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  • 1.
    Borell, Lena
    et al.
    Stockholm Gerontology Research Center, Department of Clinical Neuroscience and Family Medicine, Section of Geriatric Mediant, Karolinska Institute, Stockholm University College of Health Sciences.
    Lilja, Margareta
    Carlsson-Alm, Siv
    Stockholm Gerontology Research Center, Department of Clinical Neuroscience and Family Medicine, Section of Geriatric Mediant, Karolinska Institute, Stockholm University College of Health Sciences.
    Törnquist, Kristina
    Stockholm Gerontology Research Center, Department of Clinical Neuroscience and Family Medicine, Section of Geriatric Mediant, Karolinska Institute, Stockholm University College of Health Sciences.
    Ståhl, Eva
    Stockholm Gerontology Research Center, Department of Clinical Neuroscience and Family Medicine, Section of Geriatric Mediant, Karolinska Institute, Stockholm University College of Health Sciences.
    Community-based Occupational Therapy: A Study of Elderly People with Home Help in a Social-Welfare District in Stockholm1995In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 2, no 3-4, p. 138-144Article in journal (Refereed)
    Abstract [en]

    Since 1992 the local authorities in Sweden have been responsible for the rehabilitation of elderly people living at home. Few studies of this relatively new form of rehabilitation have been reported. The aim of this study was to describe the type of occupational- therapy interventions received by elderly people over the age of 65 living in an urban area. Another aim was to describe the patterns in the performances of 648 elderly people. The study demonstrated that most of the elderly people who received occupational therapy also received home help several times a day. indicating that these elderly people had severe problems in the activities of daily living (ADL) in the area of self-care. Home-making activities and activities outside the home were the most problematic activities. The elderly also wanted to engage in more activities than they were judged to have the capacity for and or the environmental support to do. The implications of the results for community-base, occupational-therapy programs are discussed

  • 2.
    Ek, Anna
    et al.
    Psychiatric Clinic, Norrbotten County Council, Luleå.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    How adults with ADHD get engaged in and perform everyday activities2013In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, no 4, p. 282-291Article in journal (Refereed)
    Abstract [en]

    Objective: An increasing number of adults with ADHD face problems with everyday activities, and occupational therapists play an important role regarding interventions for this particular group. However, there is a knowledge gap within occupational therapy regarding how adults with ADHD experience engagement in everyday activities. The aim of this study was to understand the experiences of engagement in, and describe how adults with ADHD performed everyday activities. Methods: Twelve people with ADHD between the ages of 21 and 38 were interviewed using a semi-structured interview guide. Data were analysed based on a qualitative content analysis. Results: The results showed how engagement in and performance of everyday activities depended on inspiration, facilitating support, and feelings of togetherness with other people. Conclusions: These results show how adults with ADHD can find strategies to become more independent in their performance of everyday activities. Furthermore, this study suggests how occupational therapists can increase opportunities for adults with ADHD to engage in different activities, make choices, and find meaning in everyday activities.

  • 3.
    Elinge, Eva
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Löfgren, Britta
    Umeå University, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Gagerman, Eva
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nyberg, Lars
    A group learning programme for old people with hip fracture: a randomized study2003In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 10, no 1, p. 27-33Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine whether a group learning programme would influence the participants' perceived activity performance and ability to participate in social life after a hip fracture. The study comprised 35 people aged 54-90 years with hip fracture who had completed ordinary care and rehabilitation after their hip fractures. They were randomized to an intervention group (n=21) or to a control group (n=14). The intervention group participated in the group learning programme, while the control group received no intervention. Directly after the intervention and at 12 months after the intervention, no significant change was seen in either group, regarding the ability to perform ADL activities measured by the Barthel ADL index, or the performance of activities that were identified as important to the individual. However, in the intervention group, the number of ADL items perceived to be performed with difficulties decreased, and the perceived ability to participate in social life increased. These changes were not found in the control group. When analysed between groups, however, the only significant difference was the ability to participate in social life after the intervention. Further research is needed to investigate whether an intensive or prolonged period of rehabilitation, at the hospital or in the patient's home, would increase the ability to resume meaningful participation in social life

  • 4.
    Elinge, Eva
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Stenvall, Michael
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Wågert, Petra von Heideken
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Löfgren, Britta
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nyberg, Lars
    Daily life among the oldest old with and without previous hip fractures2005In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 12, no 2, p. 51-8Article in journal (Refereed)
    Abstract [en]

    The aim of this cross-sectional study was to describe the oldest old, with and without previous hip fracture with regard to their ability to perform personal and instrumental activities of daily living (ADL); home adaptations received; possession of assistive devices; perceived health and morale. A random sample drawn from the population of 85-year-olds, all 90-year-olds and all > or =95-year-olds (n =253) in Umea, a city in northern Sweden, were examined. Data obtained from assessments and interviews carried out in the participants' homes, as well as data from medical charts, were analysed. Those with an earlier hip fracture (n = 58) had more difficulties in performing both personal and instrumental ADLs than those without (n = 195) but regarding individual home adaptations and the possession of assistive devices for personal care, no differences were detected between the groups. Self-perceived health and morale were equally good in both groups. The conclusion drawn is that lifelong consequences, in the form of reduced abilities to perform ADLs and wheelchair dependency are common among the oldest old after a hip fracture. Therefore, trials concerning the effects of more extensive and prolonged rehabilitation following hip fracture would be of great interest

  • 5.
    Fallahpour, Mandana
    et al.
    Karolinska institute, Neurobiology Care Sciences and Society, Division of Occupational Therapy.
    Kottorp, Anders
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet.
    Nygård, Louise
    Department of Clinical NeuroScience, Occupational Therapy and Elderly Care Research, Karolinska Institutet, Umeå University, Department of Community Medicine and Rehabilitation, Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute.
    Larsson-Lund, Maria
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Participation after acquired brain injury: Associations with everyday technology and activities in daily life2015In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 22, no 5, p. 366-376Article in journal (Refereed)
    Abstract [en]

    Background: The development of the information society has led to increased use of everyday technology and changed theconditions for participation. Enabling participation in everyday life situations is an important rehabilitation goal after acquiredbrain injury (ABI). Identifying factors associated with individuals’ experienced participation and problems therein is thereforeessential. Objective: This study aimed at exploring the relationship between perceived difficulty in everyday technology use,perceived ability in the activities of daily living (ADL), and perceived participation, and participation problems in persons withABI. Methods: Eighty-one persons with ABI participated in the study and were assessed by the Impact on Participation andAutonomy questionnaire, the Everyday Technology Use Questionnaire, and the ADL taxonomy. Results: Findings showed thatthe combined model of difficulty in everyday technology (ET) use, ADL ability, and the interaction between them explainedboth participation in various domains of everyday life, and also overall level of perceived participation and the perceivedproblems. Conclusions: The findings underscore the importance of evaluating individuals’ ability in both ET use and ADL afterABI to increase the probability of explaining these persons’ participation in desired everyday life situations and, also, forrehabilitation design.

