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  • 1.
    Skjaerven, Liv Helvik
    et al.
    Department Health and Function, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway;.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation. Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden.
    Gómez-Conesa, Antonia
    Murcia University Research Group in Physiotherapy and Health Promotion, Regional Campus of International Excellence “Campus Mare Nostrum”, Murcia, Spain.
    Catalan-Matamoros, Daniel
    Department of Journalism and Communication, University Carlos III of Madrid, Madrid, Spain. Research Group of Health Sciences CTS-451, University of Almeria, Almeria, Spain.
    A vocabulary describing health-terms of movement quality: a phenomenological study of movement communication2019In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of the study was to develop a vocabulary targeting communication of health-terms ofmovement quality, establishing professional knowledge of a movement terminology usefull withinrehabilitation.

    Methods: A phenomenological study design was chosen, inviting movement experts working inrehabilitation to describe movement observations when a change into more functional, health relatedways of moving appeared in the rehabilitation processes. 15 physiotherapy experts were recruited,five from the field of neurology, primary health care and psychiatry. The informants had between12-38 years of clinical practice, treating patients of all ages with a wide specter of diagnoses. Datacollection followed a qualitative study design, of individual, in-depth interviews, based on a semi-structured interview guide. The interviews were taped, transcribed and sent to the informants forvalidation. Data analysis followed recommendation of Giorgi, modified by Malterud. Ethical considera-tions were followed.

    Results: Data revealed a vocabulary, clustered in five themes, Biomechanical, Physiological, Psycho-socio-cultural, Existential and Overarching perspective, 16 underlying categories and 122 descriptive health-terms of movement quality.

    Conclusion: The study demonstrated a multi-perspective movement vocabulary of 122 health characteris-tic terms, developed to facilitate movement communication within the broad field of rehabilitation. Theresult calls for further research concerning a movement vocabulary.

  • 2.
    Gard, Gunvor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation. Lund University, Lund, Sweden.
    Nyboe, L.
    Aarhus University Hospital, Risskov, Denmark.
    Gyllensten, A.L.
    Lund University, Lund, Sweden.
    Clinical reasoning and clinical use of basic body awareness therapy in physiotherapy: a qualitative study?2019In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177Article in journal (Refereed)
    Abstract [en]

    Background: Clinical reasoning is the ability to integrate and apply different types of knowledge, weigh evidence critically and reflect upon the process to arrive at a diagnosis. Body awareness is an approach directed toward an awareness of how the body is used in terms of body function, behaviour, and interaction with self and others. Methods: In the present study, 36 physiotherapists (PTs) from 13 countries working with body awareness methods, mainly Basic Body Awareness Therapy (BBAT) in mental health were interviewed in six focus groups. Content analysis was used to analyse how the informants’ reasoned around the concept of body awareness therapy, and how they use it in their clinical work with patients. Result: Body awareness was conceived as being in contact with sensations and emotions, to be able to control symptoms, such as pain, to find a balance and to develop one’s identity by relating to oneself and others. BBAT was used as a whole body treatment, to promote balance and stability, to teach about body, movements, and coping strategies, to interact in a therapeutic approach and to be integrated with other methods and professionals. Conclusion: The present results can be used to improve the PTs clinical reasoning.

  • 3.
    Lundvik Gyllensten, Amanda
    et al.
    Department of Health Sciences, Research Group Physiotherapy, Lund University, Lund, Sweden.
    Nyboe Jacobsen, Lene
    Research unit for PTSD, Section for depression and anxiety, Aarhus University Hospital, Risskov, Denmark.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation. Department of Health Sciences, Research Group Physiotherapy, Lund University, Lund, Sweden.
    Clinician perspectives of Basic Body Awareness Therapy (BBAT) in mental health physical therapy: An international qualitative study2019In: Journal of Bodywork & Movement Therapies, ISSN 1360-8592, E-ISSN 1532-9283Article in journal (Refereed)
    Abstract [en]

    Introduction

    Body awareness is a movement therapy used in Physical Therapy in Mental Health especially in Scandinavia. The method Basic Body Awareness Therapy has been scientifically investigated in particular for patients with Depression, Schizophrenia and Post Traumatic Stress Syndrome (PTSD).

    Methods

    Thirty-four Physical Therapists from 13 countries working with the Basic Body Awareness Therapy method in Mental Health Care were interviewed in six focus groups about what effects they have experienced in their work with patients. The Physical Therapists worked within the whole Mental Health spectra. Content analysis was used to analyze the informants’ experiences of the clinical effects of body awareness.

    Results

    Five categories emerged: To be in contact, Refocus and coping, Sense of Self, Relations to others and Daily life activities. The results are discussed in relation to previous research, existing theories of body awareness and cognitive neuroscience and findings of experimental psychology.

    Conclusion

    The informants experienced that Basic Body Awareness Therapy worked mainly by helping the patients to be in better contact with their “bodily self.” Stability, balance, improved grounding and the ability to relax were understood as the basis to establish an improved sense of self and leading to improved acceptance of oneself and one’s ability to relate to others.

  • 4.
    Skjærven, Liv H.
    et al.
    Department of Occupational Therapy, Physiotherapy and Radiography , Western Norway University of Applied Sciences, Campus Kronstad, Bergen, Norway.
    Mattsson, M.
    Department of Clinical Sciences, Division of Psychiatry , Umeå University, Umeå, Sweden.
    Catalan-Matamoros, D.
    Department of Nursing, Physiotherapy and Medicine, University of Almeria; Faculty of Humanities, Communication and Documentation, University Carlos III of Madrid, Spain.
    Parker, A.
    Physiotherapy Department, Royal Edinburgh Hospital.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation. Department of Health Sciences, Lund University, Lund, Sweden.
    Gyllensten, Al
    Department of Health Sciences, Lund University, Lund, Sweden.
    Consensus on core phenomena and statements describing Basic Body Awareness Therapy within the movement awareness domain in physiotherapy2019In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 35, no 1, p. 80-93Article in journal (Refereed)
    Abstract [en]

    Physiotherapists are facing complex health challenges in the treatment of persons suffering from long-lasting musculoskeletal disorders and mental health problems. Basic Body Awareness Therapy (BBAT) is a physiotherapy approach within the movement awareness domain developed to bridge physical, mental, and relational health challenges. The purpose of this study was to reach a consensus on core phenomena and statements describing BBAT. A consensus-building process was conducted using the nominal group technique (NGT). Twenty-one BBAT experts from 10 European countries participated in a concentrated weekend workshop of 20 hours. All participants signed informed consent. Participants reached a consensus on 138 core phenomena, clustered in three overarching categories: clinical core, historical roots, and research and evaluation phenomena. Of the 106 clinical core phenomena, the participants agreed on three categories of phenomena: movement quality, movement awareness practice, and movement awareness therapy and pedagogy. Furthermore, the participants reached 100 percent consensus on 16 of 30 statements describing BBAT. This study provides a consensus on core phenomena and statements describing BBAT. The data reveal phenomena implemented when promoting movement quality through movement awareness. Data provide clarity in some aspects of the vocabulary as fundamental theory. Further reearch will be developed.

  • 5.
    Larsson, Agneta
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Berggård, Glenn
    Luleå University of Technology, Department of Civil, Environmental and Natural Resources Engineering, Architecture and Water.
    Rosander, Peter
    Luleå University of Technology, Department of Civil, Environmental and Natural Resources Engineering, Architecture and Water.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Gait speed with anti-slip devices on icy pedestrian crossings relate to perceived fall-risk and balance2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 14, article id 2451Article in journal (Refereed)
    Abstract [en]

    It is important to find criteria for preventive measures and appropriate assistive devices to reduce pedestrian injuries and increase walking in winter. Reducing the rate of falls on icy surfaces and improving people’s ability to safely cross a street in winter conditions by achieving an adequate walking speed, for example, need to be considered. This study explores pedestrian perceptions of fall risk, balance, and footfall transitions while using different designs for anti-slip devices on ice and snow-covered ice and relates these to measures of gait speed and friction. Trials were performed with nine pedestrians testing 19 anti-slip devices on ice and ice covered with snow. Laboratory tests of the dynamic coefficient of friction (DCOF) on plain ice were also performed. The findings suggest that there was conformity in the participants’ perceptions of good balance and low fall risk for one-fifth of the devices (three whole-foot designs and one design with built-in spikes). We also found that gait speed on icy pedestrian crossings is related to perceived fall-risk and balance control, but not to DCOF of the anti-slip devices.

