to explore possible causes of the psychiatric symptoms seen in NC1. Methods Cross-sectional study. Psychiatric symptoms were assessed by the Achenbach System of Empirically Based Assessment (ASEBA) Child Behavior Check List (CBCL) in children and by Adult Self Report (ASR) in adults. Results The mean (SD) total T-scores were 58.6 (9.2) for children and 57.0 (9.8) for adults, these being mainly driven by internalizing problems. Internalizing symptom T-scores showed that 37.5% of the children and 33.3% of the adults were in the clinical range of concern. T-scores were lower when the questionnaire’s sleep-related items were excluded. However, 27.5% of children and 22.2% of adults still remained within the total psychiatric symptoms clinical range. Psychiatric symptoms and excessive daytime sleepiness were not associated. However, in children fragmented sleep, measured by sleep-stage shift index was significantly negatively associated with all the psychiatric summary scores (all p ≤ 0.020), and awakening index was negatively associated with externalizing (p = 0.042) and total summary scores (p = 0.042). In adults, awakening index, but not sleep-stage shift index, was positively associated with internalizing score (p = 0.015). Hypocretin-1 levels showed no association with psychiatric symptoms. Conclusions We found a high prevalence of psychiatric symptoms in NC1 patients. Fragmented sleep was significantly associated with psychiatric symptoms. Keywords: narcolepsy type 1, narcolepsy with cataplexy, psychiatric symptoms, Pandemrix, H1N1

• Karlsen, Tor-Ivar; Tveide, Marit Bolstad & Fensli, Rune Werner (2018). Factors affecting seniors' attitudes on the use of information technology. Linköping Electronic Conference Proceedings. ISSN 1650-3686. 2018(145), s. 78–81. Fulltekst i vitenarkiv
• Nordstrand, Sebjørg Elizabeth Hesla; Hansen, Berit M Hjelde; Kamaleri, Yusman; Nilsen, Kristian Bernhard; Rootwelt-Revheim, Terje & Karlsen, Tor-Ivar [Vis alle 7 forfattere av denne artikkelen] (2018). Changes in quality of life in individuals with narcolepsy type 1 after the H1N1-influenza epidemic and vaccination campaign in Norway: a two-year prospective cohort study. Sleep Medicine. ISSN 1389-9457. 50, s. 175–180. doi: 10.1016/j.sleep.2018.05.037. Fulltekst i vitenarkiv Vis sammendrag

  Objective Cross-sectional studies show a lower health-related quality of life (HRQoL) in individuals with narcolepsy. We aimed to describe changes in HRQoL after two years of multidisciplinary follow-up in a cohort of mainly post-H1N1 vaccination narcolepsy type-1 (NT1) patients in Norway. Methods Prospective-cohort study. Narcolepsy diagnosis was based on the International Classification of Sleep Disorders (third edition). Psychiatric comorbidity was assessed using the Achenbach System of Empirically Based Assessment (ASEBA). HRQoL was evaluated with the Pediatric Quality of Life Inventory (PedsQL™ Generic Core Scales 4.0) at baseline and follow-up. Mean follow-up time was 20.7 (2.7) months. Results Thirty one patients (18 females) with NT1, mean age 14.6 (SD = 4.8) years answered questionnaires at baseline and follow-up. On a group level, the PedsQL Total Health Summary score significantly improved by a mean of 5.9 (95%CI = 0.4, 11.9), p = 0.038; this was mainly driven by improvements in the Physical Health Summary score by 9.8 (3.0, 16.5) points, p = 0.006 and the School Functioning Scale score by 7.5 (1.0, 13.9) points p = 0.025. The Total ASEBA score was correlated with PedsQL Total Health Summary score at baseline, but not with changes in HRQoL. Sodium oxybate (Xyrem®) treatment at follow up was positively associated with changes in PedsQL Total Health Summary score, after adjusting for age and gender, p = 0.027. Conclusion HRQoL in NT1 patients improved after two years of follow-up. The use of sodium oxybate (Xyrem®) at follow-up was associated with increases in HRQoL. Psychiatric comorbidity was correlated with HRQoL at baseline but did not predict changes in HRQoL at follow-up.