  • 6.
    Isaksson, Gunilla
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Hellman, Anna
    Kalix Primary Care.
    The influence of social support on the rehabilitation of women with spinal cord injury: experiences recounted by occupational therapists2012In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 19, no 5, p. 395-403Article in journal (Refereed)
    Abstract [en]

    Objective: Women with a spinal cord injury (SCI) often require support from others to perform their everyday activities. The aim was to describe OTs' experiences of how social support from the network influences or could influence the rehabilitation of women with SCIs. Methods: Four occupational therapists, specialized in rehabilitation of persons with SCIs, narrated 11 separate stories relating to women with an SCI. Five themes were identified: “Assisting the women to identify new ways to perform activities”, “Giving support to the women by re-establishing relationships on their behalf”, “Enabling the women to find solutions to problems that have an impact on everyday activities”, “Enabling the women to learn what it is like to live with an SCI from first-hand accounts”, and “Assisting the women to set goals in anticipation of life outside the clinic”. Results and conclusions: The results indicate that professionals within rehabilitation need to be aware of and actively create and strengthen natural social networks during the complex and demanding rehabilitation process. Furthermore, they ought to use their capacity as professionals to ensure that support is provided and to reduce negative interactions within the injured person's network, given that social support, social integration, and negative interactions have the potential to influence health and well-being. Read More: http://informahealthcare.com/eprint/PVNrjad5BhRFXpjUbMnp/full

  • 7.
    Isaksson, Gunilla
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Josephsson, Staffan
    Karolinska institute, Neurobiology Care Sciences and Society, Division of Occupational Therapy.
    Lexell, Jan
    Luleå University of Technology, Department of Health Sciences, Medical Science.
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Men's experiences of giving and taking social support after their wife's spinal cord injury2008In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 15, no 4, p. 236-246Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to gain an understanding of how men living with women with spinal cord injury (SCI) experienced and acted when they were giving and taking social support to and from their wives and other persons in their social network. Another aim was to give some possible explanations of the complex process of change that they went through. Data were collected through in-depth interviews with four men and field notes. To describe the men's subjective experiences and the process of change, a narrative approach inspired by Polkinghorne was used. The analyses resulted in one story that included the four men's experiences and action. The story showed that when the men went through a process of change, they used and needed both emotional and practical support to handle their new life situation. Furthermore, the men's experiences and action against social support changed over time. This indicated that, through narratives from spouses, professionals within rehabilitation could understand the process of change they went through after their partner's sudden injury, and support them to find strategies to handle their changed life situation. To give some possible explanations for the men's experiences and action during the process of change, the findings are discussed in relation to theories concerning adaptation and coping

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  • 8.
    Johansson, Christina
    et al.
    Labour Market Office, Luleå Municipality.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Experiences of participation in occupations of women on long-term sickleave2011In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 18, no 4, p. 294-301Article in journal (Refereed)
    Abstract [en]

    The majority of individuals on long-term sick leave experience negative effects in their lives associated with limitations on their participation, decreased income, and feelings of guilt. The aim was to describe the experiences that women on long-term sick leave have of participation in occupation. Unstructured interviews were used for the data collection, which involved eight women; a grounded theory approach was used. The results showed that the women's long-term sick leave changed their roles, daily habits, and routines, and their participation in occupations was negatively influenced. Their occupational performance also diminished, thereby having a negative influence on their social relationships. However, over time they came to find different strategies that contributed to a feeling of occupational competence and thence they started to rebuild their occupational identity. Through this began the process of occupational adaptation, which resulted in an increased experience of participating in occupation. As a conclusion, it should be noted that occupational therapy interventions should be directed at women on long-term sick leave at an early stage in the rehabilitation process to address the adaptation of their roles, habits, routines, and social environment

  • 9.
    Johansson, Karin Mauri
    et al.
    Division of Occupational Therapy, Karolinska Institutet.
    Borell, Lena
    Division of Occupational Therapy, Karolinska Institutet.
    Lilja, Margareta
    Older persons' navigation through the service system towards home modification resources2009In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 16, no 4, p. 227-237Article in journal (Refereed)
    Abstract [en]

    Home modifications are part of the occupational therapy interventions provided to persons with functional limitations in the home environment. Home modification services often involve many different actors, and persons experiencing a need for home modifications have to navigate through a network of service organizations and professional actors. The aim of this study was to explore and describe how older adults in one Swedish municipality tried to find their way and navigate through the service system in order to receive home modification services that could meet their experienced needs. A case study design was used, including four older adults with different experiences and expectations of home modification services. The relationship between the participants' expectations, experiences, and their ways to navigate through the service system was described through the metaphor of a "geographical map". Satisfaction with the service process was found when there was a match in understandings of responsibilities and eligibility between what could be read from the older persons' map and the professionals' perspective. The findings have implications for client-centred occupational therapy practice, indicating that this match can be achieved when professionals translate clients' experienced problems in everyday life into a terminology that fits into the service system. ©

  • 10.
    Johansson, Karin Mauri
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute.
    Lilja, Margareta
    Petersson, Ingela
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute.
    Borell, Lena
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute.
    Performance of activities of daily living in a sample of applicants for home modification services2007In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 14, no 1, p. 44-53Article in journal (Refereed)
    Abstract [en]

    Home modification services are provided to support persons with functional limitations to live independently at home. It is not well known what causes individuals to apply for home modifications, or in what kind of life situation this need appears. The aim of this study was to examine the relationship between performance of activities of daily living, housing and living situation, and the home modification applied for in a sample of home modification applicants. Further, the aim was to examine differences in performance of activities of daily living between subgroups with different social support. A total of 102 participants were included in the study. Data on performance of activities of daily living was collected through interviews in the participants' homes, using structured instruments. The participants reported high levels of independence in activities of daily living, and were using assistive devices to a large extent. However, the applicants clearly experienced difficulties in performing activities related to the applied home modification. The study indicates that the main reason for applying for Home Modification Grants was perceived difficulties in performance of activities of daily living. This stresses the importance of including other aspects besides independence when trying to understand persons' activity performance and planning for occupational therapy interventions.

  • 11.
    Kassberg, Ann-Charlotte
    et al.
    Division of Primary Rehabilitation Lulea, The County Council of Norrbotten.
    Prellwitz, Maria
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Larsson-Lund, Maria
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    The challenges of everyday technology in the workplace for persons with acquired brain injury2013In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, no 4, p. 272-281Article in journal (Refereed)
    Abstract [en]

    Purpose: To explore and describe how persons with an acquired brain injury (ABI) managed the everyday technology (ET) that they needed to use in their workplace and how this use influences their opportunities to work. Method: Nine persons with an ABI were interviewed and observed when managing ET in their workplace. The data were analysed qualitatively with a constant comparative method. Results: The main category, "The challenge of managing ET in the workplace", consisted of three categories, all of which reflected different kinds of discrepancies between the participants' ability to manage ET and the demands that ET imposes on them in work: "Struggling with ET to be able to continue to work; "Depending on strategies to cope with ET to continue in a particular profession", and "Managing ET at work but concerned about keeping up with the changes". Conclusions: The result revealed discrepancies between the abilities of the persons with ABI to manage ET in relation to the demands that technology imposed on them in their work setting. This indicated that professionals need to consider the role of ET when designing interventions supporting a person's return to work after an ABI.