  • 6.
    Lindgren, Ingrid
    et al.
    Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund; Physiotherapy Research Group, Department of Health Sciences, Lund University, Lund.
    Brogårdh, Christina
    Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund; Physiotherapy Research Group, Department of Health Sciences, Lund University, Lund.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Pain management strategies among persons with long-term shoulder pain after stroke: a qualitative study2019In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 33, no 2, p. 357-364Article in journal (Refereed)
    Abstract [en]

    Objective: To explore strategies that persons with persistent shoulder pain after stroke use to manage their pain in daily life. Design: A qualitative study using semi-structured face-to-face interviews, analysed by content analysis. Setting: A university hospital. Subjects: Thirteen community-dwelling persons (six women; median age: 65 years; range 57-77) with shoulder pain after stroke were interviewed median two years after the pain onset. Results: An overall theme 'Managing shoulder pain by adopting various practical and cognitive strategies' emerged from the analysis. Three categories were identified: (1) practical modifications to solve daily life problems; (2) changed movement patterns and specific actions to mitigate the pain, by non-painful movements, avoidance of pain-provoking activities and various pain distracting activities and (3) learned how to deal with the pain mentally. Several strategies were used simultaneously and they were experienced successful to various degrees. Conclusion: The findings in the present study indicate that persons with persistent shoulder pain after stroke use both practical and cognitive strategies to manage their pain.

  • 7.
    Lundvik Gyllensten, Amanda
    et al.
    Department of of Physical therapy, Lund University .
    Gard, Gunvor
    Best Practice: Basic Body Awareness Therapy – Evidence and Experiences2018In: Physiotherapy in mental health and psychiatry: a scientific and clinical based approach / [ed] edited by Michel Probst, Liv Helvik Skjaerven, Edinburgh: Elsevier, 2018, p. 151-160Chapter in book (Refereed)
  • 8. Gard, Gunvor
    et al.
    Skjaerven, Liv H.
    Department of Occupational therapy, Physiotherapy and Radiography, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen.
    From a biomedical to more psychosocial models in physiotherapy in mental health2018In: Physiotherapy in mental health and psychiatry: a scientific and clinical based approach / [ed] edited by Michel Probst, Liv Helvik Skjaerven, Edinburgh: Elsevier, 2018, p. 14-17Chapter in book (Refereed)
  • 9. Gard, Gunvor
    et al.
    Lundvik Gyllensten, Amanda
    Department of of Physical therapy, Lund University .
    Musculoskeletal pain: Evidence and critical factors in rehabilitation relevant for physiotherapy in mental health. In Physiotherapy n Mental Health and Psychiatry – a scientific and clinical based approach2018In: Physiotherapy in mental health and psychiatry: a scientific and clinical based approach / [ed] edited by Michel Probst, Liv Helvik Skjaerven, Edinburgh: Elsevier, 2018, p. 134-140Chapter in book (Refereed)
  • 10.
    Gard, Gunvor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Berggård, Glenn
    Luleå University of Technology, Department of Civil, Environmental and Natural Resources Engineering, Architecture and Water.
    Rosander, Peter
    Luleå University of Technology, Department of Civil, Environmental and Natural Resources Engineering, Architecture and Water.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Pedestrians perceptions of community walking with anti-slip devices: an explorative case study2018In: Journal of Transport and Health, ISSN 2214-1405, E-ISSN 2214-1405, Vol. 11, p. 202-208Article in journal (Refereed)
    Abstract [en]

    The risk of falls on slippery surfaces during wintertime is a public safety problem in the Nordic region in the Arctic. The aim of this case study was to explore pedestrians perceptions of walking safety, balance, slipping risk, priority for own use and subjective criteria for a well functioning anti-slip device. An experimental set-up was utilised in which nine pedestrians tested 19 anti-slip devices by simulating walking in realistic traffic situations on four different surfaces. The pedestrians favoured devices with a high number of friction points, distributed under the whole sole (in-built) or forefoot (sandpaper). Also, a whole-foot device with a high number of spikes received high ratings in all aspects measured except in balance enabling properties. Identified subjective criteria were safe foothold, comfort, enabling a normal gait, stability, silence, and predictability. The results indicate that both anti-slip properties and balance enabling properties of the device need to be considered for safe community walking

  • 11.
    Skjaerven, Liv H.
    et al.
    Department of Occupational therapy, Physiotherapy and Radiography, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen.
    Gard, Gunvor
    Perspectives on human movement, the phenomenon of movement quality and how to promote movement quality  through movement awareness as physiotherapy in mental health2018In: Physiotherapy in mental health and psychiatry: a scientific and clinical based approach / [ed] edited by Michel Probst, Liv Helvik Skjaerven, Edinburgh: Elsevier, 2018, p. 23-31Chapter in book (Refereed)
  • 12.
    Sviridova, Olga
    et al.
    Luleå University of Technology.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Michaelson, Peter
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Predictors for return to work after multimodal rehabilitation in persons with persistent musculoskeletal pain2018In: Edorium Journal of Disability and Rehabilitation, ISSN 2456-8392, Vol. 4, no 1, article id 100038D05SO2018Article in journal (Refereed)
    Abstract [en]

    Aims: To identify factors explaining return to work (RTW) 12 months after a multimodal rehabilitation (MMR) intervention in the REHSAM II project.

    Methods: The present study is a secondary assessment of the data from the randomized controlled trial REHSAM II. A total of 97 participants with persistent musculoskeletal pain were randomly allocated to MMR + web-based education or only MMR. The subjects were followed from baseline to 12 months. The baseline variables from the outcome measures were used to identify predictors. The associations between the dependent variable (i.e., RTW) and independent variables (i.e., baseline variables) were analyzed with univariate and multiple logistic regression models.

    Results: The univariate regression analyses showed that pain and disability level, the capacity to perform a task in relation to pain, hospital and psychiatric care, medication for insomnia, catastrophizing, self-assessed work ability compared with lifetime best, satisfaction with life, ability for coping and controlling work situation, ability for coping with life outside work, and sense of responsibility for managing health condition were significantly associated with RTW. In the final multiple regression model, RTW was predicted by the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ score) (p=0.003, OR=0.961) and EuroQol (EQ-5D index) (p=0.017, OR=7.283)

  • 13.
    Lindgren, Ingrid
    et al.
    Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation. Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund.
    Brogårdh, Christina
    Lund University Hospital, Skåne University Hospital, Lund, Institutionen för hälsa, vård och samhälle, Lunds universitet, Department of Health Sciences, Lund University, Department of Rehabilitation Medicine, Skåne University Hospital.
    Shoulder pain after stroke – experiences, consequences in daily life and effects of interventions: a qualitative study2018In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, no 10, p. 1176-1182Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe experiences of shoulder pain after stroke, how pain affects daily life and perceived effects of interventions.

    Method: A qualitative interview study including 13 community-dwelling persons (six women; median age 65 years) with persistent shoulder pain after stroke.

    Results: Three categories emerged from the content analysis. In “Multiple pain characteristics” an insidious pain onset was reported. The pain existed both day and night and could be located around the shoulder girdle but also have radiation to the arm and hand. An explanation of the pain was seldom given. In “Limitations caused by the pain” it was described how the pain negatively influenced personal care, household activities and leisure, but also could lead to emotional reactions. In “Multiple pain interventions with various effects” a variety of interventions were described. Self-management interventions with gentle movements were perceived most effective. A restraint attitude to pain medication due to side effects was reported.

    Conclusions: Shoulder pain after stroke can lead to a variety of pain characteristics. As the pain is complex and may affect many important areas in a person’s life, multidisciplinary rehabilitation interventions are important.

  • 14.
    Svensson, Ingrid
    et al.
    Department of Biomedical Engineering, Faculty of Engineering, Lund University.
    Gao, Chuansi
    Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Faculty of Engineering, Lund University.
    Halder, Amitava
    Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Faculty of Engineering, Lund University.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation. Division of Physiotherapy, Department of Health Sciences, Faculty of Medicine, Lund University.
    Magnusson, Måms
    Division of Physiotherapy, Department of Health Sciences, Faculty of Medicine, Lund University.
    Standing balance on inclined surfaces with different friction2018In: Industrial Health, ISSN 0019-8366, E-ISSN 1880-8026, Vol. 56, no 4, p. 292-299Article in journal (Refereed)
    Abstract [en]

    Working and walking environments often involve standing positions on different surfaces with inclination and different friction. In this study, standing balance of thirteen participants during sudden and irregular external perturbation to calf muscles was investigated. The aim of the study was to evaluate the combined effect of surface inclination and friction on standing balance. The main findings when eyes closed revealed that the standing utilised coefficient of friction (mu(SUCOF)) increased when the surface was inclined for both high and low friction materials. The anteriorposterior torque increased more anteriorly when the surface was inclined toes down and when the surface friction was low. The results indicate that the anterior posterior torque is a sensitive parameter when evaluating standing balance ability and slip risk. On inclined surface, particularly on the surface with lower friction, the potential slip and fall risk is higher due to the increase of standing utilised coefficient of friction and increased forward turning torque.