• Arntsen, Bjørnulf; Torjesen, Dag Olaf & Karlsen, Tor-Ivar (2018). Drivers and Barriers of Inter-Municipal Cooperation in Health Services – The Norwegian Case. Local Government Studies. ISSN 0300-3930. 44(3), s. 371–390. doi: 10.1080/03003930.2018.1427071. Fulltekst i vitenarkiv
• Dagsland, Vigdis Halvorsen; Andenæs, Randi & Karlsen, Tor-Ivar (2018). Generic Health-Related Quality of Life May Not Be Associated with Weight Loss 4 Years After Bariatric Surgery: a Cross-Sectional Study. Obesity Surgery. ISSN 0960-8923. s. 1–9. doi: 10.1007/s11695-018-3332-7. Fulltekst i vitenarkiv Vis sammendrag

  Background: There seem to exist a belief that weight-loss is proportionally associated with improvement of health-related quality of life (HRQoL) after bariatric surgery. HRQoL is a complex multidimensional construct of one’s perception of health and well-being and is measured through generic and disease specific questionnaires. Objectives: This study aimed to test the associations between weight-loss after bariatric surgery, and both generic and obesity-specific HRQoL, and mental distress, controlling for other patient characteristics. Methods: The study was conducted at the Department of Surgery at Haugesund Hospital (Norway) based on a cohort of bariatric surgery patients operated between 2010 and 2013. Primary outcome measures included the SF-36 (generic HRQoL), IWQoL-Lite (obesity-specific HRQoL), and HADS (mental distress). Blocks of variables (time since surgery, personal characteristics, socioeconomics, comorbidities, surgical complications, experienced life crisis, and weight-loss) were entered into hierarchical linear regression models with the four outcome measures as dependent variables. Cumulative explained variance (r2) and increase in r2 after entry of each block of variables is reported. Results: A total of 206 completed the outcome measures a mean (SD) of 4.4 (1.1) years after surgery. The generic SF-36 physical and mental composite scores were significantly associated (p<.05) with socioeconomics, baseline comorbidities and surgical complications. Obesity-specific IWQoL-Lite scores were significantly (p<.05) associated with weight-loss. Conclusions: The study indicates that post-operative weight loss is associated with obesity-specific HRQoL but demonstrates no associations between weight-loss and generic HRQoL, when controlling for other patient characteristics.

• Hjelmesæth, Jøran; Åsberg, Anders; Andersson, Shalini; Sandbu, Rune; Robertsen, Ida & Johnson, Line Kristin [Vis alle 16 forfattere av denne artikkelen] (2018). Impact of body weight, low energy diet and gastric bypass on drug bioavailability, cardiovascular risk factors and metabolic biomarkers: protocol for an open, non-randomised, three-armed single centre study (COCKTAIL). BMJ Open. 8:e021878(5), s. 1–10. doi: 10.1136/bmjopen-2018-021878. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: Roux-en-Y gastric bypass (GBP) is associated with changes in cardiometabolic risk factors and bioavailability of drugs, but whether these changes are induced by calorie restriction, the weight loss or surgery per se, remains uncertain. The COCKTAIL study was designed to disentangle the short-term (6 weeks) metabolic and pharmacokinetic effects of GBP and a very low energy diet (VLED) by inducing a similar weight loss in the two groups. Methods and analysis: This open, non-randomised, three-armed, single-centre study is performed at a tertiary care centre in Norway. It aims to compare the short-term (6 weeks) and long-term (2 years) effects of GBP and VLED on, first, bioavailability and pharmacokinetics (24 hours) of probe drugs and biomarkers and, second, their effects on metabolism, cardiometabolic risk factors and biomarkers. The primary outcomes will be measured as changes in: (1) all six probe drugs by absolute bioavailability area under the curve (AUCoral/AUCiv) of midazolam (CYP3A4 probe), systemic exposure (AUCoral) of digoxin and rosuvastatin and drug:metabolite ratios for omeprazole, losartan and caffeine, levels of endogenous CYP3A biomarkers and genotypic variation, changes in the expression and activity data of the drug-metabolising, drug transport and drug regulatory proteins in biopsies from various organs and (2) body composition, cardiometabolic risk factors and metabolic biomarkers. Ethics and dissemination: The COCKTAIL protocol was reviewed and approved by the Regional Committee for Medical and Health Research Ethics (Ref: 2013/2379/REK sørøst A). The results will be disseminated to academic and health professional audiences and the public via presentations at conferences, publications in peer-reviewed journals and press releases and provided to all participants.