  • 12.
    Kassberg, Ann-Charlotte
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Prellwitz, Maria
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Malinowsky, Camilla
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Luleå tekniska universitet.
    Larsson-Lund, Maria
    Luleå University of Technology, Department of Health Sciences, Health and Rehab. Maria.Larsson-Lund@ltu.se .
    Interventions aimed at improving the ability to use everyday technology in work after brain injury2016In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 23, no 2, p. 147-157Article in journal (Refereed)
    Abstract [en]

    Objective The aim of this study was to explore and describe how client-centred occupationaltherapy interventions may support and improve the ability to use everyday technology (ET) in worktasks in people with acquired brain injury (ABI). Method A qualitative, descriptive multiple-casestudy was designed, and occupation-based interventions were provided to three working-ageparticipants with ABI. Multiple sources were used to collect data throughout the three interventionprocesses, including assessments, field notes, and interviews. The Canadian OccupationalPerformance Measure and the Management of Everyday Technology Assessment were administeredbefore the interventions, after the interventions and at a follow-up session 2–3 monthssubsequent to the interventions. Results The three intervention processes initially consisted ofsimilar actions, but subsequently the actions took on a different focus and intensity for each case.All of the goals in each of the three case processes were achieved, and both perceived andobserved abilities to use ET in work tasks improved. Conclusions Client-centred occupationaltherapy interventions might have the potential to improve the ability to use ET in work tasks inpeople with ABI.

  • 13.
    Kassberg, Ann-Charlotte
    et al.
    Björkskatans vårdcentral.
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Experiences of ethical dilemmas in rehabilitation: Swedish occupational therapists' perspectives2008In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 15, no 4, p. 204-211Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe Swedish occupational therapists' experiences of encountering ethical dilemmas in rehabilitation and strategies they used to handle the situations. Twelve occupational therapists who work with adults with developmental disabilities were interviewed using a semi-structured interview design. Data were analysed using qualitative content analysis. The results showed that ethical dilemmas were common in the occupational therapists' daily work within rehabilitation. Many situations that created ethical dilemmas were related to occupational therapists who worked with clients and their relatives, and other healthcare providers. The results showed further that occupational therapists found it difficult to make decisions and to optimize clients' participation in decision-making, to set limits and act professionally, and to best handle the situation for the client and avoid ethical dilemmas. This study indicates the importance of illustrating experiences of ethical dilemmas within occupational therapy praxis and the meaning of discussing ethical dilemmas with different healthcare providers to reach a divided view of the client in order to develop successful and healthy strategies that will optimize the rehabilitation of clients with developmental disabilities.

  • 14.
    Larsson, Ellinor
    et al.
    Department of Community Medicine and Rehabilitation, Occupational Therapy, Umeå University.
    Nilsson, Ingeborg
    Department of Community Medicine and Rehabilitation/Occupational Therapy, Ageing and Living Conditions Program (ALC), Umeå University.
    Larsson-Lund, Maria
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Participation in social internet-based activities: Five seniors' intervention processes2013In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, no 6, p. 471-480Article in journal (Refereed)
    Abstract [en]

    Objective: To explore how client-centred occupational therapy intervention processes for participation in meaningful Social Internet-Based Activities (SIBAs) can be designed, and to explore the influences of participation in SIBAs on seniors' social activities and social contacts. Method. A qualitative, descriptive, multiple-case study was conducted, and an intervention was provided to the five participants, who were aged 65–85. Data were collected through assessment tools, field notes, and interviews. Results: The participants' needs and challenges related to SIBAs varied during the intervention processes. Individual-adapted support was provided for the seniors (by the occupational therapist) to managing the introduction to different SIBAs, their appearance on the internet, and the lack of privacy. The association between the seniors' participation in SIBAs and their satisfaction with these activities, as well as their social contacts, requires further exploration. Conclusions: Client-centred occupational therapy interventions can support seniors' participation in SIBAs and their self-reliance when performing these activities.

  • 15.
    Larsson, Maria
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Bränholm, Inga-Britt
    Umeå universitet.
    An approach to goal-planning in occupational therapy and rehabilitation1996In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 3, no 1, p. 14-9Article in journal (Refereed)
  • 16.
    Larsson-Lund, Maria
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Kottorp, Anders
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet.
    Malinowsky, Camilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation. Karolinska institutet, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden.
    Return to work in people with acquired brain injury: association with observed ability to use everyday technology2017In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 24, no 4, p. 281-289Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to explore how the observed ability to use everyday technology (ET), intrapersonal capacities and environmental characteristics related to ET use contributes to the likelihood of return to work in people with ABI. The aim was also to explore whether these variables added to the likelihood of return to work to earlier defined significant variables in the group: age, perceived ADL ability and perceived ability in ET use.

    Method: A cross-sectional study. The Management of Everyday Technology Assessment (META), the short version of the Everyday Technology Use Questionnaire (S-ETUQ) and a revised version of the ADL taxonomy were used to evaluate 74 people with ABI. Individual ability measures from all assessments were generated by Rasch analyses and used for additional statistical analysis.

    Results: The univariate analyses showed that the observed ability to use ET, as well as intrapersonal capacities and environmental characteristics related to ET use were all significantly associated with returning to work. In the multivariate analyses, none of these associations remained.

    Conclusion: The explanatory precision of return to work in people with ABI increased minimally by adding the observed ability to use ET and the variables related to ET use when age, perceived ability in ET use and ADL had been taken in account.

  • 17.
    Larsson-Lund, Maria
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Lexell, Jan
    Luleå University of Technology, Department of Health Sciences, Medical Science.
    Associations between perceptions of environmental barriers and participation in persons with late effects of polio2009In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 16, no 4, p. 194-204Article in journal (Refereed)
    Abstract [en]

    The aim of this pilot study was to assess the association between perceived environmental barriers and perceived participation in everyday life situations encountered by people with late effects of polio. A sample of 45 persons with clinically verified late effects of polio answered the Swedish versions of the Impact on Participation and Autonomy Questionnaire (IPA-S) and the Craig Hospital Inventory of Environmental Factors (CHIEF-S). The relationships between the perceived occurrence of a broad range of environmental barriers and perception of participation in life situations and problems with participation were explored. The majority of the respondents perceived that they encountered environmental barriers, but their occurrence was generally infrequent and their magnitude tended to be low. The barriers identified in the physical/structural subscale were generally most strongly related to problems with participation, compared with the four other environmental subscales. A high frequency of never encountering environmental barriers in the three subscales physical/structural, work and education, and policies in CHIEF-S were significantly related to more reports of good participation in IPA-S. These associations indicate that the participation of those with late effects of polio is influenced by their perception of the barriers they encounter. Further studies of these concepts can provide a greater understanding of disabilities and help us to promote participation in life situations for people with late effects of polio.

  • 18.
    Larsson-Lund, Maria
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Lövgren-Engström, Ann-Louice
    Luleå University of Technology, Department of Health Sciences.
    Lexell, Jan
    Response actions to difficulties in using everyday technology after acquired brain injury2012In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 19, no 2, p. 164-175Article in journal (Refereed)
    Abstract [en]

    Purpose: People with acquired brain injury (ABI) have difficulties using everyday technology (ET) in daily tasks at home and in society. To support them in managing the demands imposed by using ET, knowledge is needed concerning their response actions to the difficulties. The aim of this study was to explore and describe what characterizes response actions to difficulties using ET, their conditions, and how they influence the experiences of tasks in daily life among people with ABI. Methods: Interviews and observations were undertaken with 13 persons with an ABI. Data were analysed qualitatively using the constant comparative method. Results: The participants' response actions were categorized as (i) deliberate and organized planning, (ii) random and inflexible repeating (iii), re-evaluating tasks, (iv) explaining difficulties related to others, and (iv) proving and protecting capability. Certain conditions were decisive for the different response actions to be applied and also for their effectiveness in enabling engagement in tasks in daily life. Each participant used several types of response actions and the same action could be applied in several situations. Conclusion: To support people with an ABI to manage the demands imposed by using ET, it is important to identify the uniqueness of each client and his or her response actions to difficulties using ET and thereafter adjust the interventions accordingly.