  • 15.
    Larsson, Agneta
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Westerberg, Mats
    Luleå University of Technology, Department of Business Administration, Technology and Social Sciences, Business Administration and Industrial Engineering.
    Karlqvist, Lena
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Teamwork and Safety Climate in home care: a mixed method study2018In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, no 11, article id 2495Article in journal (Refereed)
    Abstract [en]

    A rapidly changing homecare service sector implies difficulties to control safety and health risks for staff and to guarantee standardised deliveries of services to recipients. This study aimed to describe staff perceptions of safety climate and practices in homecare service teams, and suggestions for improvements. A second aim was to identify if and how the appraisals of safety climate were related to individual perceptions of safety, mental strain and adverse events/injury. A convergent parallel mixed methods design was used. Nursing assistants and care aides (133 in total, representing 11 work teams) in the north of Sweden replied to a survey and participated in focus group interviews. Results were analysed with ANOVA (inter-team differences) and by qualitative content analysis. Significant diversity was identified between the teams in five of seven dimensions of safety climate. Important areas for improvement were: a need to define and agree on criteria for a safe working environment; leadership prioritising safety at work; and management able to provide trust, support and time. A prerequisite for these agreements was improved authority and communication between all parties involved. The safety climate dimensions were related to personal perceptions of safety and mental strain and, partly, to adverse events/injuries.

  • 16.
    Post Sennehed, Charlotte
    et al.
    Department of Clinical Sciences Lund, Lund University, Orthopedics.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Holmberg, Sara A.C.
    Department of Research and Development, Region Kronoberg.
    Stigmar, Kjerstin G.E.
    bEpidemiology and Register Centre South, Region Skåne, Lund.
    Forsbrand, Malin
    Department of Clinical Sciences Lund, Lund University, Orthopedics, Lund.
    Grahn, Birgitta E.M.
    Department of Clinical Sciences Lund, Lund University, Orthopedics, Lund.
    "Blue flags", development of a short clinical questionnaire on work-related psychosocial risk factors: A validation study in primary care2017In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 18, no 1, article id 318Article in journal (Refereed)
    Abstract [en]

    Background: Working conditions substantially influence health, work ability and sick leave. Useful instruments to help clinicians pay attention to working conditions are lacking in primary care (PC). The aim of this study was to test the validity of a short "Blue flags" questionnaire, which focuses on work-related psychosocial risk factors and any potential need for contacts and/or actions at the workplace. Methods: From the original"The General Nordic Questionnaire" (QPSNordic) the research group identified five content areas with a total of 51 items which were considered to be most relevant focusing on work-related psychosocial risk factors. Fourteen items were selected from the identified QPSNordic content areas and organised in a short questionnaire "Blue flags". These 14 items were validated towards the 51 QPSNordic items. Content validity was reviewed by a professional panel and a patient panel. Structural and concurrent validity were also tested within a randomised clinical trial. Results: The two panels (n = 111) considered the 14 psychosocial items to be relevant. A four-factor model was extracted with an explained variance of 25.2%, 14.9%, 10.9% and 8.3% respectively. All 14 items showed satisfactory loadings on all factors. Concerning concurrent validity the overall correlation was very strong rs = 0.87 (p < 0.001).). Correlations were moderately strong for factor one, rs = 0.62 (p < 0.001) and factor two, rs = 0.74 (p < 0.001). Factor three and factor four were weaker, bur still fair and significant at rs = 0.53 (p < 0.001) and rs = 0.41 (p < 0.001) respectively. The internal consistency of the whole "Blue flags" was good with Cronbach's alpha of 0.76. Conclusions: The content, structural and concurrent validity were satisfactory in this first step of development of the "Blue flags" questionnaire. In summary, the overall validity is considered acceptable. Testing in clinical contexts and in other patient populations is recommended to ensure predictive validity and usefulness.

  • 17.
    Tibaek, Sigrid
    et al.
    Department of Occupational Therapy and Physiotherapy, Rigshospitale, Glostrup.
    Gard, Gunvor
    Division of Physiotherapy, Department of Health Sciences, Lund University.
    Dehlendorff, Christian
    Danish Cancer Society Research Center.
    Iversen, Helle K.
    Department of Neurology, Rigshospitalet.
    Biering-Sorensen, Fin
    Clinic of Spinal Cord Injuries, Rigshospitalet, Glostrup.
    Jensen, Rigmor
    Department of Neurology, Rigshospitalet, Glostrup.
    Can pelvic floor muscle training improve qualityof life in men with mild to moderate post-strokeand lower urinary tract symptoms?2017In: European Journal of Physical and Rehabilitation Medicine, ISSN 1973-9087, E-ISSN 1973-9095, Vol. 53, no 3, p. 416-425Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Lower urinary tract symptoms (LUTS) have a significant impact on quality of life (QoL) in post‑stroke patients.AIM: The aim of this study was to evaluate the effect of pelvic floor muscle training (PFMT) on QoL parameters in men with post‑stroke LUTS.DESIGN: Randomized, controlled and single‑blinded trial.SETTING: Outpatients, University Hospital.POPULATION: Thirty‑one men, median age 68 (interquartile range 60-74) years, with post‑stroke LUTS were included. Thirty participants completed the study.METHODS: The participants randomized to the treatment group were treated in a systematic, controlled and intensive PFMT program over 3 months (12 weekly sessions). The participants randomized to the control group did not receive specific LUTS treatment. The effect was measured on the 36-Item Short Form Health Survey (SF-36) and the Nocturia Quality‑of‑Life (N‑QoL) Questionnaire.RESULTS: The results on SF-36 indicated significant improvement within pre- and post‑test in the domains emotional role (median 77 to 100, P=0.03) and vitality (median 65 to 70, P=0.03) in the treatment group, but not the control group. There were no statistically significant differences between groups at pre‑test, post‑test or 6-month follow‑up. The results on N‑QoL indicated statistically significant differences between pre- and post‑test in the bother/concern domain in both groups and in sleep/energy for the control group, but not the treatment group. There were no statistically significant differences between groups.CONCLUSIONS: PFMT may improve the emotional health and vitality domains of QoL in men with mild to moderate post‑stroke and LUTS; however the improvements in the treatment group were not significantly better than for the control group. PFMT did not improve nocturia‑related QoL.CLINICAL REHABILITATION IMPACT: This study is the first to evaluate the effect of PFMT on QoL parameters in men with mild to moderate post‑stroke and LUTS. The results indicate some short‑term effect on SF-36 but none on N‑QoL. However, further studies with larger sample sizes and with less restrictive inclusion and exclusion criteria are requested.

  • 18.
    Calner, Tommy
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Nordin, Catharina
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Eriksson, Margareta K.
    Department of Public Health, Norrbotten County Council, Luleå.
    Nyberg, Lars
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Michaelson, Peter
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Effects of a self-guided, web-based activity programme for patients with persistent musculoskeletal pain in primary healthcare: A randomized controlled trial2017In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 21, no 6, p. 1110-1120Article in journal (Refereed)
    Abstract [en]

    BACKGROUNDWeb-based interventions for pain management are increasingly used with possible benefits, but never used in addition to multimodal rehabilitation (MMR). MMR is recommended treatment for persistent pain in Sweden. The aim was to evaluate the effects of a self-guided, web-based programme added to MMR for work ability, pain, disability and health-related quality of life.METHODSWe included 99 participants with persistent musculoskeletal pain in a randomized study with two intervention arms: (1) MMR and web-based intervention, and (2) MMR. Data was collected at baseline, 4 and 12 months. Outcome measures were work ability, working percentage, average pain intensity, pain-related disability, and health-related quality of life.RESULTSThere were no significant effects of adding the web-based intervention to MMR regarding any of the outcome variables.CONCLUSIONSThis trial provides no support for adding a self-guided, web-based activity programme to MMR for patients with persistent musculoskeletal pain.SIGNIFICANCEThe comprehensive self-guided, web-based programme for activity, Web-BCPA, added to multimodal treatment in primary health care had no effect on work ability, pain, disability or health-related quality of life. Future web-based interventions should be tailored to patients' individual needs and expectations

  • 19.
    Kostenius, Catrine
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Lindgren, Eva
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Bykachev, Kirsi
    University of Eastern Finland.
    Karppi, Jussi
    University of Eastern Finland.
    Kumpulainen, Kirsti
    University of Eastern Finland.
    Sormunen, Marjorita
    University of Eastern Finland.
    Turunen, Outi
    University of Eastern Finland.
    Turunen, Hannele
    University of Eastern Finland.
    Thompson, Lucy
    University of Aberdeen.
    Wilson, Philip
    University of Aberdeen.
    Breivik, Elin Anne
    Norwegian Centre for e-Health Research.
    Hege Fagerheim, Siv
    Norwegian Centre for e-Health Research.
    Larsen, Frank
    Norwegian Centre for e-Health Research.
    Experiences of using eHealth to improve psychiatry services for children andadolescents in peripheral areas2017In: Ninth International Congress of Arctic Social Sciences: People and Place (ICASS IX), 2017Conference paper (Refereed)
  • 20.
    Nordin, Catharina
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation. Department of Primary Health Care, Region Norrbotten, Piteå.
    Michaelson, Peter
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Eriksson, Margareta K.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation. Department of Public Health, Norrbotten County Council, Luleå.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    It's about me: patients’ Experiences of Patient Participation in the Web Behavior Change Program for Activity in Combination With Multimodal Pain Rehabilitation2017In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 19, no 1, p. 62-72, article id e22Article in journal (Refereed)
    Abstract [en]

    Background

    Patients’ participation in their health care is recognized as a key component in high-quality health care. Persons with persistent pain are recommended treatments with a cognitive approach from a biopsychosocial explanation of pain, in which a patient’s active participation in their rehabilitation is in focus. Web-based interventions for pain management have the potential to increase patient participation by enabling persons to play a more active role in rehabilitation. However, little is known about patients’ experiences of patient participation in Web-based interventions in clinical practice.

