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  • 1.
    Calner, Tommy
    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.
    Michaelson, Peter
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Experiences of physiotherapy treatment of persons with persistent musculoskeletal painManuscript (preprint) (Other academic)
    Abstract [en]

    The aim of this study was to explore and describe experiences of physiotherapy treatment of people with persistent musculoskeletal pain. Eleven participants with persistent musculoskeletal pain from the back, neck, or shoulders were included in the study. Data were collected by interviews using a semi-structured interview guide and were analysed with qualitative content analysis. The analysis resulted in one main category “Towards acceptance and management of pain” which was formulated and built up by the four categories “Establishing and maintaining alliance”, “Being active, taking initiative and facing challenge”, “Appreciating guidance, incentive and a sounding board” and “Acquired knowledge and developed awareness”. The main category and the categories describe how the participants used knowledge, awareness, movements and exercises learned from the physiotherapy treatment to develop strategies to manage pain and the process of acceptance. A trustful alliance with the physiotherapist and a continuous dialogue was important. The participants were actively involved in the process when exercises, activities and other treatment modalities were individualized. This was rewarding but also an effort and a challenge. The physiotherapist’s initiatives and actions were considered important as incentive and support.

  • 2.
    Calner, Tommy
    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.
    Michaelson, Peter
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    “I know what I want but I’m not sure how to get it”: Expectations of physiotherapy treatment of persons with persistent pain2016In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 25, p. e142-e143Article in journal (Refereed)
  • 3.
    Calner, Tommy
    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.
    Michaelson, Peter
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    I know what I want but I’m not sure how to get it: expectations of physiotherapy treatment of persons with persistent pain2017In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, no 3, p. 198-205Article in journal (Refereed)
    Abstract [en]

    Expectations of physiotherapy treatment of patients with persistent pain have been shown to influence treatment outcome and patient satisfaction, yet this is mostly explored and described in retrospective. The aim of the study was to explore and describe the expectations people with persistent pain have prior to physiotherapy treatment. Ten participants with persistent musculoskeletal pain from the back, neck, or shoulders were included in the study. Data were collected by interviews using a semi-structured interview guide and were analyzed with qualitative content analysis. The analysis resulted in one main category: “The multifaceted picture of expectations” and four categories: 1) Standing in the doorway: curious and uncertain; 2) Looking for respect, confirmation and knowledge; 3) Expecting treatment, regular training, and follow up; and 4) Having dreams, being realistic, or feeling resigned. The main category and the categories describe a multifaceted picture of the participants’ expectations, gradually developed and eventually encompassing several aspects: good dialog and communication, the need to be confirmed as individuals, and getting an explanation for the pain. The results also show that the participants expected tailored training with frequent follow-ups and their expectations of outcome ranged from hope of the best possible results to realistic or resigned regarding pain relief and activity levels.

  • 4.
    Calner, Tommy
    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.
    Michaelson, Peter
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation. Luleå University of Technology, Department of Health Sciences, Medical Science.
    Physiotherapy treatment experiences of persons with persistent musculoskeletal pain: A qualitative study2019In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore and describe the physiotherapy treatment experiences of persons with persistent musculoskeletal pain. Eleven participants with persistent musculoskeletal pain in the back, neck, or shoulders were included in the study. Data was collected via semi-structured interviews and were analysed with qualitative content analysis. The analysis resulted in the theme "Towards acceptance and management of pain", comprising four sub-themes: 1) Establishing and maintaining a therapeutic alliance; 2) Being active, taking initiative and facing challenges; 3) Appreciating guidance, incentive and having a sounding board; and 4) Acquired knowledge and new body awareness change behaviours. The theme and sub-themes describe how the participants used increased knowledge, awareness, movements and exercises learned from the physiotherapy treatment to develop strategies for managing pain and the process of acceptance. A trusting relationship and continual dialogue with the physiotherapist was considered to be important. The participants were actively involved in the process as exercises, activities and other treatment modalities were individualized. This was rewarding but also challenging and required effort on their part. The physiotherapist's initiatives and actions were an important incentive and means of support.

  • 5.
    Carabante, Jenni Riekkola
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Rutberg, Stina
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Lilja, Margareta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Spousal caregivers' experiences of participation in everyday life when using respite care2016Conference paper (Refereed)
  • 6.
    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.