  • 19.
    Larsson-Lund, Maria
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Nyman, Anneli
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Occupational challenges in a digital society: A discussion inspiring occupational therapy to cross thresholds and embrace possibilities2019In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014Article in journal (Refereed)
    Abstract [en]

    The digital transformation of society and the increased need for digital competence implies extensive changes in peoples’ everyday lives and occupations. Heretofore, the discussion in the field of occupational therapy about the consequences of digitalisation has been vague. The aim of this discussion paper is to outline some reflections and to offer some arguments on how to meet the changes following digitalisation and its impact on occupational therapy. The discussion focuses on three issues: the new conditions for participation in a digital society and the role of occupational therapy and occupational therapists in the evolving digital society as well as what occupational therapists need to be pro-active and to embrace the ongoing changes in a digital society. In conclusion, occupational therapy needs to advance its position and become pro-active to cross the threshold and to embrace the possibilities that digitalisation holds for peoples’ everyday lives to support occupational justice and health.

  • 20.
    Larsson-Lund, Maria
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Nyman, Anneli
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Participation and occupation in occupational therapy models of practice: A discussion of possibilities and challenges2017In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 24, no 6, p. 393-397Article in journal (Refereed)
    Abstract [en]

    Background: Occupation has been the focus in occupational therapy practice to greater or lesser degrees from a historical viewpoint. This evokes a need to discuss whether concepts that are added to our field will enhance or blur our focus on occupation.

    Aim: To explore how the concept of participation in the International Classification of Functioning, Disability and Health (ICF) is related to the concept of occupation by reviewing and comparing its use in three models of practice within occupational therapy. The aim was also to generate discussion on possibilities and challenges concerning the relationship of participation and occupation.

    Method: The models reviewed were The Model of Human Occupation (MOHO), the Canadian Model of Occupational Performance and Engagement (CMOP-E) and the Occupational Therapy Intervention Process Model (OTIPM).

    Results: The concept of participation was related to occupation in different ways in these models. Based on the review some challenges and considerations for occupational therapy were generated.

    Conclusion: Relating the concept of participation from the ICF to the concept of occupation in models of practice can be challenging. At the same time, relating the concepts can be a resource to develop occupational therapy and the understanding of occupational issues in society.

  • 21.
    Larsson-Lund, Maria
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Tamm, Maare
    How a group of disabled persons experience rehabilitation over a period of time2001In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 8, no 2, p. 96-104Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to describe how a group of mainly elderly disabled persons experienced their rehabilitation over a period of time focusing on their interactions with professionals, relatives and the community. Fifteen persons who had suddenly been taken ill and who had received rehabilitation were interviewed. The interview transcripts were analysed qualitatively. The results showed that the informants' experiences could be described in a form of three rehabilitation chains, each one consisting of a number of phases. First, a medical rehabilitation chain that started at the onset of the informants' disability. This chain was relatively short and reflected the informants' interactions with the professionals. A psychological rehabilitation chain that represented the informants' internal struggle towards a new meaningful life. The third was labelled a social rehabilitation chain. This chain became visible later in the rehabilitation process and reflected the informants' interactions with their relatives and their experiences of a stigmatizing society. Although rehabilitation in Sweden is claiming to apply a holistic perspective encompassing medical, psychological and social aspects, the results of the study showed that it is not perceived so by the informants in the study, who experienced rehabilitation mainly in the medical rehabilitation chain.

  • 22. Lexell, Jan
    et al.
    Lexell, Eva Månsson
    Department of Rehabilitation, Lund University Hospital, Sweden.
    Iwarsson, S
    Department of Rehabilitation, Lund University Hospital, Sweden.
    The complexity of daily occupations in multiple sclerosis2006In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 13, no 4, p. 241-8Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to describe which self-care, productivity, and leisure occupations individuals with multiple sclerosis (MS) perceive as difficult to perform on admission to rehabilitation and the individuals' own perception of the importance of, performance of, and satisfaction with these occupations. Whether the reported self-care, productivity, and leisure occupations were related to sex, age, disease severity, and living arrangements was also investigated. Forty-seven men and women (mean age 49.4 years) were assessed with the Canadian Occupational Performance Measure (COPM) on admission to rehabilitation. The individuals reported 366 occupations (median 8, range 3-15), which were categorized as self-care (51%), productivity (30%), and leisure (19%). Three COPM subcategories--household management (26%), personal care (21%), and functional mobility (20%)--accounted for two-thirds of the reported occupations. All prioritized occupations (n = 238; (median 5, range 2-7) had high ratings for importance and the ratings for performance and satisfaction were generally low. Men reported significantly more occupations related to self-care than women, but no significant difference between the sexes could be found for productivity and leisure. No significant differences between the occupational areas were found when age, disease severity, or/and living arrangements were included in the analysis. In conclusion, individuals with MS perceive difficulties with occupations related to all aspects of daily life. This underscores the need to use assessment tools that capture the complexity of daily occupations.

  • 23. Lilja, Margareta
    et al.
    Nygård, Louise
    Department of Clinical NeuroScience, Occupational Therapy and Elderly Care Research, Karolinska Institutet.
    Biorell, Lena
    Department of Clinical NeuroScience, Occupational Therapy and Elderly Care Research, Karolinska Institutet.
    The transfer of information about geriatric clients in the occupational therapy chain of care: An intervention study2000In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 7, no 2, p. 51-59Article in journal (Refereed)
    Abstract [en]

    Continuity of interventions for elderly persons after discharge from hospital is affected by the communication between professionals involved in the rehabilitation process. This study describes an intervention project that was implemented to improve ways of transferring information relating to geriatric clients between occupational therapists working on different organizational levels. An assessment of activities of daily living (the ADL taxonomy) was used as a uniform instrument of communication. The results revealed that aspects of temporality, structure, professionalism and the instrument's usefulness influenced the transfer of information. Systematic discharge planning schemes, written and formally structured information, a feedback loop for communication, and collaboration with the clients and their families in the discharge process are all suggested as ways of transferring information.

  • 24.
    Lindén, Anita
    et al.
    Luleå University of Technology, Department of Health Sciences.
    Lexell, Jan
    Luleå University of Technology, Department of Health Sciences.
    Larsson-Lund, Maria
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Perceived difficulties using everyday technology after acquired brain injury: influence on activity and participation2010In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 17, no 4, p. 267-75Article in journal (Refereed)
    Abstract [en]

    Using everyday technology (ET) is a prerequisite for activities and participation at home and in the community. It is well known that persons with an acquired brain injury (ABI) can have limitations in activities of daily living but our knowledge of their difficulties using ET is not known. Thirty-six persons (27 men and 9 women, mean age 44 years, age range 26-60) with an ABI (2-10 years post injury) were interviewed, using the Everyday Technology Use Questionnaire (ETUQ), about their perceived difficulties using ET and how these difficulties influenced their everyday activities and their possibilities to participate at home and in the community. A majority (78%) of the persons reported difficulties using ET. The most common difficulties were related to the use of telecommunication and computers. Despite these difficulties, a majority still used most objects and services independently. Twenty-six participants (72%) perceived that their difficulties using ET influenced their everyday activities and their possibility to participate at home and in the community. The results indicate that rehabilitation following an ABI should consider whether clients' use of ET influences their activity and participation and adopt interventions accordingly. The results also indicate that difficulties using ET need to be considered in the design of community services to prevent societal barriers.