    Objective

    The objective of our study was to explore patients’ experiences of patient participation in a Web Behavior Change Program for Activity (Web-BCPA) in combination with multimodal rehabilitation (MMR) among patients with persistent pain in primary health care.

    Methods

    Qualitative interviews were conducted with 15 women and 4 men, with a mean age of 45 years. Data were analyzed with qualitative content analysis.

    Results

    One theme, “It’s about me,” and 4 categories, “Take part in a flexible framework of own priority,” “Acquire knowledge and insights,” “Ways toward change,” and “Personal and environmental conditions influencing participation,” were developed. Patient participation was depicted as being confirmed in an individualized and structured rehabilitation framework of one’s own choice. Being confirmed was fundamental to patient participation in the interaction with the Web-BCPA and with the health care professionals in MMR. To acquire knowledge and insights about pain and their life situation, through self-reflection in the solitary work in the Web-BCPA and through feedback from the health care professionals in MMR, was experienced as patient participation by the participants. Patient participation was described as structured ways to reach their goals of behavior change, which included analyzing resources and restrictions, problem solving, and evaluation. The individual’s emotional and cognitive resources and restrictions, as well as health care professionals and significant others’ attitudes and behavior influenced patient participation in the rehabilitation. To some extent there were experiences of restrained patient participation through the great content of the Web-BCPA.

    Conclusions

    Patient participation was satisfactory in the Web-BCPA in combination with MMR. The combined treatment was experienced to increase patient participation in the rehabilitation. Being confirmed through self-identification and finding the content of the Web-BCPA trustworthy was emphasized. Patient participation was experienced as a learning process leading to new knowledge and insights. Higher user control regarding the timing of the Web-BCPA and therapist guidance of the content may further increase patient participation in the combined treatment.

  • 21.
    Gard, Gunvor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Working conditions and workplace health and safety promotion in home care: a mixed method study from Swedish managers´ perspectives2017In: Archives of Environmental & Occupational Health, ISSN 1933-8244, E-ISSN 2154-4700, Vol. 72, no 6, p. 359-365Article in journal (Refereed)
    Abstract [en]

    Today, we can see a trend towards increased psychosocial strain at work among home care managers and staff. The aim of this study is to describe home care managers' views on their own psychosocial working conditions and on how to promote workplace health and safety in a municipality in northern Sweden. A mixed methods design was used, including questionnaire and qualitative focus group data. The qualitative data were analysed by manifest content analysis. The results indicate that most managers perceived increased variety in work and opportunities for development at work, but at the same time increased demands. The managers suggested that workplace health and safety could be improved by risk assessment and improved communication, a clear communication chain by a real as well as a virtual platform for communication. In summary, workplace health and safety could be improved by risk assessments and by a physical as well as a virtual platform for communication.

  • 22.
    Nordin, Catharina
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab. Department of Primary Health Care, Norrbotten County Council.
    Michaelson, Peter
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Eriksson, Margareta K.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab. Department of Primary Health Care, Norrbotten County Council.
    Effects of the Web Behavior Change Program for Activity and Multimodal Pain Rehabilitation: Randomized Controlled Trial2016In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 18, no 10, p. 24-41, article id 265Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Web-based interventions with a focus on behavior change have been used for pain management, but studies of Web-based interventions integrated in clinical practice are lacking. To emphasize the development of cognitive skills and behavior, and to increase activity and self-care in rehabilitation, the Web Behavior Change Program for Activity (Web-BCPA) was developed and added to multimodal pain rehabilitation (MMR).

    OBJECTIVE:

    The objective of our study was to evaluate the effects of MMR in combination with the Web-BCPA compared with MMR among persons with persistent musculoskeletal pain in primary health care on pain intensity, self-efficacy, and copying, as part of a larger collection of data. Web-BCPA adherence and feasibility, as well as treatment satisfaction, were also investigated.

    METHODS:

    A total of 109 participants, mean age 43 (SD 11) years, with persistent pain in the back, neck, shoulder, and/or generalized pain were recruited to a randomized controlled trial with two intervention arms: (1) MMR+WEB (n=60) and (2) MMR (n=49). Participants in the MMR+WEB group self-guided through the eight modules of the Web-BCPA: pain, activity, behavior, stress and thoughts, sleep and negative thoughts, communication and self-esteem, solutions, and maintenance and progress. Data were collected with a questionnaire at baseline and at 4 and 12 months. Outcome measures were pain intensity (Visual Analog Scale), self-efficacy to control pain and to control other symptoms (Arthritis Self-Efficacy Scale), general self-efficacy (General Self-Efficacy Scale), and coping (two-item Coping Strategies Questionnaire; CSQ). Web-BCPA adherence was measured as minutes spent in the program. Satisfaction and Web-BCPA feasibility were assessed by a set of items.

    RESULTS:

    Of 109 participants, 99 received the allocated intervention (MMR+WEB: n=55; MMR: n=44); 88 of 99 (82%) completed the baseline and follow-up questionnaires. Intention-to-treat analyses were performed with a sample size of 99. The MMR+WEB intervention was effective over time (time*group) compared to MMR for the two-item CSQ catastrophizing subscale (P=.003), with an effect size of 0.61 (Cohen d) at 12 months. There were no significant between-group differences over time (time*group) regarding pain intensity, self-efficacy (pain, other symptoms, and general), or regarding six subscales of the two-item CSQ. Improvements over time (time) for the whole study group were found regarding mean (P<.001) and maximum (P=.002) pain intensity. The mean time spent in the Web-based program was 304 minutes (range 0-1142). Participants rated the items of Web-BCPA feasibility between 68/100 and 90/100. Participants in the MMR+WEB group were more satisfied with their MMR at 4 months (P<.001) and at 12 months (P=.003).

    CONCLUSIONS:

    Adding a self-guided Web-based intervention with a focus on behavioral change for activity to MMR can reduce catastrophizing and increase satisfaction with MMR. Patients in MMR may need more supportive coaching to increase adherence in the Web-BCPA to find it valuable.

  • 23.
    Areskoug Josefsson, Kristina
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Juuso, Päivi
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Rolander, Bo
    Jönköping University.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Health Care Students' Attitudes Toward Addressing Sexual Health in Their Future Profession: Validity and reliability of a questionnaire2016In: International Journal of Sexual Health, ISSN 1931-7611, E-ISSN 1931-762X, Vol. 28, no 3, p. 243-250Article in journal (Refereed)
    Abstract [en]

    Objectives: To test the reliability and validity of the Students' Attitudes Towards Addressing Sexual Health questionnaire (SA-SH), measuring students' attitudes towards addressing sexual health in their future professions.

    Method: A cross-sectional online survey (22 items) were distributed to 186 nursing, occupational therapy and physiotherapy students in Sweden, April 2015. Validity and reliability were tested.

    Results: The construct validity analysis led to three major factors: present feelings of comfortableness, future working environment and fear of negative influence on future patient relations. The construct validity, internal consistency reliability and intrarater reliability showed good results.Conclusion: The SA-SH is valid and reliable.

  • 24.
    Areskoug Josefsson, Kristina
    et al.
    Högskolan i Jönköping, The Jönköping Academy for Improvement of Health and Welfare.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Rolander, Bo
    Högskolan i Jönköping, HHJ, Avd. för beteendevetenskap och socialt arbete.
    Juuso, Päivi
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Health care students' attitudes towards working with sexual health in their professional roles - survey of students at nursing, physiotherapy and occupational therapy programmes2016In: Conference abstracts: Pre-conference abstracts, 2016Conference paper (Refereed)
  • 25.
    Areskoug Josefsson, Kristina
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Rolander, Bo
    Jönköping University, Futurum, Academy for Health and Care, Jönköping County Council.
    Juuso, Päivi
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Health Care Students’ Attitudes Towards Working with Sexual Health in Their Professional Roles: Survey of Students at Nursing, Physiotherapy and Occupational Therapy Programmes2016In: Sexuality and disability, ISSN 0146-1044, E-ISSN 1573-6717, Vol. 34, no 3, p. 289-302Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore differences and similarities in health care students’ attitudes towards working with and communicating with patients about sexual health issues in their future professions. The aim was also to explore whether the students’ gender, age and future professions were influencing factors and whether there was a change in attitude depending on educational levels, gender, age and future professions. The study also aimed to explore the potential development of those differences and similarities in attitudes between health care students having achieved different levels of education and training in their future professions. A cross-sectional quantitative study was performed with an online survey distributed to nursing, occupational therapy and physiotherapy students. The students believed that they needed increased sexual health education and increased communication skills about sexual health. Gender and future profession are factors that significantly affect the attitudes of the students towards working with sexual health. Nursing and occupational therapy students have a more positive attitude towards addressing sexual health in their future professions than do physiotherapy students. Further research is needed in this field to improve competence in sexual health for all student groups, particularly physiotherapy students. Further research is also needed to explore the significance of gender regarding education in sexual health and attitudes towards working with sexual health.