  • 7.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Aktivitet: Det sociala nätverkets betydelse för delaktighet i dagliga aktiviteter2009Conference paper (Other (popular science, discussion, etc.))
  • 8.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Aktivitet: Kvinnors upplevelser av förändring i det sociala nätverket efter en ryggmärgsskada2005Conference paper (Other (popular science, discussion, etc.))
  • 9.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Aktivitet: Psykiskt sjukas beskrivning av sina dagliga aktiviteter i hemmiljö2001Conference paper (Other (popular science, discussion, etc.))
  • 10.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Det sociala nätverkets betydelse för delaktighet i dagliga aktiviteter: erfarenheter från kvinnor med ryggmärgsskada och deras män2007Doctoral thesis, comprehensive summary (Other academic)
    Abstract [sv]

    Det övergripande syftet i denna avhandling var att få en fördjupad kunskap om och förståelse för upplevelsen av den sociala miljöns betydelse för delaktighet i dagliga aktiviteter hos kvinnor med ryggmärgsskada och deras män samt om upplevelsen förändrades över tid. För att besvara syftet valdes en kvalitativ forskningsdesign till de fyra studierna. Totalt kom 13 kvinnor, mellan 25 och 65 år, med en ryggmärgsskada att delta i studie I- III. I studie IV, deltog fyra män som var gifta/sambo med någon av kvinnorna i studie I-II. All data samlades in genom intervjuer och minnesanteckningar fördes parallellt. Under intervjuerna ställdes frågor i ett tidsperspektiv för att fånga förändringsprocessen. Olika kvalitativa metoder har använts för analys till studierna. I resultatet från studie I framkom olika förändringar i kvinnornas sociala nätverk. Kvinnorna var i behov av både emotionellt och praktiskt stöd för att vara delaktiga i dagliga aktiviteter. Det var en ny erfarenhet som det tog tid att anpassa sig till. Resultatet visade även att kvinnorna efter skadan kom att ta större ansvar för relationer i nätverket och hur dessa kom att utvecklas. Kvinnorna kom också att förändra sina egna vanor för att bibehålla tidigare roller och relationer med personer i deras nätverk. I studie II framkom att emotionellt och praktiskt stöd skapade upplevelser av trygghet och gemenskap som ledde till att kvinnorna blev motiverade till att delta i dagliga aktiviteter. I ett tidsperspektiv blev det också tydligt att kvinnorna strax efter skadan var i behov av att få stöd, medan de en längre tid efter skadan upplevde det betydelsefullt att stödet var ömsesidigt. Studie III visade på en komplexitet i kvinnornas berättelser om hur de blev bemötta i dagliga aktiviteter och en skillnad mellan hur personer agerade i förhållande till dem och hur kvinnorna själva agerade över tid. Det kan ses som en förklaring till att kvinnornas agerande förändrades från att vara passiva till aktiva i möten med personer i deras nätverk. Studie IV resulterade i en berättelse som inkluderar männens upplevelser och agerande. I berättelsen framkommer att männen gick igenom en dynamisk förändringsprocess och att de tog emot och gav både emotionellt och praktiskt stöd för att hantera deras förändrade livssituation. Sammanfattningsvis visar resultatet att kvinnor med en ryggmärgsskada upplevde påtagliga förändringar i deras sociala nätverk efter skadan, vilket på ett flertal sätt påverkade deras möjligheter till att vara delaktiga i dagliga aktiviteter. För att anpassa sig till denna nya livssituation kom kvinnorna, men även deras män, att successivt utveckla olika strategier i förhållande till deras nätverk. Resultatet visar även på vikten av att inom rehabiliteringen identifiera personer i det sociala nätverket som klienter utvecklat sin relation till och samverkar med i vardagen och integrera dem i rehabiliteringen. Vidare, dessa resultat bygger på kvinnorna och männens berättelser från strax före skadan fram till nutid och genom dessa berättelser kunde den komplexa förändringsprocess de gick igenom fångas

  • 11.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Kvinnors upplevelser av förändring i det sociala nätverket efter en ryggmärgsskada2005Conference paper (Other academic)
  • 12.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Social support motivates participation in occupation2007In: AT-forum och Nordisk kongress för arbetsterapeuter: på Stockholmsmässan 19-20 april 2007, Förbundet Sveriges arbetsterapeuter , 2007, p. 15-Conference paper (Other academic)
  • 13.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Women's perception of changes in the social network after a spinal cord injury2004Conference paper (Other academic)
  • 14.
    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