  • 25.
    Lövgren-Engström, Ann-Louice
    et al.
    Luleå University of Technology, Department of Health Sciences.
    Lexell, Jan
    Luleå University of Technology, Department of Health Sciences.
    Larsson-Lund, Maria
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Difficulties in using everyday technology after acquired brain injury: a qualitative analysis2010In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 17, no 3, p. 233-243Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to identify and describe the characteristics of the difficulties using everyday technology in persons with an aquired brain injury (ABI), and their experiences of how these difficulties influenced their life. Thirteen persons with an ABI were interviewed about their difficulties in using everyday technology and were observed in their use of technology. Data were analysed qualitatively with a constant comparative method. The results showed that the persons' experiences formed two categories: "A variety of combinations of difficulties in the use of everyday technology" and "Restrictions in life". The difficulties identified were related not only to everyday technology itself but also to the interaction between the technology, the task, the person, and the environment. These difficulties influenced their experiences of restrictions in occupational performance, personal identification, and participation in society. The results emphasize that occupational therapists who design interventions for people with an ABI need to accommodate both the technology and other interacting aspects in order to overcome difficulties in using everyday technology.

  • 26.
    Malinovsky, Camilla
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy , Karolinska Institutet .
    Fallhapour, Mandana
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Larsson-Lund, Maria
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Nygård, Louise
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy , Karolinska Institutet .
    Kottorp, Anders
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Stockholm.
    Skill clusters of ability to manage everyday technology among people with and without cognitive impairment, dementia and acquired brain injury2018In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 25, no 2, p. 99-107Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    In order to develop supporting interventions for people demonstrating problems ET use, a detailed level of description of strengths and deficits is needed.

    AIMS:

    To explore clusters of specific performance skill required when using ET, and to evaluate if and in what way such clusters are associated with age, gender, diagnosis, and types of ETs managed.

    MATERIALS AND METHODS:

    A secondary analysis of 661 data records from 203 heterogeneous samples of participants using the Management of Everyday Technology Assessment (META) was used. Ward's method and a hierarchical tree cluster analysis were used to determine and define the skill clusters.

    RESULTS:

    Four distinct clusters of performance skill item profiles were found, across the 661 data records. These were then, based on each individuals' cluster profiles in managing ET, categorized into two groups. The two groups were associated with, diagnosis and type of ETs managed.

    CONCLUSIONS AND SIGNIFICANCE:

    The findings support a more dyadic person-ET approach in evaluation of ET management. The information from the skill clusters can be used to develop targeted intervention guides for occupational therapy and healthcare.

  • 27.
    Malinowsky, Camilla
    et al.
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Luleå tekniska universitet.
    Larsson-Lund, Maria
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    The association between perceived and observed ability to use everyday technology in people of working age with ABI2014In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, no 6, p. 465-472Article in journal (Refereed)
    Abstract [en]

    Objective: Everyday technology (ET), including computers and automated telephone services, is increasingly required for everyday functioning. However, people with acquired brain injury (ABI) may have difficulty with ET use. To design interventions to support ET use, further knowledge of how to assess dimensions of such use is needed. Methods: This study investigated the relationship between the perceived difficulty of ET use (self-reported using the short version of the Everyday Technology Use Questionnaire, S-ETUQ) and observed ability to use ET (observed using the Management of Everyday Technology Assessment, META) in a sample of people with ABI (n = 81). Data were analysed using a Rasch measurement model, and person measures of perceived difficulty and observed ability to use ET were identified and correlated. Results and conclusions: The person measures had a correlation of 0.49 (p < 0.001). In groups of different severity levels after ABI, significant associations were found in the moderate (0.36) and severe (0.47) disability groups. In the good recovery group, only a non-significant correlation was found (0.21). This indicates that the S-ETUQ and the META measure different but complementary dimensions of ET use. Hence, the assessments are proposed to be used together in clinical practice to more fully understand the ability of people with ABI to use ET.

  • 28.
    Malinowsky, Camilla
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    Olofsson, Alexandra
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Nyman, Anneli
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Larsson-Lund, Maria
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Patterns of participation: Facilitating and hindering aspects related to places for activities outside the home after stroke2020In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 27, no 3, p. 204-212Article in journal (Refereed)
    Abstract [en]

    Background: Being engaged in activities in places outside the home after a stroke can be challenging. Knowledge about what characterize places outside the home is important to support participation.

    Objectives: To explore patterns of participation in places for activities outside the home after stroke and whether these patterns were associated with personal and environmental aspects.

    Material and methods: Sixty-three people with stroke were interviewed using the Participation in Activities and Places Outside Home (ACT-OUT) questionnaire. A two-step cluster analysis was used to identify patterns of participation and non-parametric test was used to explore potential associations to the patterns of participation.

    Results: Four clusters of patterns of participation, based on frequency, familiarity of the place/the way to the place and perceived distance, were identified. The patterns were significantly associated with type of place, activity domain, retained or abandoned participation, transportation and being accompanied by someone. The severity of disability was significantly associated with groups of individuals with different patterns of participation.

    Conclusions: Different combinations of aspects facilitated and hindered whether or not participation changed. To support people with stroke in their endeavour to retain or recapture participation, social support is important to consider in relation to transportation, activities and places outside the home.

  • 29.
    McMillen, Ann-Mari
    et al.
    Lulea, Department of Rehabilitation, Primary Health Care.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Disabled persons' experience of dependence on assistive devices2002In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 9, no 4, p. 176-83Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to elucidate disabled persons' experience of dependence on assistive devices. Fifteen persons were interviewed with a narrative approach. A qualitative thematic content analysis was used to analyse the interview text. The analysis resulted in four themes with nine sub-themes. The study shows that the participants' experience of being dependent on assistive devices included possibilities such as gaining a better quality of life and being able to live a normal life. The dependence also led to obstacles like a fear of injuring oneself when utilizing assistive devices, difficulties in accepting them and worry about future needs for devices. The participants experienced a changed reception from other people and problems imposed by society or the community. They felt that they were treated in a different way and were in the way. A lack of access to public places and a feeling of helplessness when faced with the power of the authorities were other experiences of the participants. The relationship between the approach that people take to their illness and the acceptance of using assistive technology needs further study. Further research concerning the way in which people handle their dependence on assistive devices needs to be conducted.

  • 30.
    Nygård, Louise
    et al.
    Division of Occupational Therapy, NVS, Karolinska Institutet, Huddinge.
    Starkhammar, Sofia
    Division of Occupational Therapy, NVS, Karolinska Institutet, Huddinge.
    Lilja, Margareta
    The provision of stove timers to individuals with cognitive impairment2008In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 15, no 1, p. 4-12Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to identify the characteristics of persons who were provided with timing devices on stoves, and to investigate the application procedure and recommendations for timer options. The case files at an Agency for Home Modifications in an urban community in Sweden during 2002 (n = 945) were audited. The sample was divided into two groups: those diagnosed or suspected of dementia or age-related memory deficits (n = 788), and those with other diagnoses (n = 151). Overall, the applicants for stove timers were elderly females, living alone. Assistance with the application forms by health professionals was common in both groups. However, the options available for tailoring the use of the device were not used consistently and the opportunity for professional follow-up appeared limited. The device seemed to be used as a safety precaution rather than as a device to support independent activity performance based on individual users' needs. The results indicate that improvements in the implementation and provision of stove timers could be achieved through education and collaboration between different stakeholders.