• Øgård-Repål, Anita; Strand, Ståle Arvill & Karlsen, Tor-Ivar (2017). Karakterpress, kroppspress og gjengpress - Fokusgruppeintervju av jenter i 9. klassetrinn etter funn fra Ungdata undersøkelsen. Tidsskrift for psykisk helsearbeid. ISSN 1503-6707. 14(2), s. 109–120. doi: 10.18261/issn.1504-3010-2017-02-03. Fulltekst i vitenarkiv
• Christiansen, Wenche Skeivoll; Karlsen, Tor-Ivar & Larsen, Inger Beate (2017). Materiell og profesjonell stigmatisering av mennesker med sykelig overvekt. Nordisk tidsskrift for helseforskning. ISSN 1504-3614. 13(2). doi: 10.7557/14.4195. Fulltekst i vitenarkiv
• Svanevik, Marius; Risstad, Hilde; Karlsen, Tor-Ivar; Kristinsson, Jon Adalsteinn; Småstuen, Milada C & Kolotkin, Ronette L. [Vis alle 10 forfattere av denne artikkelen] (2017). Patient-reported outcome measures 2 years after standard and distal gastric bypass-a double-blind randomized controlled trial. Obesity Surgery. ISSN 0960-8923. 28(3), s. 606–614. doi: 10.1007/s11695-017-2891-3. Fulltekst i vitenarkiv
• Risstad, Hilde; Svanevik, Marius; Kristinsson, Jon Adalsteinn; Hjelmesæth, Jøran; AASHEIM, ERLEND T. & Hofsø, Dag [Vis alle 11 forfattere av denne artikkelen] (2016). Standard vs distal roux-en-Y gastric bypass in patients with body mass index 50 to 60 a double-blind, randomized clinical trial. JAMA Surgery. ISSN 2168-6254. 151(12), s. 1146–1155. doi: 10.1001/jamasurg.2016.2798. Fulltekst i vitenarkiv
• Andersen, John Roger; Aasprang, Anny; Karlsen, Tor-Ivar; Natvig, Gerd Karin; Våge, Villy & Kolotkin, Ronette Loganzo (2015). Health-related quality of life after bariatric surgery: a systematic review of prospective long-term studies. Surgery for Obesity and Related Diseases. ISSN 1550-7289. 11(2), s. 466–473. doi: 10.1016/j.soard.2014.10.027. Fulltekst i vitenarkiv Vis sammendrag

  Impaired health-related quality of life (HRQoL) is common in bariatric surgery candidates and is often one of the motivating factors for seeking bariatric surgery. Although many studies have reported changes in HRQoL after bariatric surgery, few are long-term prospective studies and no systematic review has been conducted. A systematic database search identified studies reporting HRQoL preoperatively and≥5 years after bariatric surgery. Change in HRQoL over time was the outcome variable, divided into primary and secondary outcomes. Seven prospective cohort studies met the inclusion criteria. Eight HRQoL measures and 6 surgical methods were identified. Long-term follow-up time ranged from 5–10 years, sample sizes from 44 to 655 patients, and follow-up rates from 61% to 92%. None of the 7 studies were randomized controlled trials, and only 2 studies used control groups. Six of 7 studies showed statistically significant improvements in all of the primary outcomes, and 1 study showed statistically significant improvements in 1 of 2 primary outcomes. Of the statistically significant HRQoL improvements, 92% were clinically meaningful. Peak improvements in primary HRQoL outcomes were typically observed during the first years of follow-up, followed by a gradual decline that seemed to stabilize 5 years postoperatively. Long-term HRQoL scores typically remained improved relative to preoperative scores but were somewhat below population norm scores. In conclusion, while bariatric surgery candidates reported impaired HRQoL presurgically, their HRQoL improved considerably after bariatric surgery and much of the initial HRQoL improvements were maintained over the long term.

• Almås, Cecilie Brøvig; Almås, Elsa Mari; Karlsen, Tor-Ivar & Giami, Alain (2014). La sexologie en Norvège entre 2001et 2011: Une étude comparative = Sexology in Norway in 2001 and 2011: A comparative and cross-sectional study. Sexologies: revue europeenne de sante sexuelle - european journal of sexual health. ISSN 1158-1360. 23(1), s. 14–17. doi: 10.1016/j.sexol.2013.12.001. Fulltekst i vitenarkiv
• Andersen, John Roger; Karlsen, Tor-Ivar & Kolotkin, Ronette Loganzo (2014). Obesity and Its Impact Upon Quality of Life, Integrative Weight Management. Springer. ISSN 9781493905478. doi: 10.1007/978-1-4939-0548-5_15. Fulltekst i vitenarkiv
• Almås, Cecilie Brøvig; Almås, Elsa Mari; Karlsen, Tor-Ivar & Giami, Alain (2014). Sexology in Norway in 2001 and 2011: A comparative and cross-sectional study. Sexologies: revue europeenne de sante sexuelle - european journal of sexual health. ISSN 1158-1360. 23(1), s. e9–e17. doi: 10.1016/j.sexol.2013.12.002. Fulltekst i vitenarkiv Vis sammendrag

  a comparative cross-sectional study Norwegian sexology practitioners have been studied in 2001 and in 2011 concerning professional background, sexology training, therapeutic approaches and clinical sexology problems. The Norwegian sexology professional group is small and the Norwegian Association of Clinical Sexology counted around 150 members in 2011. In 2001, a two-year half time further education program in sexology counselling started at the university of Agder. Since 2001, 164 sexology counsellors have been educated from this program. The objective of the study was to understand how these changes might have influenced the field of sexology in Norway. The participants in the 2011 study are significantly different from those who responded in 2001. More female sexology practitioners have entered the field. There are more respondents with a social and health bachelor degree, and fewer physicians and psychologists among the respondents. The participants use a wider range of therapeutic approaches, but not significantly more sexology treatment methods. The problems the participants see are in many ways similar in 2001 and 2011, but they report overall more problems from their female clients and more relational problems and problems with sexual desire from their male clients in 2011. Based on the importance of interdisciplinary work, described by the biopsychosocial model, the authors recommend recruitment of different professional groups, and the importance of maintaining the interests of psychologists and physicians and other experienced professionals in the field of sexology in Norway.