  • 15.
    Isaksson, Gunilla
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Josefsson, Staffan
    Neurotec Department, Division of Occupational Therapy, Karolinska Institute, Huddinge.
    Lexell, Jan
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    To regain participation in occupations through human encounters: narratives from women with spinal cord injury2007In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 29, no 22, p. 1679-1688Article in journal (Refereed)
    Abstract [en]

    Purpose. To gain an understanding of how women with spinal cord injury (SCI) experienced human encounters in occupations and how these influenced their participation. Method. The data were collected through two or three in-depth interviews with 13 women (age 25 - 61 years) with SCI. Data analysis was carried out by using a paradigmatic analysis of narrative data, followed by an interpretation based on a narrative theory. Results. The results showed a complexity where the women's experiences and acting in human encounters changed over time. In these human encounters the women struggled with conflicts, supported other persons that were insecure and revaluated their apprehension about persons in their social network. These multidimensional human encounters thereby enabled them to regain participation in occupations. Conclusions. This shows that human encounters are important for persons with disabilities so they can restructure their occupational identity and their needs for participation in occupations. The study also showed that the use of narratives as a tool within rehabilitation could lead to an increased understanding of the subjective changes that occur over time for a person with a disability

  • 16.
    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

  • 17.
    Isaksson, Gunilla
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Josephsson, Staffan
    Karolinska institutet, Sektionen för arbetsterapi.
    Lexell, Jan
    Luleå University of Technology, Department of Health Sciences.
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    To regain participation in occupations through human encounters: narratives from women with spinal cord injury2008Conference paper (Other academic)
  • 18.
    Isaksson, Gunilla
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Lexell, Jan
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Social support provides motivation and ability to participate in occupation2007In: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 27, no 1, p. 23-30Article in journal (Refereed)
    Abstract [en]

    In this study, a qualitative perspective of how 13 women (aged 25 to 61 years) with spinal cord injury perceive the importance of social support for their participation in occupation is presented. The data were collected through repeated in-depth interviews and field notes, and the analysis used a grounded theory approach. The women needed both emotional and practical support, which was important in a time perspective and motivated them to participate in occupation. The women needed to receive support soon after the injury, but after a period of time they needed to give and receive support in a reciprocal fashion. Social support is therefore an effective rehabilitation strategy that can motivate people with disabilities to participate in meaningful occupation. The importance of social support for a person's motivation and ability to participate in occupation expands our knowledge of the relationship between individuals, their social environment, and occupation.

  • 19.
    Isaksson, Gunilla
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Lexell, Jan
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Skär, Lisa
    Josephsson, Staffan
    Institutionen Neurotec, Sektionen för arbetsterapi, Karolinska institutet.
    Projekt: Det sociala nätverkets betydelse för delaktighet i dagliga aktiviteter - Erfarenheter från kvinnor med ryggmärgsskada och deras män2010Other (Other (popular science, discussion, etc.))
    Abstract [sv]

    Projektets övergripande syfte  Syftet med detta projekt var att få en fördjupad kunskap om och förståelse för upplevelsen av den sociala miljöns betydelse för delaktighet i dagliga aktiviteter hos kvinnor med en ryggmärgsskada och deras män samt om upplevelsen förändrades över tid.   Kort beskrivning av projektet  Projektet fokuserar på betydelsen av det sociala nätverket och dess relation till aktivitet och hälsa inom rehabilitering och arbetsterapi. Utgångspunkten var att det behövs en ökad kunskap om hur personer med funktionshinder upplever betydelsen av socialt stöd från det sociala nätverket eftersom en framgångsrik rehabilitering förutsätter att en person med funktionshinder upplever socialt stöd från det sociala nätverket. Målgruppen för att belysa detta har i projektet varit kvinnor som drabbats av en ryggmärgsskada, då de ofta får omfattande funktionshinder med förändrade vanor vid aktivitetsutförande samt förändrade relationer i deras sociala nätverk. Vidare för att kunskap om kvinnor med ryggmärgsskada är begränsad. I projektet har även män som var sammanboende med kvinnor med en ryggmärgsskada ingått. Metodologiskt har projektet en kvalitativ inriktning där deltagarna intervjuats om deras upplevelser av det sociala nätverkets betydelse för delaktighet i vardagen från strax före skadan fram till idag. Resultaten visar att över tid utvecklades ett förändrat samspel mellan kvinnorna och deras sociala nätverk som influerade deras delaktighet i dagliga aktiviteter. Resultatet påvisade även betydelsen av berättelser för att fånga dynamiken och komplexiteten i den förändringsprocess som både kvinnorna och männen som var sammanboende med dem gick igenom. Vidare hur klient-centrerad praxis som inkluderar även anhöriga kan utveckla en djupare förståelse för dynamiken och samspelet mellan personen, aktiviteter och socialt samspel.  Detta forskningsprojekt kan därför tillföra arbetsterapeuter, men även annan personal inom rehabilitering, en ökad kunskap om den sociala miljöns betydelse för utförandet av aktiviteter i det dagliga livet. 