  • 31.
    Nyman, Anneli
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Enacted togetherness: A concept to understand occupation as socio-culturally situated2020In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014Article in journal (Refereed)
    Abstract [en]

    Background: This paper is in line with the on-going discussion of a theoretical re-orientation towards acknowledging the socio-cultural dimensions of occupation.

    Aim: To define enacted togetherness as a concept and share our understandings of how this concept can add to the understanding of occupation as socio-culturally situated.

    Method and material: The concept enacted togetherness emerged from empirical findings of a larger research project with older adults living with late-life depression. Informed by a transactional understanding of occupation and a narrative approach, the concept emerged as a contextually situated process holding qualities and potential as a source of meaning-making.

    Findings: Enacted togetherness as described herein has a clear association to occupation in terms of doing activities together. We reflect on enacted togetherness as a process of meaning-making, connecting people and places through unfolding stories; as an arena where togetherness and belonging can be created; and as a space for interpretation, providing opportunities to negotiate issues of meaning that can lead to possibilities for change.

    Conclusion: The concept of enacted togetherness can contribute to the ongoing discussion of a theoretical reorientation towards understanding socio-cultural dimensions of occupation.

    Significance: Enacted togetherness is a concept that can contribute to occupational therapy and occupational science as it adds to an understanding of the qualities and potentials inherent in engagement in occupations with others.

  • 32.
    Nyman, Anneli
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Togetherness in another way: Internet as a tool for togetherness in everyday occupations among older adults2015In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 22, no 5, p. 387-393Article in journal (Refereed)
    Abstract [en]

    Objective: This article explores and describes how the Internet was experienced as a tool for togetherness in everyday occupations among older adults. Methods: Discussions with 12 older adults, divided into three focus groups, generated data that were analysed using a grounded theory approach. Six women and six men between 67 and 79 years of age were purposively selected and recruited from a retirement organization in northern Sweden. Results: Findings reflect how online contexts generated new possibilities for togetherness in everyday occupations and created a sense of belonging with others and to society at large. However, togetherness through the Internet was also associated with ambiguity and uncertainty among older adults. The Internet provided opportunities for togetherness that were somehow different from togetherness derived from face-to-face contact, but it was also connected with a fear and a resistance. Conclusions: Findings from this research can extend our understanding of how online contexts have the possibility to promote togetherness in everyday occupations and what it means to be part of such a context among older adults. In light of these findings, the need is highlighted to consider the Internet as a tool for older adults to be socially engaged with the potential to reduce loneliness and isolation.

  • 33.
    Nyman, Anneli
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Josephsson, Staffan
    Department of Neurobiology, Caring Sciences and Society, Division of Occupational Therapy, Karolinska Institutet.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Being part of an unfolding story: togetherness in everyday occupations when ageing2014In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, no 5, p. 368-376Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to explore and enhance the understanding of how togetherness in everyday occupations is experienced and discussed among older adults. Method: Focus-group discussions generated the data and a total of 12 participants, including six women and six men, divided into three groups, participated in this study. Analysis was performed using a grounded theory approach. Results: The findings reflect how togetherness in everyday occupations can be comprehended as multifold transactional processes, emphasizing how an acted belonging was a situated experience connecting people and places through unfolding stories. The findings suggest that the process of meaning-making in ongoing life was closely associated with togetherness and was negotiated with others through shared culture and experiences. Togetherness meant being part of something in which the persons involved were contributing to each other in various ways. However, being part of togetherness was complicated, especially when the person’s life situation was challenged in some way. Conclusions: It was apparent from the analysis that togetherness could not be taken for granted. Rather, the findings reflect how togetherness was created and maintained through an ongoing process of nurturing established relationships as well as creating something new around occupations with others.

  • 34.
    Nyman, Anneli
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Larsson-Lund, Maria
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Influences of the social environment on engagement in occupations: the experience of persons with rheumatoid arthritis2007In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 14, no 1, p. 63-72Article in journal (Refereed)
    Abstract [en]

    The aim of this explorative study was to describe and enhance the understanding of how persons with rheumatoid arthritis (RA) experience the influence of the social environment on their engagement in occupations. Nine persons were interviewed and the data obtained were analysed using a comparative method. The findings revealed that other persons in the social environment influenced informants' experiences of engaging in occupations in two ways, which formed the categories: "Constructive collaboration" and "Insufficient collaboration". These categories had certain properties related to the actions the others undertook to assist the informants during their collaboration. These assisting actions influenced the informants' possibilities to engage in occupations, and also their experience of engagement. The findings also showed that the "Conditions for collaboration" varied and influenced their collaboration, which thereby constituted a third category. The findings may contribute to a deeper understanding of how other persons can facilitate and restrict meaningful occupational experiences. This provides knowledge that can be used by occupational therapists when empowering their clients and those close to them to reflect on their actions and the consequences of these actions to enhance occupational engagement.

  • 35.
    Olofsson, Alexandra
    et al.
    Luleå University of Technology, Department of Health Sciences, Health, Medicine and Rehabilitation.
    Larsson-Lund, Maria
    Luleå University of Technology, Department of Health Sciences, Health, Medicine and Rehabilitation.
    Nyman, Anneli
    Luleå University of Technology, Department of Health Sciences, Health, Medicine and Rehabilitation.
    Everyday activities outside the home are a struggle: Narratives from two persons with acquired brain injury2020In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 27, no 3, p. 194-203Article in journal (Refereed)
    Abstract [en]

    Background: Participation restriction is a common consequence after acquired brain injury (ABI).

    Aim: To explore and identify problematic situations in everyday activities outside the home for persons with acquired brain injury.

    Material and Method: Two persons of working age with ABI were included. Data were generated through repeated semi-structured interviews and participant observations. Narrative analysis was used to capture ongoing processes related to problematic situations during engagement in everyday activities outside the home.

    Results: The narratives reflect how places, everyday activities and social relations were closely connected and influenced engagement in everyday activities outside the home. The participants visited fewer places and performed more of their everyday activities alone in their homes after the injury compared to before. They were struggling to create meaning in their lives and trying to reformulate their identity. Problematic situations often occurred outside the home as a result of unexpected events. The narratives indicate a struggle to find new routines to handle challenging situations.

    Conclusions: The results provide an understanding of how problematic situations occurred and were managed in different ways. By observing everyday situations professionals can gain access to how persons with ABI act in and reflect upon problematic situations which can eventually improve the design of individually tailored interventions.

  • 36.
    Persson, Marit
    et al.
    Lulea, Department of Rehabilitation, Primary Health Care.
    Zingmark, Karin
    Department of Health and Medical Care, County Council of Norrbotten.
    Living with a person with Alzheimer's disease: Experiences related to everyday occupations2006In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 13, no 4, p. 221-228Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to illuminate experiences of daily occupations among spouses living with a person with Alzheimer's disease (AD). The study contains phenomenological-hermeneutic interpretation of interviews with eight spouses. The analysis revealed the participants as being in the process of a changing occupational situation. They come to live an occupational life intertwined with their partners' needs. An ongoing process of occupational adjustment is taking place as a response to the changing situation. The spouses were occupied with consequences of their partner's disease. They were striving for occupational meaning and at the same time living with threats to meaningful occupations. It can be concluded that living with a partner with AD is a complex dealing with occupational meaning. This complexity should be considered in interventions.