  • 26.
    Bykachev, Kirsi
    et al.
    University of Eastern Finland.
    Tossavainen, Kerttu
    University of Eastern Finland.
    Kumpulainen, Kirsti
    University of Eastern Finland.
    Wilson, Philip
    University of Aberdeen.
    Kostenius, Catrine
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Lindgren, Eva
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Bjørvig, Siri
    University Hospital of North Norway.
    Borgen, Morten
    University Hospital of North Norway.
    Improving psychiatry services for children and adolescents with eHealth in peripheral areas2016Conference paper (Other academic)
  • 27.
    Bykachev, Kirsi
    et al.
    University of Eastern Finland.
    Tossavainen, Kerttu
    University of Eastern Finland.
    Kumpulainen, Kirsti
    University of Eastern Finland.
    Kostenius, Catrine
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Lindgren, Eva
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Wilson, Philip
    University of Aberdeen.
    Bjørvig, Siri
    University Hospital of North Norway.
    Borgen, Morten
    University Hospital of North Norway.
    Multi-professional collaboration and consultation: Improving child and adolescent psychiatry with eHealth2016Conference paper (Other academic)
  • 28.
    Gard, Gunvor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Dagis, Daina
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Physiotherapy students´ perceptions of learning in clinical practice in Sweden and India2016In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 36, p. 381-386Article in journal (Refereed)
    Abstract [en]

    Background: Is it reasonable to assume that conditions for learning differ between universities and countries. Increased understanding of similarities and differences of student´s perceptions of learning environment can be useful in the development of the physiotherapy education as well as of the profession as such. Through international comparisons the benefits and challenges of educational programs can be made transparent and serve as base for improvement.Objective: The objective of this study was to describe and compare physiotherapy students´ perceptions of their learning environment in clinical practice in India and Sweden.Design and setting: A questionnaire study was performed, covering physiotherapy students' perceptions of their clinical learning environment, the physiotherapy supervisor within the clinical context, their supervisory relationship and the role of the clinical supervisor at two Universities, Luleå in Sweden and Amity in New Delhi, India.Participants: Undergraduate students at two physiotherapy programmes, in New Delhi, India and in Luleå, Sweden participated in the questionnaire study.Results: In general, both groups had high rankings of their perceptions of the clinical learning environment. The Swedish students ranked individual supervision, participation in meetings, the supervisor as a resource, being a part of the team and giving them valuable feedback higher than the Indian group. The supervisory relationship was equally satisfying in groups, providing valuable feedback and acknowledging equality and mutuality in the relationship. The Indian group ranked the supervisor as a colleague, as a support in learning, and that he/she made them feel comfortable in meetings higher than the Swedish group.Conclusions: Both groups had high ratings of the supervisor and the clinical learning context Participation at meetings was higher rated in the Swedish and the supervisor as a support in learning higher rated of the Indian students.

  • 29.
    Tornøe, Birte
    et al.
    Department of Health Sciences, Lund University.
    Andersen, Lars L.
    National Research Centre for the Working Environment, Copenhagen.
    Skotte, Jørgen H.
    National Research Centre for the Working Environment, Copenhagen.
    Jensen, Rigmor
    Department of Neurology, Danish Headache Centre, University of Copenhagen, Glostrup Hospital.
    Jensen, Claus
    Huge Consulting, ApS, Haslev.
    Madsen, Bjarne K.
    Department of Neurology, Danish Headache Centre, University of Copenhagen, Glostrup Hospital.
    Gard, Gunvor
    Department of Health Sciences, Lund University.
    Skov, Liselotte
    Department of Pediatrics E, Children’s Headache Clinic, University of Copenhagen, Herlev and Gentofte Hospitals.
    Hallström, Inger
    Department of Health Sciences, Lund University.
    Specific strength training compared with interdisciplinary counseling for girls with tension-type headache: randomized controlled trial2016In: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 9, p. 257-270Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Childhood tension-type headache (TTH) is a prevalent and debilitating condition for the child and family. Low-cost nonpharmacological treatments are usually the first choice of professionals and parents. This study examined the outcomes of specific strength training for girls with TTH.METHODS: Forty-nine girls aged 9-18 years with TTH were randomized to patient education programs with 10 weeks of strength training and compared with those who were counseled by a nurse and physical therapist. Primary outcomes were headache frequency, intensity, and duration; secondary outcomes were neck-shoulder muscle strength, aerobic power, and pericranial tenderness, measured at baseline, after 10 weeks intervention, and at 12 weeks follow-up. Health-related quality of life (HRQOL) questionnaires were assessed at baseline and after 24 months.RESULTS: For both groups, headache frequency decreased significantly, P=0.001, as did duration, P=0.022, with no significant between-group differences. The odds of having headache on a random day decreased over the 22 weeks by 0.65 (0.50-0.84) (odds ratio [95% confidence interval]). For both groups, neck extension strength decreased significantly with a decrease in cervicothoracic extension/flexion ratio to 1.7, indicating a positive change in muscle balance. In the training group, shoulder strength increased $10% in 5/20 girls and predicted [Formula: see text] increased $15% for 4/20 girls. In the training group, 50% of girls with a headache reduction of $30% had an increase in [Formula: see text] >5%. For the counseling group, this was the case for 29%. A 24-month follow-up on HRQOL for the pooled sample revealed statistically significant improvements. Fifty-five percent of the girls reported little to none disability.CONCLUSION: The results indicate that both physical health and HRQOL can be influenced significantly by physical exercise and nurse counseling. More research is needed to examine the relationship between physical exercise, [Formula: see text], and TTH in girls. Thus, empowering patient education to promote maximum possible outcomes for all children needs more attention.

  • 30.
    Gemark Simonsen, Jenny
    et al.
    Division of Occupational and Environmental Medicine, Lund University.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Swedish Sonographers' perceptions of ergonomic problems at work and their suggestions for improvement2016In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 17, no 1, article id 391Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Sonographers' perceptions of ergonomic and work-related pain problems at work have so far mostly been researched in quantitative studies by questionnaires. There is a need of experience-based research to deepen the knowledge about how sonographers perceive ergonomic problems at work. Therefore, the aim of this qualitative study was to describe sonographers' perceptions of ergonomic problems at work, and their suggestions for improvement strategies.

    METHODS:

    Twenty-two female sonographers were individually interviewed regarding different aspects of their physical working environment. Content analysis was applied.

    RESULTS:

    The sonographers perceived different ergonomic problems in their working environment, but to offer patient comfort and to obtain the best possible images were often prioritized over working posture. Echocardiography was considered demanding as the examination is performed with little variation in posture. Ergonomic improvements included reducing the manual handling of the transducer, optimizing the adjustability of equipment, and taking the patient's physique and health into account. As some examinations were perceived to be more ergonomically demanding, variation between examinations was suggested, however, this requires broader skills.

    CONCLUSION:

    Sonography, especially echocardiography is ergonomically demanding but the improvement strategies suggested were perceived useful and applicable.

  • 31.
    Larsson, Agneta
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Berggård, Glenn
    Luleå University of Technology, Department of Civil, Environmental and Natural Resources Engineering, Architecture and Water.
    Rosander, Peter
    Luleå University of Technology, Department of Civil, Environmental and Natural Resources Engineering, Architecture and Water.
    The impact of users gait patterns and perceptions in the development of quality criterias for anti-slip devices and winter shoes2016Conference paper (Refereed)
  • 32.
    Larsson, Agneta
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Röijezon, Ulrik
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Olsson, Ing-Mari
    Artist- och musikerhälsan i Malmö.
    Engquist, Karin
    Artist- och musikerhälsan i Malmö.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    A web-based health promotion intervention for music students in Sweden2015In: Musician's Health and Performance. 2nd Conference (MHPC2015): Book of abstracts, 2015Conference paper (Refereed)
    Abstract [en]

    Aim: In this presentation a study protocol for a web-based health promotion intervention for music students, and the rationale behind it, will be described. The aim is to develop a new dynamic web-portal with an interactive multimodal health intervention program for musicians and music students, and perform a controlled feasibility and effect study among music students.Methods: A web-based competence development and coaching program for music students in Sweden will be developed and performed according to a cognitive approach with focus on the students own goals. The program will include knowledge concerning how to promote cognitive and emotional coping in performance situations; ergonomically sound playing postures; as well as how to prevent bodily symptoms, mental distress and hearing disorders. Participants will be music students from two regions in Sweden, Skåne and Norrbotten. The intervention group will have access to the web-based program together with web-based group coaching, while the control group will receive general web-based information. The intervention will continue for 6 month and outcome measures will be collected before, after intervention and after 12 months to evaluate the feasibility and health effects of the intervention. Expected outcomes: It is reasonable to believe that an increased awareness of healthy and balanced positions while playing, systematic use of pauses and variation during rehearsal, stress management skills and a sound attitude towards control of e.g. playing related fatigue and pain can improve the music students’ prerequisites for a healthy and sustainable working life. Discussion/Conclusion: This project will contribute with knowledge about feasibility and effects of e-health solutions specifically designed for music students and musicians. Feasible and efficient e-health solutions for musicians and other performing artists can have major impact for these professions in Sweden due to the large distances and the scarceness of specialized occupational health care providers within performing arts medicine.Acknowledgement: This research is supported by the Areas of excellence in research and innovation at Luleå university of technology - Innovative art and science, who have granted funding for project initiation.