  • 20.
    Isaksson, Gunilla
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Lilja, Margareta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Carabante, Jenni Riekkola
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Womack, Jennifer L.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Challenges in occupational therapy when providing home-based rehabilitation for senior citizens2016In: 1st CONTEC-ENOTHE Congress: National University of Ireland, Galway 15-19 June 2016, 2016, p. 325-Conference paper (Refereed)
  • 21.
    Isaksson, Gunilla
    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.
    En kvinnas berättelse om sitt vardagliga liv efter en ryggmärgsskada2011Conference paper (Other academic)
  • 22.
    Isaksson, Gunilla
    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.
    One woman's story about her everyday life after a spinal cord injury2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 16, p. 1376-1386Article in journal (Refereed)
    Abstract [en]

    Purpose. The aim was to describe and offer an explanation for how one woman viewed her everyday life after a spinal cord injury (SCI). Method. Data were collected by conducting three interviews with one woman with a SCI. Open-ended questions were used with the intention of capturing the woman's own story. The narrative approach inspired by Polkinghorne was used to describe the woman's experiences of her everyday life after the SCI. Results. The analysis revealed that, events influenced her everyday life after a SCI and these events influenced her identity, habits and participation in activities. Further, how she has gone from a state of hopelessness in the early days to a reconstructed identity, associated with a new insight during the 2 years after the accident through a complex and dynamic process of change. In our interpretation we have attempted to provide an explanation of why this outcome came about. Conclusions. When using narratives, professionals within health-care could focus on the individual instead of the diagnosis or disability. Further, according to a client-centred perspective it is important to attain the client's experiences and knowledge to gain a more complete picture in order to obtain a profound understanding of the client.

  • 23.
    Isaksson, Gunilla
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Social support provides motivation and ability to participate in occupation2008Conference paper (Other academic)
  • 24.
    Isaksson, Gunilla
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Lexell, Jan
    Women's perception of changes in the social network after a spinal cord injury2005In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 27, no 17, p. 1013-1021Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To describe how women with a spinal cord injury (SCI) perceived changes in the social network, and how these changes affected their ability to participate in occupation. METHOD: Thirteen women, aged 25 to 61 years, with a SCI were interviewed twice. The interviews focused on their ability to participate in occupation, their relations with individuals within the social network, and changes in the social network following the SCI. The analysis was carried out using qualitative content analysis. RESULTS: The women described an emotional need for social support after the SCI to participate in occupation. This was a new experience that required time to adapt to. The women also described a need for practical social support from the social network members to manage meaningful occupation. After the SCI, the women had developed new habits through close cooperation with members in the social network. The women felt that they had become more responsible for the development of their relations. Many relations had improved after the SCI, while some had decreased. The women had also developed new relations with other persons with disabilities. CONCLUSIONS: The women perceived substantial changes in the social network following the SCI, which in several ways affected their ability to participate in occupation. To adapt to their new life situation, the women gradually developed different strategies. The results point out the need to identify persons in the social network that women with SCI develop relations with, and integrate them in the rehabilitation process.

  • 25.
    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

  • 26.
    Lindström, Maria
    et al.
    Department of Social Welfare, Adults, Division of Support and Development, Local Authority Senior Medicine Advisor, Umeå Municipality.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Personalized Occupational Transformations: Narratives from Two Occupational Therapists’ Experiences with Complex Therapeutic Processes2017In: Occupational Therapy in Mental Health, ISSN 0164-212X, E-ISSN 1541-3101, Vol. 33, no 1, p. 15-30Article in journal (Refereed)
    Abstract [en]

    Recovery and occupation-centered practices with persons with severe psychiatric disabilities involve many dynamic issues and processes. This study aimed to develop an understanding of how the therapeutic process unfolds in occupational therapy among persons with severe psychiatric disabilities living in sheltered or supported housing. Repeated interviews were conducted with two occupational therapists working in sheltered and supported housing facilities. Narrative analysis was used to analyze their stories. The findings reveal “personalized occupational transformations” describing significant events of interaction establishing therapeutic processes to promote personal agency and social recovery while targeting meaningful activities based on each resident’s wishes