  • 37.
    Petersson, Ingela
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet.
    Kottorp, Anders
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet.
    Bergström, Jakob
    Department of Learning, Informatics, Management and Ethics, Medical Statistical Unit, Karolinska Institutet.
    Lilja, Margareta
    Longitudinal changes in everyday life after home modifications for people aging with disabilities2009In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 16, no 2, p. 78-87Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate longitudinal impacts of home modifications on the difficulty of performing everyday life tasks for people aging with disabilities, and to investigate whether other factors had any additional impacts on difficulty in everyday life tasks for people receiving home modifications. Methods: The sample consisted of 103 persons aging with disabilities and in need of home modifications, divided into an intervention group and a comparison group. The data were first subjected to Rasch analysis and a random coefficient model was used. Results: Participants in the intervention group reported a significantly lower level of difficulty in everyday life tasks compared with those in the comparison group. One confounding factor, number of months waiting for home modification, had an impact on difficulty in everyday life. Conclusion: Home modifications are effective in decreasing difficulty in performing everyday life tasks up to six months after the installation. Furthermore, to be effective home modifications need to be installed in a timely fashion. For each consecutive month the person waited for their home modification the difficulty of performing everyday life tasks increased. Therefore, it is important that home modifications be installed as soon as possible after the need has been identified.

  • 38.
    Prellwitz, Maria
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Tamm, Maare
    Luleå tekniska universitet.
    Attitudes of key persons to accessibility problems in playgrounds for children with restricted mobility: a study in a medium-sized municipality in northern Sweden1999In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 6, no 4, p. 166-173Article in journal (Refereed)
    Abstract [en]

    Playgrounds are an important outdoor environment for children. Yet few playgrounds are designed to be accessible to children with restricted mobility. In this study the child with restricted mobility is defined as one who is unable to move around without the aid of a wheelchair, walking-frame, walking-stick or other walking device. The purpose of the study was to explore the attitudes to accessibility problems in playgrounds among two groups of key persons: "creators" and "users of playgrounds" in a medium-sized municipality in northern Sweden. Eleven key persons (5 "creators of playgrounds" and 6 "users of playgrounds") were interviewed in a semi-structured interview. The interviews were analysed according to content analysis and could be coded under different themes. The results showed that those who created playgrounds had (i) a fragmented organization, (ii) insufficient knowledge of disabilities, (iii) poor economy, and (iv) attitudes as an obstacle. Interviews with the users of the playgrounds were coded under two themes (i) the playground is not for me (i.e. for children with restricted mobility) and (ii) assistance is a precondition for accessibility. The results were discussed in the light of how the inaccessibility of play environments can affect the development of children with restricted mobility, and affect their possibilities of a life on a par with that of other children

  • 39.
    Prellwitz, Maria
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Tamm, Maare
    Luleå tekniska universitet.
    How children with restricted mobility perceive their school environment2000In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 7, no 4, p. 165-173Article in journal (Refereed)
    Abstract [en]

    The purpose of this qualitative interview study was to describe how pupils with restricted mobility perceive their school environment with regard to physical-technical and psychological-social accessibility. Ten pupils with restricted mobility in the age range 7-12 years (five boys and five girls) were included in the study. These pupils attended ten different schools (four pupils at junior primary school and six pupils at senior primary school). As an instrument, parts of BAS (assessment of adaptations in school environments), a semistructured interview guide, were used. Content analysis of the interview transcripts was carried out and could be clustered in five main themes: inner environment, outer environment, teaching situation, social contacts with peers, and relations towards personnel. The results showed that even though the interviewed pupils considered that the physical-technical school environment was generally satisfactory, it still led to the pupils being excluded from certain contexts, both teaching and play contexts. Problems with physical accessibility resulted in the pupils losing valuable opportunities for contacts and relations with friends, i.e. shortcomings in the physical environment had social consequences. The psychological-social environment was also generally perceived as being free of problems, with the exception that the interviewed pupils stated that they were sometimes teased because of their disability. The conclusion can be drawn that disability is something that occurs between the individual and his or her physical-technical and psychological-social something that occurs between the individual and his or her physical-technical and psychological-social environments, which to a certain extent can be remedied by making changes to these environments

  • 40.
    Riekkola Carabante, Jenni
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Rutberg, Stina
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Lilja, Margareta
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Spousal caregivers’ experiences of participation in everyday life when living in shifting contexts2019In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 25, no 6, p. 457-465Article in journal (Refereed)
    Abstract [en]

    Background: To promote health and well-being, and to meet the desires of the growing elderly population to age in place, elderly spousal caregivers need adequate support such as respite care services. More knowledge is needed about elderly spousal caregivers’ experiences in relation to participation, which is an aspect of health that remains relatively unexplored for this group.

    Aim: To explore and describe how elderly spousal caregivers experience and discuss participation in everyday life when living in shifting contexts due to the use of respite care.

    Method: A grounded theory approach was used during data generation and analysis, which involved repeated focus group interviews with 12 spousal caregivers.

    Results: Complexity and ambiguity was understood to imbue participation in everyday life. Being in charge of everyday life was challenging for spousal caregivers, and created a need for personal time. Respite care and home care service gave them time, although when interacting with social contexts other issues arose that influenced their own recovery.

    Conclusions: A holistic ‘situation centered’ approach that focuses on the elderly couple’s life story and needs might capture a wider perspective and enable adequate support that influences their health, well-being, and participation in everyday life.

  • 41.
    Schultze, Christina
    et al.
    School of Health Professions, Institute of Occupational Therapy, Research and Development, Zurich University of Applied Sciences.
    Page, Julia
    School of Health Professions, Institute of Occupational Therapy, Research and Development, Zurich University of Applied Sciences.
    Kottorp, Anders
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet.
    Lilja, Margareta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Adapting functional assessments for use in a new context: a balancing act2013In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, no 5, p. 336-342Article in journal (Refereed)
    Abstract [en]

    Objective: It is common practice today to process translations and adaptations of assessments through a committee review in order to render them suitable for use in a new context. The aim of this study was to elaborate issues that arise during the harmonization process in a committee review illustrated by the example of adapting the Pediatric Evaluation Disability Inventory (PEDI) for a German-speaking region of Europe to gain semantic, conceptual, and cultural equivalence of the translated version. Methods: The harmonization process was based on the subtle balancing act of (i) staying close to the original assessment, while adapting the translation to the new context, (ii) making decisions and reaching a consensus, (iii) the group dynamics versus planned course of the review committee. Results: The findings illustrate that achieving equivalence between the original and the target translated assessment was not always unproblematic and the risk of remaining misfitting items was found. The findings also highlight further influencing elements and discuss the challenges researchers face when planning to take on the task of translating and adapting an assessment. Conclusions: Some recommendations for conducting a committee review are formulated.