  • 33.
    Berggård, Glenn
    et al.
    Luleå University of Technology, Department of Civil, Environmental and Natural Resources Engineering, Architecture and Water.
    Rosander, Peter
    Luleå University of Technology, Department of Civil, Environmental and Natural Resources Engineering, Architecture and Water.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Konsumenttester av vinterskor och halkskydd2015Report (Other academic)
    Abstract [sv]

    Sjukvårdsbaserad skadestatistik från Sverige visar att singelolyckor med fotgängare på is och snö, orsakar höga skadetal. I Sverige beräknas ca 10000 män och 15000 kvinnor uppsöka sjukvård på grund av skada vid fall på snö och is. Personer skadade i fallolyckor på snö och is har svårare skador och längre konvalescenstid jämfört med fotgängare som faller på barmark. Det är därför viktigt att identifiera preventiva metoder och hjälpmedel för fallolyckor vintertid.Syftet med detta arbete har varit att genomföra konsumenttester av vinterskor och halkskydd på olika underlag med avseende på hur väl de fungerar som skydd mot att halka samt hur användarvänliga de upplevs av brukaren. I arbetet har det också varit viktigt att försöka identifiera kriterier som kan anses vara betydelsefulla för att bedöma vinterväglagsegenskaperna. Dessutom fanns ett behov av att ta fram underlag och förslag på en standardiserad metod för halkskydds-/vinterskortester och en märkning som ger konsumenterna möjlighet att bedöma och jämföra halkskyddens respektive vinterskornas egenskaper innan köp.Testmetoden som tagits fram för att undersöka halkskyddens och skornas egenskaper bygger på tidigare erfarenheter från tester av halkskydd. Metoden bygger på att försökspersoner genomför gångtester med halkskydd och skor på olika underlag samtidigt som olika mätmetoder, både objektiva och subjektiva, används för att kategorisera gång. Tester har genomförts av 9 försökspersoner, över 45 år, 4 män och 5 kvinnor, som testat 19 halkskydd och 20 olika skor. Fyra olika underlag har använts för att kategorisera egenskaperna på de undersökta halkskydden och skorna: is, is täckt med snö, packad snö, torr betong.Testmetoden har kompletterats med laboratoriemätningar av halkskyddens och skosulornas friktion på is samt hårdheten hos skornas sulor. Multipel hierarkisk multipel regressionsanalys användes för att identifiera vilka kriterier som kan ha betydelse för fotgängarnas skattade helhetsupplevelse av de testade halkskydden på olika underlag.Resultatet av förmätningarna visar att testgruppen (fem kvinnor och fyra män med medålder 47 år) motsvarar en normalpopulation, avseende variationer i de uppmätta bakgrundsparametrarna.FIOH:s friktionsmätningar på is av samtliga skor och halkskydd visar att halkskydden har genomgående högre friktionsvärden än skorna, dvs. de har bättre fäste på is än de skor som testats men resultaten visar på små skillnader mellan de sämsta halkskydden och de bästa skorna.Resultat från friktionsmätningen, som den utförs idag i fixerat utförande, ger inte överensstämmelse med försökspersonernas upplevelser av gångsäkerhet eller fallrisk. Försökspersonernas gångcykel med hälisättning, överrullning och fotavveckling bygger upp den samlade uppfattningen om egenskaperna och fångas enbart i de subjektiva mätmetoderna.Sex kriterier som bedömts viktiga att ta hänsyn till när det gäller halkfri gång med en vintersko har kunnat identifieras via analys av försökspersonernas fritextsvar avseende fördelar, nackdelar och övrig funktionalitet: gångsäkerhet, möjliggör ett naturligt gångmönster, stabilitet, förutsägbarhet, flexibilitet och passform/komfort. Gångsäkerhet är viktigast och omfattar fäste/grepp, detta är viktigast på is, is/snö vid gång samt vid start och stopp.Sju subjektiva kriterier för halkskydd har också identifierats; gångsäkerhet, tillåter naturligt gångmönster, stabilitet, förutsägbarhet, flexibilitet, passform/komfort, och ljud. Gångsäkerhet är viktigast.Den självskattade hälisättningen på underlagen ren is samt på snö på is framkom som det viktigaste kriteriet för testpersonernas helhetsupplevelse av skyddet. Även skattad fotavveckling på alla underlag med främst på främst på snö på is var av betydelse. Upplevd balans och fallrisk var mest utslagsgivande för helhetsupplevelsen av de halkskydd som inte valdes för eget bruk. Det tyder på att en lägre grad av skattad kontroll av kroppshållning och balans under gång med skyddet är en relevant indikator för att identifiera skydd med bristande funktioner.Variablerna subjektivt skattad fallrisk, balans, hälisättning och fotavveckling kan samtliga relateras till ett skydds halkegenskaper och funktion. Upplevd fallrisk samvarierar med såväl balans, hälisättning och fotavveckling vilket innebär att kriteriet upplevd fallrisk kan antas omfatta de övriga och kan väljas som en enskild variabel i fortsatta analyser.Kvalitetsnivåer i bedömningsskalor kan antas gå att knyta till de subjektiva kriterierna.En standardiserat testmetod för klassindelning av egenskaper för vinterskor respektive halkskydd bör bygga på mätmetoder med försökspersoner enligt ovan.Fortsatta studier med fler testpersoner behövs för att verifiera de resultat som indikeras ovan.

  • 34.
    Rosander, Peter
    et al.
    Luleå University of Technology, Department of Civil, Environmental and Natural Resources Engineering, Architecture and Water.
    Berggård, Glenn
    Luleå University of Technology, Department of Civil, Environmental and Natural Resources Engineering, Architecture and Water.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Konsumenttester av vinterskor och halkskydd2015Conference paper (Other academic)
    Abstract [sv]

    I Sverige beräknas ca 10000 män och 15000 kvinnor uppsöka sjukvård på grund av skada vid fall på snö och is. Personer skadade i fallolyckor på snö och is har svårare skador och längre konvalescenstid jämfört med fotgängare som faller på barmark. Samhällets kostnader för fallolyckor på snö och is är minst dubbelt så stor som kostnaden för vinterväghållningen. Det är därför viktigt att identifiera preventiva metoder och hjälpmedel för fallolyckor vintertid och möjliggöra säkra promenader året runt.Marknaden erbjuder idag flera olika modeller av halkskydd som kan minska fallrisk på is och snö. Syftet med detta arbete har varit att genomföra konsumenttester av vinterskor och halkskydd på olika underlag med avseende på hur väl de fungerar som halkskydd samt hur användarvänliga de upplevs av brukaren. I arbetet har det också varit viktigt att försöka identifiera kriterier som kan anses vara betydelsefulla för att bedöma om ett halkskydd är säkert och funktionellt.

  • 35.
    Lindqvist, Anna-Karin
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Kostenius, Catrine
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Rutberg, Stina
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Parent participation plays an important part in promoting physical activity2015In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, article id 27397Article in journal (Refereed)
    Abstract [en]

    Although physical activity (PA) is an important and modifiable determinant of health, in Sweden only 15% of boys and 10%of girls aged 15 years old achieve the recommended levels of PA 7 days per week. Adolescents’ PA levels are associated withsocial influence exerted by parents, friends, and teachers. The purpose of this study was to describe parents’ experiencesof being a part of their adolescents’ empowerment-inspired PA intervention. A qualitative interview study was performedat a school in the northern part of Sweden. A total of 10 parents were interviewed, and the collected data were analyzedwith qualitative content analysis. Three subthemes were combined into one main theme, demonstrating that parents are oneimportant part of a successful PA intervention. The life of an adolescent has many options and demands that make it difficultto prioritize PA. Although parents felt that they were important in supporting their adolescent, a successful PA interventionmust have multiple components. Moreover, the parents noted that the intervention had a positive effect upon not only theiradolescents’, but also their own PA. Interventions aimed at promoting PA among adolescents should include measures tostimulate parent participation, have an empowerment approach, and preferably be school-based.