  • 27.
    Lundström, Ulrica
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Lilja, Margareta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gray, David
    Disability and Community Participation Research Office (DACPRO), Washington University School of Medicine.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Experiences of participation in everyday occupations among persons aging with a tetraplegia2015In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 11, p. 951-957Article in journal (Refereed)
    Abstract [en]

    This study aimed to gain understanding of participation in everyday occupations through life stories of persons aging with a traumatic spinal cord injury (SCI). Method: A narrative method was used for data collection and a paradigmatic analysis was used to analyze data. Results: The analysis resulted in three themes that illustrate how the participants acted to participate in everyday occupations, how that changed over time, and some concerns about their future. The first theme illustrates how participants following SCI acted to become agents of their lives and participate in everyday occupations. The second theme illustrates how participants had to prioritize participation in meaningful occupations due to personal and environmental factors. The third theme shows how they had to try new strategies to continue participation in occupations, due to secondary health complications related to aging. Conclusions: This study captures how persons aging with tetraplegia acted to participate in everyday occupations from soon after the injury until several decades later. In addition, their ability to act and participate changed over time. Our findings provide knowledge that can guide clinicians in their work within this complex area of rehabilitation. Besides, it can also guide the work with policy recommendations for healthcare and social service systems.Implications for Rehabilitation

  • 28.
    Lundström, Ulrica
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab. Department of Health Sciences, Lunds University.
    Lilja, Margareta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    "To Work Just Like Anyone Else": a narrative from a man aging with spinal cord injury2017In: Healthcare, E-ISSN 2227-9032, Vol. 5, no 4, article id 87Article in journal (Refereed)
    Abstract [en]

    People aging with spinal cord injury (SCI) develop medical problems commonly associated with the aging process at a younger age than the general population. However, research about how the life story changes and how meaning will be experienced in occupations is lacking. The aim was to describe and offer an explanation of how a man experienced meaning in everyday occupations while aging with an SCI. Four narrative interviews were performed over a four-year period, with a man in his fifties, who lived with SCI for 39 years. The narrative analysis generated an overall plot, named "To Work Just Like Anyone Else," and gives a picture of his experiences, thoughts, and reflections about meaning in occupations, from when he became injured to the present, and in relation to his future. His life story is characterized by secondary health complications, and his experiences of negotiating with the aging body and making choices to continue working. Further, how occupational risk factors, e.g., imbalance, alienation, and deprivation, occur as a result of lack of rehabilitation and support from social systems is addressed. Future research should explore how rehabilitation and social systems can support people aging with SCI to experience meaning in everyday occupations and to have balance in everyday life.

  • 29.
    Lundström, Ulrica
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Lilja, Margareta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Petersson, Ingela
    Sektionen för arbetsterapi/Institutionen NVS/Karolinska institutet.
    Lexell, Jan
    Institutionen för Hälsovetenskap, Lunds universitet/Avdelningen för rehabiliteringsmedicin, Lunds Universitetssjukhus.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Leisure repertoire among persons with a spinal cord injury: Interests, performance, and well-being2014In: Journal of Spinal Cord Medicine (JSCM), ISSN 1079-0268, E-ISSN 2045-7723, Vol. 37, no 2, p. 186-192Article in journal (Refereed)
    Abstract [en]

    Objective: To explore and describe the leisure repertoire of persons with traumatic spinal cord injury (SCI) and how the repertoire is related to interest, performance, and well-being.Design: Cross-sectional study.Setting: A total of 97 persons with traumatic SCI were recruited from the non-profit national organization, RG Active Rehabilitation in Sweden.Outcome measure: Data were collected through a two-part postal survey. The first comprised of questions investigating socio-demographic variables and injury characteristics; the second part included an interest checklist with 20 areas of leisure activities.Results: The participants were mostly interested in, performed, and experienced well-being from social and culture activities and TV/DVD/movies. The areas of leisure activities in which they had most likely experienced changes after the SCI were outdoor activities, exercise, and gardening. Gender, age, and to some extent, time since injury were related to interest, performance, well-being, and changed performance.Conclusions: The results provided an explanation and limited description of a changed leisure repertoire among persons after a traumatic SCI. The study showed that gender, age, and time since injury were more closely related to the choice of leisure activities to include in the leisure repertoire than the level of injury. This knowledge can be of importance when professionals in the field of rehabilitation are planning and implementing interventions concerning leisure activities for persons with SCI.