  • 42.
    Sirkka, Marianne
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Larsson-Lund, Maria
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Zingmark, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Occupational therapists' experiences of improvement work: a journey towards sustainable evidence-based practice2014In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, no 2, p. 90-97Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this qualitative descriptive study was to describe occupational therapists' experiences of participating in long-term improvement work based on the Occupational Therapy Intervention Process Model. Method. Data were collected by focus groups interviewed on two occasions (2006 and 2011). Nineteen occupational therapists participated on each occasion. The data obtained were analysed using a qualitative content analysis. Findings. The long-term improvement work was experienced as a journey towards sustainable and evidence-based occupational therapy practice. The journey, guided by the Occupational Therapy Intervention Process Model, led to increased client-centred and occupation-focused practice. The long journey of change involved three intertwined themes. The first theme describes how the occupational therapists transformed their thoughts and actions on an individual and group level. The second theme describes how they dealt with conflicting feelings and faced the duality of change. The third theme describes a shared professional culture, including confidence, clarity, and inter-professional community. Conclusion: The study shows how the collective use of an occupational therapy model of practice can lead to an integration of evidence-based knowledge that has long-lasting achievements in practice.

  • 43.
    Sirkka, Marianne
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Zingmark, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Larsson-Lund, Maria
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    A process for developing sustainable evidence-based occupational therapy practice2014In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, no 6, p. 429-437Article in journal (Refereed)
    Abstract [en]

    Objective: The purpose of this qualitative descriptive study was to describe how long-term improvement work based on the Occupational Therapy Intervention Process Model (OTIPM) evolved in an occupational therapy unit. Method: Data included written documents related to the improvement work (435 pages in total) from 2001 to 2013 that were analysed using pattern matching. Results: The findings from the analysis of the documents formed three main patterns describing reorientation towards the OTIPM, establishment of the implementation of the OTIPM, and ensuring the sustainability of the implementation. Each pattern contained a number of phases of the improvement work emanating from different reasons and resulting in different long-term achievements. The transformation between the phases was smooth, and several of the phases became starting points for improvement work that continued throughout the years. Conclusion: The findings showed how an occupational therapy model of practice, such as the OTIPM, can guide an improvement process and keep it going over a long period of time, thereby supporting sustainable improvements in practice.

  • 44.
    Sundkvist, Ylva
    et al.
    Piteå River Valley Hospital, Department of Medicine and Rehabilitation.
    Zingmark, Karin
    Department of Health and Medical Care, County Council of Norrbotten.
    Leading from intermediary positions: First-line administrators' experiences of their occupational role and situation2003In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 10, no 1, p. 40-46Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to illuminate how first-line administrators in healthcare organizations perceive their occupational role and situation. Interviews were conducted with eight first-line administrators in healthcare environments (five women and three men). Five were registered nurses, one was an occupational therapist, one a physiotherapist and one had a degree in logopaedics. A semi-structured formula with broad open-ended questions was used for the personal interviews. A qualitative interpretive method was used in the analysis. The analysis resulted in three categories describing the perceived role and situation of being a first-line administrator, namely, "developing strategies to manage the leadership role", "being part of an organizational culture characterized by traditional values", and "treading a fine line and striving to manage the balancing act". The results from this study indicate that there is a need to support this group of leaders with training adjusted to the role and situation of leading from intermediary positions in organizations.

  • 45.
    Tamm, Maare
    Boden University College of Health Sciences.
    Ethical dilemmas encountered by community-based occupational therapists in home care settings1996In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 4, p. 180-187Article in journal (Refereed)
  • 46.
    Tamm, Maare
    Boden University College of Health Sciences.
    Relatives as a help or a hindrance: a grounded theory study seen from the perspective of the occupational therapist1999In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 6, no 1, p. 36-45Article in journal (Refereed)
    Abstract [en]

    Family caregivers are the primary source of support for rehabilitation in the home setting for frail elderly people. The purpose of the study was to gain a deeper understanding of how occupational therapists view the family caregivers and their own role in rehabilitation in the home-care setting. The investigation was carried out as a grounded theory study. Interview transcripts from 18 community-based occupational therapists were analysed according to the constant comparative method for grounded theory described by Glaser & Strauss. Six categories were grounded in the data, forming a model describing how occupational therapists view family caregivers dealing with a demanding situation of existential insecurity (the core category). These six categories formed two higher-order categories-family caregivers as a help or as a hindrance. The role of the occupational therapists in relation to relatives varied, depending on the part played by the relatives themselves, but it was better defined and distinct when relatives acted as a help than when they acted as a hindrance.

  • 47.
    Tamm, Maare
    et al.
    Luleå tekniska universitet.
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    How I play: roles and relations in the play situations of children with restricted mobility2000In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 7, no 4, p. 174-82Article in journal (Refereed)
    Abstract [en]

    The purpose of this grounded theory study was to gain knowledge and understanding of how children with restricted mobility play in different play situations. The group investigated consisted of 10 children with restricted mobility, aged from 6 to 12 years, living in northern Sweden. In this study, the child with restricted mobility is defined as a child unable to move around without the aid of a wheelchair, walking trolley, crutches or other walking device. The children were interviewed about play and were observed in different play situations. The transcribed interviews and observations were analysed according to the constant comparative method of grounded theory described by Glaser and Strauss (1967). The analysis resulted in a model (How I play, core category) describing the child's relations in different play situations, the factors that gave rise to different types of play and the consequences of the play. The different types of play were: (A) play with friends - (a) interactive play and (b) onlooker play; (B) play alone; and (C) play with adults. Most play came to be placed in categories B and C, that is the children played mostly alone or with adults. The results were discussed on the basis of Mead's theory of identity development and Bronfenbrenner's theory of developmental ecology, that is how children's play influences their development when adults are so often present

  • 48.
    Vik, Kjersti
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute.
    Lilja, Margareta
    Nygård, Louise
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute.
    The influence of the environment on participation subsequent to rehabilitation as experienced by elderly people in Norway2007In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 14, no 2, p. 86-95Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to illuminate how the environment may influence participation among elderly people who have undergone community-based rehabilitation in Norway, after an acute illness or accident. Fourteen persons over 65 years of age were selected with the specific intention of gaining a variety of ages, both genders, and people living in different kinds of housing. Three focus groups were established and repeated interviews were held with each group. A constant comparative analysis was used to analyse the data. The main finding was that the participants experienced pressure from their environment to concentrate on performing the most necessary daily activities rather than on participation. Three main encounters with environments seemed to be important for this: encountering people and society, encountering private and formal assistance, and encountering occupation. The support that the participants received from family and friends was more important for their participation than having accessible physical environments. The findings suggest that occupational therapists must consider themselves to be part of a societal environment that can hinder participation.

  • 49.
    Womack, Jennifer L.
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Lilja, Margareta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Care partner dyad strategies to support participation in community mobility2016In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 23, no 3, p. 220-229Article in journal (Refereed)
    Abstract [en]

    Background Factors supporting continued community mobility for older adults warrant attention due to the relationship between mobility, health, and social participation. Although community mobility is typically considered from the perspective of individual functional abilities, care partnerships represent a situation in which maintaining community mobility has implications for the well-being of all members. Aim The aim of this research was to explore and describe strategies used by older adult care partner dyads to support and maintain participation in community mobility. Methods Ethnographic case studies of three care partner dyads were conducted using in-depth interviews, participant observation, photographs, and reciprocal data analysis. An inductive, constant comparative data analysis resulted in thematic descriptions of strategies employed by the care partner dyads. Results Three strategies were identified in collaboration with care partners: (i) Acting in accordance with the values of the relationship, (ii) Finding and using available assistive technology and (iii) Relying on social networks. Conclusion and significance Strategies identified by participants were more relational than procedural in nature, indicating the need for occupational therapists working with care partner dyads to consider historical routines, social connectedness, and needs of the care partnership in addition to functional abilities of the care recipient when addressing community mobility

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