  • 36.
    Mattsson, Malin
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Boström, Carina
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Mihai, Carina
    Internal Medicine and Rheumatology Department, Carol Davila University of Medicine and Pharmacy, Cantacuzino Hospital, Bucharest.
    Stocker, Juliane
    Department of Rehabilitation, Nijmegen Centre for Evidence Based Practice, Radboud University Medical Centre, Nijmegen.
    Geyh, Szilvia
    Department of Health Sciences and Health Policy, University of Lucerne.
    Stummvoll, Georg
    Department of Internal Medicine 3, Division of Rheumatology, Medical University of Vienna.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Möller, Bozena
    Sunderby sjukhus, Luleå, Department of Rheumatology, Sunderby Hospital.
    Hesselstrand, Roger
    Department of Rheumatology, Lund University.
    Sandqvist, Gunnel
    Department of Rheumatology, Lund University.
    Draghicescu, Oana
    Internal Medicine and Rheumatology Department, Carol Davila University of Medicine and Pharmacy, Cantacuzino Hospital, Bucharest.
    Gherghe, Ana Maria
    Internal Medicine and Rheumatology Department, Carol Davila University of Medicine and Pharmacy, Cantacuzino Hospital, Bucharest.
    Voicu, Malina
    Research Institute for Quality of Life, Romanian Academy of Science, Bucharest.
    Distler, Oliver
    Department of Rheumatology and Institute for Physical Medicine, University Hospital Zurich.
    Smolen, Josef S.
    Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna.
    Stamm, Tanja A.
    Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna.
    Personal factors in systemic sclerosis and their coverage by patient-reported outcome measures: A multicentre European qualitative study and literature review2015In: European Journal of Physical and Rehabilitation Medicine, ISSN 1973-9087, E-ISSN 1973-9095, Vol. 51, no 4, p. 405-421Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Systemic Sclerosis (SSc) is an autoimmune disease where thickening of the skin can lead to reduced body function and limitations in activities. Severe forms can also affect and seriously damage inner organs. Patient--centred rehabilitation emphasises considerations of patients' background, experience and behaviour which highlights the need to know if patient--reported outcome measures (PROMs) include such personal factors.AIMS: To identify and describe personal factors in the experiences of functioning and health of persons with SSc and to examine if and to what extent PROMs in SSc--research cover these factors.DESIGN AND POPULATION: Data from a qualitative study with focus group interviews in patients with SSc were analysed and PROMs in SSc--research were identified in a literature review between 2008--2013.SETTING: Outpatient clinics at rheumatology department in four European countries.METHODS: Data from interviews with 63 participants were analysed using a structure of personal factors developed by Geyh et al. Identified PROMs were analysed and linked to main concepts, related to the personal factors, found in the interview data.RESULTS: Nineteen main concepts related to the area "patterns of experience and behaviour" in the personal factor structure, 16 to "thoughts and beliefs", nine to "feelings", one to "motives" and one to "personal history and biography" respectively. Among the 35 PROMs identified, 15 did not cover any of the identified concepts. Concepts within the area of "feelings" were mostly covered by the PROMs. Five of the PROMs covered "patterns of experience and behaviour" while "motives" and "personal history and biography" were not covered at all. Four of the identified PROMs covered concepts within the areas "feelings", "thoughts and beliefs" and "patterns of experience and behaviour" in the same instrument. The Illness Cognition Questionnaire and Illness Behaviour Questionnaire were such PROMs.CONCLUSION: Patterns of experience and behaviour had the highest number of concepts related to personal factors, but few of the PROMs in SSc--research covered these factors. Only some PROMs covered several personal factors areas in the same instrument.CLINICAL REHABILITATION IMPACT: The results would be of value when developing a core set for outcome measurements in SSc.

  • 37.
    Josefsson, Kristina Areskoug
    et al.
    Department of Health Sciences, Division of Physiotherapy, Lund University.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Physiotherapy as a promoter of sexual health2015In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 31, no 6, p. 390-395Article in journal (Refereed)
    Abstract [en]

    Despite the holistic intention of physiotherapy, sexual health receives insufficient attention by physiotherapists. Sexual health is an important part of general health and well-being, which is often negatively affected by physical and psychological disorders. There are several reasons why sexual health should be addressed by physiotherapists, and this article aims to describe the role of the physiotherapist as a promoter of good sexual health and implementation of sexual health in clinical physiotherapy.

  • 38.
    Skjaerven, Liv H.
    et al.
    Department of Physiotherapy, Faculty of Health and Social Sciences, Bergen University College, Bergen University College, Department of Physical Therapy.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Sundal, Mary Anne
    Department of Occupational Therapy, Physiotherapy and Radiography, Faculty of Health and Social Sciences, Bergen University College.
    Strand, Liv Inger
    Department of Global Public Health and Primary Care, Physiotherapy Research Group, University of Bergen.
    Reliability and validity of the Body Awareness Rating Scale (BARS), an observational assessment tool of movement quality2015In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 17, no 1, p. 19-28Article in journal (Refereed)
    Abstract [en]

    Movement quality assessed by the Body Awareness Rating Scale (BARS) is used as an indicator of health and self-efficacy in patients with long-lasting musculoskeletal and mental health problems. The objective of the study was to examine reliability and construct validity of the movement quality scale. 25 patients and 25 healthy persons were included. Internal consistency was examined by Cronbach's α, reliability by intraclass correlation coefficient (ICCagreement) and measurement error reported by standard error of measurement (SEM) and smallest detectable change (SDC). Construct validity was examined by testing hypotheses of moderate association between the observational scale and the self-report Short-Form Health Survey (SF-36) subscales and the General Perceived Self-Efficacy Scale (GPSES). A hypothesis about the difference in scores between groups being expected to differ in health states was tested. Internal consistency (α) was 0.92. Inter-tester reliability was ICC = 0.99 and SEM = 0.8. The test–retest reliability was ICC = 0.96 and SEM = 1.4, implying that improvement should be above 3.3 (SDC) to claim a treatment effect. BARS was moderately correlated (0.30 ≤ rs < 0.60) with most SF-36 subscales and GPSES. The patients demonstrated less movement quality than healthy persons. Evidence was provided of high internal consistency and reliability in qualified testers. Construct validity was indicated, as BARS reflected various aspects of health and self-efficacy.

  • 39.
    Josefsson, Kristina Areskoug
    et al.
    Division of Physiotherapy, Lund University.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Sexual Health as a Part of Physiotherapy: The Voices of Physiotherapy Students2015In: Sexuality and disability, ISSN 0146-1044, E-ISSN 1573-6717, Vol. 33, no 4, p. 513-532Article in journal (Refereed)
    Abstract [en]

    The aim of the project was to explore and describe the views of physiotherapy students concerning sexual health as a part of physiotherapy education, and to enable them in their future profession as physiotherapists to be able to discuss sexual health matters with patients in an informed, sensitive and relaxed way. A qualitative interview study with data collection through focus group interviews was performed and analyzed with thematic content analysis. There was a strong consensus among the physiotherapy students in believing that sexual health should be acknowledged by physiotherapists. The theme that emerged from the data was: Sexual health—a professional challenge. The interviews resulted in the following categories: professional challenge, personal life experiences, communication, perceptive patient understanding, environmental factors and need for competence development. Students are positive towards working with sexual health. They believe that sexual health is an important aspect of quality of life, and therefore should be a part of physiotherapy education. Sexual health needs to be more addressed in the physiotherapy education. Students lack knowledge of lesbian, gay, bisexual, transgender and queer, sexual health and communication about sensitive issues. Perceived barriers towards working with sexual health could probably be lessened with increased education, but further research is needed. Personal development, knowledge, experience and environmental factors facilitate communication about sexual health.

  • 40.
    Björklund, Cecilia
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Erlandsson, Lena-Karin
    Department of Health Sciences, Lund University.
    Lilja, Margareta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Temporal Patterns of Daily Occupations Related to Older Adults' Health in Northern Sweden2015In: Journal of Occupational Science, ISSN 1442-7591, E-ISSN 2158-1576, Vol. 22, no 2, p. 127-145Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to identify characteristics of temporal patterns of daily occupations that could be related to high and low subjective health among older adults in Northern Sweden. A cross-sectional design imprinted by time-geographic methodology was used and participants 70 years and older were purposively selected and divided into groups of high and low health using the SoC-29 and SF-36 questionnaires. Daily occupations data were registered and analysed using VISUAL Time-PAcTS and related to health conditions using SPSS. The results showed that the participants in the high- and low-health groups showed similar patterns of participation in occupations during the 24-hour sequences describing their daily routines. Some differences in patterns of frequency and duration of occupations were shown between health groups during the 24-hour sequences as well as within six intervals. The low-health group showed higher frequencies and longer durations for “care for oneself” and “reflection and recreation” occupations and lower for “house-keeping” and “procure and prepare food” occupations compared to the high-health groups. There were few significant differences between the high- and low-health groups' mean durations for occupations. The results of this study could contribute to the support and assistance of occupations of older adults in society.