  • 30.
    Lundström, Ulrica
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Wahman, K.
    Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Seiger, Å.
    Division of Neurodegeneration, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Grey, DB
    Disability and Community Participation Research Office (DACPRO), Department of Neurology, Washington University School of Medicine, St Louis, MO.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Lilja, Margareta
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Participation in activities and secondary health complications among persons aging with traumatic spinal cord injury2017In: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 55, no 4, p. 367-372Article in journal (Refereed)
    Abstract [en]

    STUDY DESIGN:

    Cross-sectional study.

    OBJECTIVES:

    To describe participation in activities and explore the relationship with secondary complications among persons aging with a traumatic spinal cord injury (SCI).

    SETTING:

    A regional SCI outpatient center in Sweden.

    METHODS:

    Data were collected through a phone survey, which included 10 activities from the instrument PARTS/M-v3 (PARTicipation Survey/Mobility version-3) together with data from the participants' medical records. Cross-tabulation and χ2 were used for data analysis.

    RESULTS:

    In this study, 121 persons matched the inclusion criteria and the final study sample comprised 73 participants (60% response rate): 55 men and 18 women. Mean age was 63.7±9.4 years, and mean time since injury was 36.3±9.2 years. Regardless of duration of SCI, all 73 participated in dressing, bathing and leisure activities. Women reported better health than men. Particularly for those who lived 36-55 years after injury; increasing pain, fatigue, spasticity and decreased muscle strength were negatively affecting participation in activities, especially exercise and active recreation. Additionally, a need to save strength/energy was also a reason for not participating in the activities. Perceived future support and concerns in relation to personal assistance, assistive devices and rehabilitation was also reported.

    CONCLUSION:

    Increasing secondary health complications and a need to save strength/energy influenced participation in activities. Laws and/or governmental policies regarding personal assistance and assistive devices did not always support participation in activities. Interventions should aim to create a balance among activities in everyday life

  • 31.
    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.
    The Internet: an Entrance to Togetherness or a Risk of Segregation Among Older Adults?2016Conference paper (Refereed)
  • 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.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Josephsson, Staffan
    Karolinska Institutet.
    Delaktighet i dagliga aktiviteter genom sociala interaktioner2011Conference paper (Other academic)
  • 34.
    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.
    Josephsson, Staffan
    Karolinska Institutet.
    Alsaker, Sissel
    Norwegian University of Science and Technology.
    Lindström, Maria
    Umeå Universitet.
    Aldrich, Rebecca
    University of southern California.
    Rethinking occupation in research and clinical practice: Joining people, places and meaning2012Conference paper (Refereed)
    Abstract [en]

    Josephsson S, Alsaker S, Isaksson G, Lindström M, Aldrich R, Nyman A. Rethinking occupation in research and clinical practice: Joining people, places and meaning. Discussion Forum at Conference: SSO: USA; Society for the Study of occupation: USA, October 2012.

    Recent developments in occupational science conceptualize occupation and its relation to place in terms of dynamic processes rather than components and structures. It could be phrased as a move from what occupation is to how it works. There has been a simultaneous trend of challenging the view of occupation as residing within individuals. Combining these two developments, occupation may now be conceptualized as emerging from situations that encompass transactions of person, culture, environment, and more. The aim of this panel is to reflect and discuss the consequence of this shift for occupation-based research and practice. Based on the included papers we will argue for the need of a less individual and static conceptualization of occupation and we will consider possible ways on how such shift of conceptualization can be achieved. The panel will include five papers: Sissel Alsaker will present research on enacted meaning using a narrative– in – action approach among women in Norway with chronic rheumatic condition. She will argue for how narrative – in – action might be an analytic resource to access occupation as ongoing processes rather than in terms of static characteristics. Maria Lindström will discuss based on her intervention research on persons with persistent mental illness, showing how the lack of a social conceptualization of occupation can decrease the visibility of certain research results. Gunilla Isaksson will base her reasoning on a narrative study on how men living with women with spinal cord injury experienced and acted in the complex process of change they went through after the women’s injury and how support was acted among them and their social network. Rebecca Aldrich will discuss the relationship of process and occupation’s social nature, as exemplified by data on routines from ethnographic research on North Carolinian discouraged workers. Finally, Anneli Nyman will demonstrate drawing from an ongoing study on social processes of participation among elderly women with depression and using narrative analysis on interview data, how enacted togetherness can be a resource for occupation-based practice with persons under such conditions. References: Aldrich, R. & Dickie, V. (In press): “It’s hard to plan your day when you have no money”: Discouraged workers’ occupational possibilities and the need to reconceptualize routine. Work, A Journal of Prevention, Assessment, and Rehabilitation. Alsaker, S. & Josephsson, S. (2010) Occupation and meaning: Narrative in everyday activities of women with chronic rheumatic conditions. OTJR – Occupation, Participation and Health, 30(2), 58-67). Lindström, M (2011) Promoting agency among people with severe psychiatric disability: occupation-oriented interventions in home and community settings. (Doctoral dissertation). Umeå University Key words: occupation; social; process; unit of analyses Discussion: -Why is it important for occupational science research to rethink how we conceptualize occupation? -What can a contextual, process-oriented and multifaceted conceptualization of occupation mean in occupational science research as well as clinical practice? -What are the consequences of such conceptualizations for how we measure and assess outcomes in research as well as in practice?