• Gjevestad, Espen Svendsen; Karlsen, Tor-Ivar; Røislien, Jo; Mæhlum, S. & Hjelmesæth, Jøran (2013). The effectiveness of secondary and tertiary care lifestyle intervention in morbidly obese patients: a 1-year non-randomized controlled pragmatic clinical trial. Clinical Obesity. ISSN 1758-8103. 3(1-2), s. 39–50. doi: 10.1111/cob.12011. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar; Søhagen, Maryon & Hjelmesæth, Jøran (2013). Predictors of weight loss after an intensive lifestyle intervention program in obese patients: a 1-year prospective cohort study. Health and Quality of Life Outcomes. 11(1). doi: 10.1186/1477-7525-11-165. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Background: Studies of lifestyle intervention programs in morbid obesity report large variations in weight loss outcomes. This is reported not only between but also within standardized programs. Such reports point to participants’ characteristics as possible predictors of this outcome. The aim of this prospective cohort study was to identify predictors of weight loss after a 1-year partly residential intensive lifestyle intervention program (ILI). Methods: Morbidly obese patients (n=199), all Caucasian, 71% women, mean (SD) age 45.2 (11.1) years, body mass index (BMI) 42.0 (6.2) kg/m2, and excess body weight (>BMI=25 kg/m2) 49.4 (19.6) kg, were referred from public hospitals to a rehabilitation center and enrolled consecutively. The 1-year ILI comprised of four (n=104) or five (n=95) stays at the rehabilitation center. In both cases there was one main stay for 4 weeks and the remaining stays lasted 1 week each. In the home periods the patients were followed up by telephone and by their general practitioners (GP). The patients were also encouraged to use a predefined paper based diary. Health related quality of life (HRQL), diagnostic, anthropometric, socio-demographic, psychosocial and intervention characteristics were measured at baseline, 12 weeks and 1 year. Multiple linear regression analyses were performed to extract possible predictors of weight loss at 1-year. Direct and indirect effects of these predictors were tested through structural equation modeling. Results: The mean (SD) 1-year weight loss was 10 (11) kg, corresponding to an 8 (8) % reduction of body weight from baseline. Mean excess weight loss (EWL) was 20 (22) % ranging from 104% to −77%. The adherence to a diary (r=.16), type 2 diabetes (r=−.14) and frequency of GP-visits (r=.23) were significantly associated with EWL at 12 weeks. Predictors of 1-year EWL were 12 week EWL (r=.66), occupational status (r=.11), age (r=.19), and mental HRQL (r=−.16), all p<.05. The path model explained 50% of the variation (r2=.50) of 1-year EWL. Conclusion: Larger 12 week weight loss, being employed, lower mental HRQL and being older predicts larger weight loss after 1 year in morbidly obese patients following ILI. Not having type 2 diabetes, using a diary combined with regular GP follow-up influence the 12-week weight loss.

• Karlsen, Tor-Ivar; Lund, Randi Størdal; Røislien, Jo; Tonstad, Serena; Natvig, Gerd Karin & Sandbu, Rune [Vis alle 7 forfattere av denne artikkelen] (2013). Health related quality of life after gastric bypass or intensive lifestyle intervention: a controlled clinical study. Health and Quality of Life Outcomes. 11. doi: 10.1186/1477-7525-11-17. Fulltekst i vitenarkiv Vis sammendrag