  • 35.
    Nyman, Anneli
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Josephsson, Staffan
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    A Narrative of Agency Enacted within the Everyday Occupations of an Older Swedish Woman2014In: Journal of Occupational Science, ISSN 1442-7591, E-ISSN 2158-1576, Vol. 21, no 4, p. 459-472Article in journal (Refereed)
    Abstract [en]

    This article explores how agency is enacted in everyday occupations with others and evolves over time. Agency is a complex concept that is closely linked to human occupation. By using a transactional perspective and a narrative approach, our ambition was to explore agency beyond individual acts or responsibilities. To achieve this, we used a story of an older woman in the context of being widowed and living with late-life depression. Data were generated over time using interviews and by taking part in the participant's everyday occupations. Narrative analysis was used to create a contextualized in-depth story. The findings show how resources embedded in enacted stories can challenge one's view of oneself as a victim and create possibilities to be an agent, thereby illustrating how agency becomes enacted in the context of acting together in everyday occupations. In light of these findings, we reflect on how a transactional perspective can contribute to exploring the concept of agency as contextually situated and embedded in occupations. Further, we reflect on how the transactional dimensions of everyday occupations can be explored through a narrative approach.

  • 36.
    Nyman, Anneli
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Josephsson, Staffan
    Karolinska Institutet.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Being part of an enacted togetherness: narratives of elderly people with depression2012In: Journal of Aging Studies, ISSN 0890-4065, E-ISSN 1879-193X, Vol. 26, no 4, p. 410-418Article in journal (Refereed)
    Abstract [en]

    In this article, we explored how five elderly persons with depression engaged in everyday activities with others, over time, and how this was related to their experience of meaning. Repeated interviews and participant observations generated data that was analysed using a narrative approach. Analysis identified togetherness as an acted relation, “enacted togetherness”, emphasising how the act of doing everyday activities with someone created togetherness and belonging, and being part of an enacted togetherness seemed to be a way for the participants to negotiate and construct meaning. Opportunities for doing things together with someone were closely associated to the place where the participants lived. Furthermore, engagement in activities together with others created hope and expectations of future acting. Findings from this research can extend our understanding of how participating in everyday activities is experienced as a social process including change over time, presenting the perspective of elderly people themselves. In light of these findings, we highlight the need to consider how opportunities to become part of an enacted togetherness can be created. Also, we aspire to contribute to the debate on how to understand the complexity related to social aspects of ageing and add to the emerging understanding of everyday activities as transactional, incorporating people and the environment in a dynamic process that goes beyond the individual.

  • 37.
    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.

  • 38.
    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.

  • 39.
    Riekkola, 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.
    Healthcare professionals’ perspective on how to promote older couples’ participation in everyday life when using respite care2019In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, no 2, p. 427-435Article in journal (Refereed)
    Abstract [en]

    Aims

    The aim is to describe healthcare professionals’ perspectives on how they understand and promote older couples’ participation in everyday life when using residential respite care.

    Design and Methods

    Eighteen healthcare professionals with varying degrees of competence and from one residential respite care facility participated in four focus group interviews. Data were analysed through qualitative latent content analysis.

    Findings

    The findings revealed a broad, multifaceted view of participation and ways in which participation in everyday life is promoted by these professionals. Trustworthy relationships between professionals, spousal caregivers and clients were implicated. Promoting participation also necessitated that clients have access to meaningful activities. In addition, participation entailed an environment that supported various needs.

    Conclusion

    Promoting participation for older couples that are using respite care involves multifaceted perspectives that consider social–relational aspects including both the client and their spouse. Furthermore, attention is needed to the meaning a change of context between home and the respite care facility has on relationships, environments and activities in everyday life. Such an approach could benefit the couples’ shared everyday life situation and in a wider perspective, also influence their health and well‐being when ageing in place together.

  • 40.
    Riekkola, 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.
    Strategies of older couples to sustain togetherness2019In: Journal of Aging Studies, ISSN 0890-4065, E-ISSN 1879-193X, Vol. 48, p. 60-66Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore how elderly couples, who are in need of social services in the community, act and reason over time regarding their everyday togetherness. Data were generated through repeated interviews and participant observations with three older couples. A narrative method was used for data generation and analysis. The findings present four parallel narratives illustrating how the couples, over time, strove to continue living their lives in togetherness despite the many challenges that had emerged. These narratives show the complexity and variety of strategies that the couples adopted to handle different situations of everyday life and the couples’ experiences and feelings connected to these situations. The strategies that the couples used resulted, for example, in performing more activities together in another way, using respite care and reorganizing their social interactions. The spousal caregiver had a leading role to manage day-to-day life and to initiate and perform the strategies. Simultaneously, an important reciprocity existed in their relationship that gave meaning to their efforts of sustaining togetherness. These findings give a deeper understanding of the complexity of their situation and of how meaning is created in their everyday life through enacted togetherness. The findings highlight the need for professionals within social services in the community to embrace a couple's whole situation, involving both partners. 

  • 41.
    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

  • 42.
    Womack, Jennifer L.
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation. The University of North Carolina at Chapel Hill, USA.
    Lilja, Margareta
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Dickie, Virginia
    The University of North Carolina at Chapel Hill, USA.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Occupational Therapists’ Interactions With Older Adult Caregivers: Negotiating Priorities and Expertise2019In: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 39, no 1, p. 48-55Article in journal (Refereed)
    Abstract [en]

    Although numerous studies have examined provider–caregiver interactions and their influence on care outcomes, few represent the perspective of the provider or specifically consider occupational therapy practitioners. The aim of this article is to explore the perspectives of occupational therapists regarding interactions with older adult caregivers in geriatric practice settings. The study was conducted using a constructivist grounded theory approach based on data obtained from repeated focus group sessions and subsequent individual reflections. Occupational therapy practitioners interact with older adult caregivers in ways that reflect negotiations about who holds expertise and whose priorities are most relevant in care situations. These interactions are influenced by health care contexts that foreground the needs of the care recipient. A deeper understanding of caregiving as an occupation via a transactional perspective may serve to illuminate complex care situations and optimize therapist–caregiver interactions.

  • 43.
    Womack, Jennifer L.
    et al.
    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.
    Crossing a Line: A narrative of risk-taking by older women serving as caregivers2017In: Journal of Aging Studies, ISSN 0890-4065, E-ISSN 1879-193X, Vol. 41, p. 60-66Article in journal (Refereed)
    Abstract [en]

    Background

    Caregiving carried out by adults for other adults is increasing around the world as the demographics of many industrialized countries shift toward an older population with escalating care needs toward the end of life. Although much has been written about caregiving, few studies document the experiences of providing care as narrated by the caregivers.

    Aim

    To explore the everyday experiences of older adults serving as primary informal caregivers to significant others.

    Methods

    A process of narrative inquiry was used via repeated interviews with three older women caregivers providing care to family members or friends. The data were analyzed using storyboarding techniques and identifying critical turning points, culminating in a poetic transcription of the resulting narrative.

    Results

    These caregivers describe a tension that exists across their experiences and communication with authorities on whom they rely for guidance and collaboration. Situations in which this tension pushes the caregivers to act in ways that represent risk to themselves or their care recipients are central to the collective narrative.

    Conclusion and significance

    The everyday experiences of older adult caregivers include not only familiar care routines, but also advocacy on behalf of care recipients and negotiations with external authorities, resulting at times in unwelcome risk-taking. Their narrative warrants attention due to the lack of power described by caregivers when acting on behalf of their care recipients and the need for those in authority to recognize their dilemma.

1 - 43 of 43
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