  Background There is little robust evidence relating to changes in health related quality of life (HRQL) in morbidly obese patients following a multidisciplinary non-surgical weight loss program or laparoscopic Roux-en-Y Gastric Bypass (RYGB). The aim of the present study was to describe and compare changes in five dimensions of HRQL in morbidly obese subjects. In addition, we wanted to assess the clinical relevance of the changes in HRQL between and within these two groups after one year. We hypothesized that RYGB would be associated with larger improvements in HRQL than a part residential intensive lifestyle-intervention program (ILI) with morbidly obese subjects. Methods A total of 139 morbidly obese patients chose treatment with RYGB (n=76) or ILI (n=63). The ILI comprised four stays (seven weeks) at a specialized rehabilitation center over one year. The daily schedule was divided between physical activity, psychosocially-oriented interventions, and motivational approaches. No special diet or weight-loss drugs were prescribed. The participants completed three HRQL-questionnaires before treatment and 1 year thereafter. Both linear regression and ANCOVA were used to analyze differences between weight loss and treatment for five dimensions of HRQL (physical, mental, emotional, symptoms and symptom distress) controlling for baseline HRQL, age, age of onset of obesity, BMI, and physical activity. Clinical relevance was assessed by effect size (ES) where ES<.49 was considered small, between .50-.79 as moderate, and ES>.80 as large. Results The adjusted between group mean difference (95% CI) was 8.6 (4.6,12.6) points (ES=.83) for the physical dimension, 5.4 (1.5–9.3) points (ES=.50) for the mental dimension, 25.2 (15.0–35.4) points (ES=1.06) for the emotional dimension, 8.7 (1.8–15.4) points (ES=.37) for the measured symptom distress, and 2.5 for (.6,4.5) fewer symptoms (ES=.56), all in favor of RYGB. Within-group changes in HRQOL in the RYGB group were large for all dimensions of HRQL. Within the ILI group, changes in the emotional dimension, symptom reduction and symptom distress were moderate. Linear regression analyses of weight loss on HRQL change showed a standardized beta-coefficient of –.430 (p<.001) on the physical dimension, –.288 (p=.004) on the mental dimension, –.432 (p<.001) on the emotional dimension, .287 (p=.008) on number of symptoms, and .274 (p=.009) on reduction of symptom pressure. Conclusions Morbidly obese participants undergoing RYGB and ILI had improved HRQL after 1 year. The weaker response of ILI on HRQL, compared to RYGB, may be explained by the difference in weight loss following the two treatments.

Se alle arbeider i NVA

• Karlsen, Tor-Ivar (2025). Breathing therapy for patients with medically unexplained physical symptoms and dysfunctional breathing. A pilot and feasibility trial. doi: 10.18712/NSD-NSD3255-V3. Fulltekst i vitenarkiv Vis sammendrag

  Medisinsk uforklarlige fysiske symptomer (MUPS) er symptomer uten identifiserbar organisk årsak som fører til funksjonsnedsettelse. MUPS er svært utbredt i allmennpraksiskonsultasjoner. Denne pilotstudien hadde som mål å undersøke effektiviteten og gjennomførbarheten av et 5-ukers pustetreningsprogram for pasienter som oppfyller kriteriene for MUPS. Publisert datasett

• Kvåle, Gro; Kiland, Charlotte; Karlsen, Tor-Ivar & Torjesen, Dag Olaf (2023). Implementing intersectoral agency in local public health work. Fulltekst i vitenarkiv
• Almås, Elsa Mari; Karlsen, Tor-Ivar; Lapping-Carr, Leiszle; Giami, Alain; Smith, Anthony & Matsui, Osmar [Vis alle 12 forfattere av denne artikkelen] (2023). Professional Education in Sexology. European Results. Fulltekst i vitenarkiv
• Vatnøy, Torunn Kitty; Dale, Bjørg; Skinner, Marianne Sundlisæter & Karlsen, Tor-Ivar (2022). Kompetanseutvikling og ledelse i sykepleietjenesten i KAD. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar (2022). Skam, depresjon og selvmord i transbefolkningen. Fulltekst i vitenarkiv
• Vatnøy, Torunn Kitty; Dale, Bjørg; Karlsen, Tor-Ivar & Skinner, Marianne Sundlisæter (2020). Sykepleiekompetanse ved kommunale akutt døgnplasser. Fulltekst i vitenarkiv
• Torjesen, Dag Olaf; Karlsen, Tor-Ivar; Kiland, Charlotte & Hansen, Morten Balle (2020). Antecedents of public service motivation, institutional differences and characteristics among Danish and Norwegian local government administrative top-managers. Fulltekst i vitenarkiv
• Vatnøy, Torunn Kitty; Skinner, Marianne Sundlisæter; Karlsen, Tor-Ivar & Dale, Bjørg (2020). Correction to: Nursing competence in municipal in-patient acute care in Norway: a cross-sectional study (BMC Nursing, (2020), 19, 1, (70), 10.1186/s12912-020-00463-5). BMC Nursing. 19(1). doi: 10.1186/s12912-020-00519-6. Fulltekst i vitenarkiv
• Giami, Alain; Bolstad, Silje Håvard; Panjo, Henri; Almås, Elsa Mari; Karlsen, Tor-Ivar & Benestad, Esben Esther Pirelli [Vis alle 8 forfattere av denne artikkelen] (2019). Access to health care among trans population in Europe Trans: Health and Citizenship. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar & Frivold, Gro (2019). Family members’ reporting of anxiety and depression after intensive care units stay—a cross-sectional survey study. Fulltekst i vitenarkiv
• Lorentzen, Jolanta Halabowska; Medhus, Asle Wilhelm; Hertel, Jens Kristoffer; Karlsen, Tor-Ivar; Borgeraas, Heidi & Sandbu, Rune [Vis alle 10 forfattere av denne artikkelen] (2019). Gastroesophageal reflux disease in patients With severe obesity and type 2 diabetes one year after sleeve gastrectomy or roux-en-y gastric bypass. A Randomized controlled trial. Surgery for Obesity and Related Diseases. ISSN 1550-7289. 15, s. S3–S3. doi: 10.1016/j.soard.2019.08.052. Fulltekst i vitenarkiv
• Benestad, Esben Esther Pirelli; Almås, Elsa Mari; Bolstad, Silje-Håvard; Karlsen, Tor-Ivar & Giami, Alain (2019). Paths leading to suicide attempts among Norwegian trans people. Fulltekst i vitenarkiv
• Almås, Elsa Mari; Benestad, Esben Esther Pirelli; Bolstad, Silje Håvard; Karlsen, Tor-Ivar & Giami, Alain (2019). Mental health in gender incongruent individuals in Norway. Fulltekst i vitenarkiv
• Kiland, Charlotte; Torjesen, Dag Olaf & Karlsen, Tor-Ivar (2019). The interplay between top civil servants and civil society in local government in the age of New Public Governance. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar (2019). Hvordan systematisere og bruke ny kunnskap fra befolkningsundersøkelser. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar (2019). Hvilke faktorer er assosiert med folkehelsearbeidernes egenopplevde gjennomslag i kommunenes folkehelsearbeid? Data fra nasjonal kartlegging i prosjektet: Folkehelsearbeid i norske kommuner 2019 (FLINK 2019). Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar (2019). Hva forstår vi med et systematisk folkehelsearbeid? Fulltekst i vitenarkiv
• Giami, Alain; Panjo, Henri; Scandurra, Cristiano; Valerio, Paolo; Almås, Elsa Mari & Benestad, Esben Esther Pirelli [Vis alle 10 forfattere av denne artikkelen] (2019). Access to health care among trans population in Europe. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar; Giami, Alain; Benestad, Esben Esther Pirelli; Bolstad, Silje-Håvard & Almås, Elsa Mari (2019). Paths leading to suicide attempts among Norwegian trans people. Fulltekst i vitenarkiv
• Bolstad, Silje-Håvard; Karlsen, Tor-Ivar; Benestad, Esben Esther Pirelli; Almås, Elsa Mari & Giami, Alain (2019). Gender Self Definition for Measuring Transition Pathways in Norway. Fulltekst i vitenarkiv
• Almås, Elsa Mari; Benestad, Esben Esther Pirelli; Karlsen, Tor-Ivar; Bolstad, Silje-Håvard & Giami, Alain (2019). Mental health in gender incongruent individuals below 20 years of age. Fulltekst i vitenarkiv
• Almås, Elsa Mari; Benestad, Esben Esther Pirelli; Karlsen, Tor-Ivar; Bolstad, Silje-Håvard & Giami, Alain (2019). Sexual excitement and sexual attraction in individuals who experience gender incongruence in Norway. Fulltekst i vitenarkiv
• Enriques-Estrada, Victor Manuel; Benestad, Esben Esther Pirelli; Almås, Elsa Mari; Karlsen, Tor-Ivar; Bolstad, Silje-Håvard & Giami, Alain (2019). “Born in the right or the wrong country?” A comparison of quality of life for the trans populations in Mexico and Norway with Born in the right or the wrong country. Comparison of the quality of life for the trans populations in Mexico and Norway with focus on psychological measures in relation to societal changes that has taken place. Fulltekst i vitenarkiv
• Vatnøy, Torunn Kitty; Karlsen, Tor-Ivar & Dale, Bjørg (2018). KRITISKE ASPEKTER VED SYKEPLEIEKOMPETANSEN I KOMMUNALE AKUTTE DØGNENHETER. SYKEPLEIERE OG LEGERS ERFARINGER. Fulltekst i vitenarkiv
• Torjesen, Dag Olaf; Karlsen, Tor-Ivar; Kiland, Charlotte & Hansen, Morten Balle (2018). Public service motivation among senior executives in Danish and Norwegian local government – challenged but still viable? Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar (2018). Folkehelse, livskvalitet og fedme. Fulltekst i vitenarkiv
• Torjesen, Dag Olaf; Saxi, Hans Petter; Torsteinsen, Harald & Karlsen, Tor-Ivar (2018). Norwegian local government CEOs 1988-2017: Stablemates and administrative entrepreneurs in complementary cooperation with the mayor. Fulltekst i vitenarkiv
• Benestad, Esben Esther Pirelli; Almås, Elsa Mari; Karlsen, Tor-Ivar & Bolstad, Silje Håvard (2018). Født i «feil kropp» i feil land: Ny undersøkelse om kjønnsinkongruens i Norge gir alarmerende resultater. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar (2018). Folkehelse, fedme og livskvalitet. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar (2018). Neste generasjon eldre og holdninger til internett-teknologi. Fulltekst i vitenarkiv
• Almås, Elsa Mari; Benestad, Esben Esther Pirelli; Bolstad, Silje Håvard; Karlsen, Tor-Ivar & Giami, Alain (2018). Gender Health and Citizenship. Fulltekst i vitenarkiv
• Nordstrand, Sebjørg Elizabeth Hesla; Hansen, Berit M Hjelde; Kamaleri, Yusman; Nilsen, Kristian Bernhard; Karlsen, Tor-Ivar & Knudsen, Stine (2017). Changes in Quality of Life in individuals with narcolepsy in Norway after H1N1-influensa epidemic in 2009- a 2-year prospective cohort study. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar; Tveide, Marit Bolstad & Fensli, Rune Werner (2017). Factors affecting seniors' attitudes on the use of information technology. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar; Dagsland, Vigdis & Randi, Andenaes (2017). CONTRADICTING THE IFSO-STATEMENT: WEIGHT LOSS DOES NOT PREDICT IMPROVEMENT OF GENERIC QUALITY OF LIFE. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar (2017). Alvorlig fedme og livskvalitet. Indremedisineren. ISSN 1891-1617. 2017(4). Fulltekst i vitenarkiv
• Lorentzen, Jolanta Halabowska; Medhus, Asle Wilhelm; Hjelmesæth, Jøran; Hofsø, Dag; Karlsen, Tor-Ivar & Sandbu, Rune [Vis alle 8 forfattere av denne artikkelen] (2016). GERDQ- og GSRS-skjemaer kan være utilstrekkelig til å diagnostisere gastroøsofageal reflukssykdom (GØRS). Oseberg Refluksstudie, Tønsberg. Fulltekst i vitenarkiv
• Svanevik, Marius; Risstad, Hilde; Kristinsson, Jon Adalsteinn; Hjelmesæth, Jøran; Aasheim, Erlend Eithun & Hofsø, Dag [Vis alle 11 forfattere av denne artikkelen] (2016). Livskvalitet og tarmfunksjon etter proksimal og distal gastrisk bypass – en dobbeltblind randomisert kontrollert studie. Fulltekst i vitenarkiv
• Risstad, Hilde; Svanevik, Marius; Kristinsson, Jon Adalsteinn; Hjelmesæth, Jøran; Aasheim, Erlend Eithun & Hofsø, Dag [Vis alle 11 forfattere av denne artikkelen] (2016). Vekttap og markører for kardiometabolsk risiko 2 år etter proksimal og distal gastrisk bypass hos pasienter med KMI 50 til 60 kg/m2 i en dobbeltblindet, randomisert klinisk studie. Fulltekst i vitenarkiv
• Larsen, Catharina; Karlsen, Tor-Ivar; Benestad, Beate; Lekhal, Samira & Hjelmesæth, Jøran (2015). Quality of life in obese children and adolescents. A systematic literature review of randomized clinical trials. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar (2015). Hvordan skal statistikk forstås, analyseres og anvendes i kommuneplanarbeidet? Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar (2015). Helserelatert livskvalitet etter fedmekirurgi, status. Fulltekst i vitenarkiv
• Lorentzen, Jolanta; Medhus, Asle Wilhelm; Hjelmesæth, Jøran; Hofsø, Dag; Karlsen, Tor-Ivar & Sandbu, Rune [Vis alle 7 forfattere av denne artikkelen] (2015). Esophageal motility in morbidly obese patients with type 2 diabetes. Fulltekst i vitenarkiv
• Lorentzen, Jolanta; Hjelmesæth, Jøran; Medhus, Asle Wilhelm; Hofsø, Dag; Karlsen, Tor-Ivar & Sandbu, Rune [Vis alle 7 forfattere av denne artikkelen] (2015). Questionnaires may be insufficient to diagnose gastroesophageal reflux disease (GERD) in morbidly obese patients with type 2 diabetes. Fulltekst i vitenarkiv
• Svanevik, Marius; Risstad, Hilde; Kristinsson, Jon Adalsteinn; Hjelmesæth, Jøran; AASHEIM, ERLEND T. & Hofsø, Dag [Vis alle 11 forfattere av denne artikkelen] (2015). Helserelatert livskvalitet og tarmfunksjon etter proksimal og distal gastrisk bypass – en dobbelt blind randomisert kontrollert studie. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar (2015). Prioriteringer av folkehelseutfordringer. Fulltekst i vitenarkiv
• Svanevik, Marius; Kristinsson, Jon Adalsteinn; Hjelmesæth, Jøran; Aasheim, Erlend T; Hofsø, Dag & Søvik, Torgeir Thorson [Vis alle 11 forfattere av denne artikkelen] (2015). Proximal versus distal gastric bypass in patients with body mass index 50-60 kg/m2: A double-blind, randomized clinical trial. Fulltekst i vitenarkiv
• Lorentzen, Jolanta Halabowska; Hjelmesæth, Jøran; Medhus, Asle Wilhelm; Hofsø, Dag; Karlsen, Tor-Ivar & Sandbu, Rune [Vis alle 7 forfattere av denne artikkelen] (2015). Questionnaires may be insufficient to diagnose gastroesophageal reflux disease (GERD) in morbidly obese patients with type 2 diabetes. United European Gastroenterology Journal (UEG Journal). ISSN 2050-6406. Fulltekst i vitenarkiv
• Risstad, Hilde; Svanevik, Marius; Kristinsson, Jon Adalsteinn; Hjelmesæth, Jøran; AASHEIM, ERLEND T. & Hofsø, Dag [Vis alle 11 forfattere av denne artikkelen] (2015). Proximal versus distal gastric bypass in patients with body mass index 50-60 kg/m2: A double-blind, randomized clinical trial. Surgery for Obesity and Related Diseases. ISSN 1550-7289. 11(6), s. S1–S2. doi: 10.1016/j.soard.2015.10.003. Fulltekst i vitenarkiv Vis sammendrag

  Patients with a body mass index (BMI, kg/m2) of 50 or more experience substantial weight loss, but often remain morbidly obese after proximal Roux’en Y gastric bypass (RYGB). We tested whether a distal RYGB improves patient outcomes in a double-blind randomized clinical trial.

• Sandbu, Rune; Seip, Birgitte Karen Berggreen; Medhus, Asle Wilhelm; Lorentzen, Jolanta Halabowska; Hjelmesæth, Jøran & Hofsø, Dag [Vis alle 7 forfattere av denne artikkelen] (2015). Esophageal motility in morbidly obese patients with type 2 diabetes. United European Gastroenterology Journal (UEG Journal). ISSN 2050-6406. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar; Lund, Randi Størdal; Sandbu, Rune & Hjelmesæth, Jøran (2014). Health related quality of life 5 years after bariatric surgery and intensive lifestyle intervention for morbid obesity. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar; Lund, Randi Størdal; Sandbu, Rune & Hjelmesæth, Jøran (2014). Health related quality of life 5 years after bariatric surgery and intensive lifestyle intervention for morbid obesity. Obesity Facts. ISSN 1662-4025. 7, s. 130–130. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar & Hjelmesæth, Jøran (2013). Predictors of weight loss after an intensive lifestyle intervention program in obese patients: a 1-year prospective cohort study. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar; Lund, Randi Størdal; Røislien, Jo; Tonstad, Serena; Natvig, Gerd Karin & Sandbu, Rune [Vis alle 7 forfattere av denne artikkelen] (2013). Changes in health related quality of life after gastric bypass or comprehensive lifestyle intervention: a controlled clinical study. Fulltekst i vitenarkiv
• Svanevik, Marius; Risstad, Hilde; Solheim, Brita; Kristinsson, Jon Adalsteinn; Karlsen, Tor-Ivar & Søvik, Torgeir Thorson [Vis alle 10 forfattere av denne artikkelen] (2013). Proximal versus distal laparoscopic gastric bypass in superobesity – perioperative results from a randomized controlled trial. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar (2012). Validity of SF-36 in morbid obesity. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar; Lund, Randi Størdal; Røislien, Jo; Tonstad, Serena; Sandbu, Rune & Hjelmesæth, Jøran (2012). Changes in health related quality of life after gastric bypass or intensive lifestyle intervention: A controlled clinical study. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar; Lund, Randi Størdal; Røislien, Jo; Tonstad, Serena; Natvig, Gerd Karin & Sandbu, Rune [Vis alle 7 forfattere av denne artikkelen] (2012). Health related quality of life after gastric bypass or intensive lifestyle intervention: a controlled clinical study. Obesity Facts. ISSN 1662-4025. 5(12), s. 184–184. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar (2017). Folkehelseplanlegging i kommunene. Idéhefte om helseoversikter og planstrategi. Kommuneforlaget AS. ISSN 9788244623599. Fulltekst i vitenarkiv
• Karlsen, Tor-Ivar (2014). Morbid obesity and health related quality of life. Universitetet i Oslo. Fulltekst i vitenarkiv
• Skeivold, Wenche; Karlsen, Tor-Ivar & Larsen, Inger Beate (2012). Sykelig overvekt, kjønn og stigmatisering. Hvilke erfaringer har norske kvinner og menn med sykelig overvekt i forhold til stigmatisering? Universitetet i Agder. Fulltekst i vitenarkiv

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