  • 41.
    Mattsson, Malin
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Möller, Bozena
    Sunderby sjukhus, Luleå, Department of Rheumatology, Sunderby Hospital.
    Stamm, Tanja A.
    Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Boström, C.
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Uncertainties and opportunities for patients with SLE2015In: Clinical and Experimental Rheumatology, ISSN 0392-856X, E-ISSN 1593-098X, Vol. 33, no 3, p. S5-Article in journal (Other academic)
  • 42.
    Romé, Åsa
    et al.
    Department of Health Sciences, Division of Physiotherapy, Lund University.
    Persson, Ulf
    Swedish Institute for Health Economics (IHE).
    Ekdahl, Charlotte
    Department of Health Sciences, Division of Physiotherapy, Lund University.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Costs and outcomes of an exercise referral programme: A 1-year follow-up study2014In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 16, no 2, p. 82-92Article in journal (Refereed)
    Abstract [en]

    Aims: To analyse, at a 1-year follow-up, cost offset and outcomes of changing the physical activity behaviour due to a primary care intervention. Methodology: Participants were 528 inactive individuals with lifestyle-related health problems, 18–84 years, and randomized into a high-dose intervention group (n = 270) or a low-dose intervention group (n = 257). The 4-month lasting intervention “Physical Activity on Prescription” (PAP) contained exercise, education and motivational counselling. At the 1-year follow-up, 178 individuals (95 in the high-dose group, 83 in the low-dose group) were assessed with the IPAQ (International Physical Activity Questionnaire) short form, perceived physical activity and functional ability (Six Minute Walk Test). Motivation and attitudes towards physical activity were assessed with a questionnaire, and analysed based on factor analysis. Major findings: physical activity increased significantly, but without differences between high-dose and low-dose groups. The rate of inactive individuals decreased from 75% to 53%. Analysis of motivation showed no differences between the groups. Principal conclusion: The PAP-program significantly improved physical activity behaviour at the 1-year follow-up, and reduced costs for inactivity by 22%. Economic incentives, i.e. expenditures and individuals’ own valuation of leisure time, seem to influence preferences for participation in the PAP-program. Social–cognitive factors seem important when changing physical activity behaviour. Prescribed exercise may work pre-motivational for changed physical activity behaviour

  • 43.
    Lindqvist, Anna-Karin
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Kostenius, Catrine
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Fun, feasible and functioning: Students’ experiences of a physical activity intervention2014In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 16, no 4, p. 194-200Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to describe students’ experiences of participating in a physical activity (PA) intervention. Methodology: A purposive sampling was used; 14 students (four boys and 10 girls) were interviewed and the collected data was analysed using qualitative content analysis. Major findings: One main theme was identified: fun, feasible and functioning. The following two subthemes also emerged: the multi-component intervention fits several, but not all, and manageable measuring can also be motivating. The main theme elucidates that fun was an important factor for joining the study; the students also experienced he empowerment-inspired intervention and the data collection to be fun and feasible. According to the students, the intervention was functioning since they experienced that it increased their PA. Principal conclusions: An empowerment approach that includes forming partnerships with students is a promising avenue for developing PA interventions for schools, regardless of whether the person concerned is a parent, teacher, school nurse or physiotherapist, but one size will never fit all.

  • 44.
    Lind, Anette
    et al.
    Socialförvaltningen, Hälsa & sjukvård & rehabilitering, Luleå.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Harmful effects in personal assistents´ client transfer situations2014In: Ergonomics Open Journal, ISSN 1875-9343, E-ISSN 1875-9343, Vol. 7, p. 1-5Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe personal assistants’ risks for harmful effects in client transfer situations at work. Observation and assessment of their working postures in transfer situations were performed by the Swedish ergonomic regulations concerning “red flags” (AFS 1998:1), by video recordings and by biomechanical analysis. The results showed that among eight home care assistants, four assistants had a low-back posture in client transfer situations which was flexed and/or rotated >60, classified as a harmful effect, a red flag, with a high risk for musculoskeletal workrelated symptoms and disorders and the other four had a risk for harmful effects, yellow flags. The harmful effects were noted in highly flexed and rotated working postures when technical equipment was not used or not possible to use anthropometrically correct. All eight personal assistants´ neck flexion indicated yellow flags, thus there were risks for harmful effect in the neck.

  • 45.
    Nordin, Catharina
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Fjellman-Wiklund, Anncristine
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    In search of recognition: patients’ experiences of patient participation prior to multimodal pain rehabilitation2014In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 16, no 1, p. 49-57Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore primary healthcare patients’ experiences of patient participation prior to multimodal pain rehabilitation. Data was collected from interviews with 17 patients, aged 23–59 years, after completing multimodal rehabilitation. Data was analysed using qualitative content analysis. The theme, In search of recognition, depicted patient participation prior to the multimodal pain rehabilitation as a lack of recognition in the healthcare system. A demand for medical help and the healthcare professionals’ preferential right to interpret the patients’ condition formed the category Need for medical affirmation. In the category Emotional and cognitive alienation, patients emphasized distress when being unconfirmed. This entailed an emotional and cognitive distance between the patients and the healthcare professionals. Situational factors, together with patients’ emotional and cognitive prerequisites and patients’ strategies to be included in dialogue represented the category Need to communicate, which influenced the opportunities to participate. For healthcare professionals, it is important to understand that patients in multimodal pain rehabilitation may have experiences of a clinician-centred behaviour in the past. Patients may have been unconfirmed and their point of view disregarded. For the future, greater effort for dialogue and patients’ involvement in decision-making and rehabilitation planning is needed.

  • 46.
    Lindqvist, Anna-Karin
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Mikaelsson, Katarina
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Westerberg, Mats
    Luleå University of Technology, Department of Business Administration, Technology and Social Sciences, Innovation and Design.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Kostenius, Catrine
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Moving From Idea to Action: Promoting Physical Activity by Empowering Adolescents2014In: Health Promotion Practice, ISSN 1524-8399, E-ISSN 1552-6372, Vol. 15, no 6, p. 812-818Article in journal (Refereed)
    Abstract [en]

    Background. Physical activity provides fundamental health benefits for children and youth. The aim of the study was to explore the possibility of conducting an empowerment-inspired intervention and examine the impact of the intervention in promoting moderate and vigorous physical activity (MVPA) among adolescents. Method. A nonrandomized trial with a concurrent control group was carried out. Physical activity data were collected before and after the intervention with daily questions by short message service. Self-efficacy, social support, and attitude were also measured before and after the intervention since they were possible mediators. Results. The intervention was created by the students, the researchers, and the teachers using an empowerment-based approach. Students in the intervention group (n = 21) increased their MVPA on average by 4.9 (SD = 28.9) minutes per day, and students in the control group (n = 25) reduced their MVPA on average by 25.4 (SD = 23.0) minutes per day (p = .000). Conclusions. The intervention might have contributed to a promotion of physical activity among students in the intervention group. The most valuable contribution this study provides is the knowledge that it is possible to develop and conduct an empowerment-inspired intervention to promote adolescent physical activity.

  • 47.
    Gard, Gunvor
    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.
    Nyberg, Lars
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Eriksson, Margareta K.
    Department of Public Health, Norrbotten County Council, Luleå.
    Michaelson, Peter
    Luleå University of Technology, Department of Health Sciences, Health and Rehab. peter.michaelson@ltu.se .
    Nordin, Catharina
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Calner, Tommy
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Multimodal pain rehabilitation (MMR) with additional tailored web-based pain rehabilitation: an RCT study2014Conference paper (Other academic)
  • 48.
    Björklund, Cecilia
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Lilja, Margareta
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute.
    Erlandsson, Lena-Karin
    Department of Health Sciences, Lund University.
    Temporal Patterns of Daily Occupations among Older Adults in Northern Sweden2014In: Journal of Occupational Science, ISSN 1442-7591, E-ISSN 2158-1576, Vol. 21, no 2, p. 143-160Article in journal (Refereed)
    Abstract [en]

    This study sought to expand knowledge regarding patterns of daily occupations and, specifically, to explore and describe the daily occupations of Swedish people aged over 70 years by investigating sequences, contexts and time-use. A cross-sectional design with a time-geographic approach was used. Open time diaries from 151 participants were collected and analysed using the software VISUAL-TimePAcTS. The results were illustrated as a routine of six pooled intervals during 24-hour sequences. The intervals comprised different lengths of time and each interval was dominated by different occupations. Night was dominated by ‘care for oneself’; morning by ‘house-keeping’ and ‘reflection and recreation’; lunch-time by care for oneself; afternoon by ‘reflection and recreation’; dinner/tea-time by ‘care for oneself’, and evening by ‘reflection and recreation’. The results were also illustrated as characteristic profiles of occupations visualised by the number of participants in each occupation during 24-hour sequences. Occupations were mainly supported by the home environment. Summed time-use showed the highest proportions in ‘care for oneself’ and ‘reflection and recreation’ occupations. To what extent health and well-being experiences of patterns of daily occupations might be related to challenges and fulfilment of basic occupational needs requires further investigation

  • 49.
    Nordin, Catharina
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Fjellman-Wiklund, Anncristine
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University.
    Being in an exchange process: experiences of patient participation in multimodal pain rehabilitation2013In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, no 6, p. 580-586Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To explore primary healthcare patients’ experiences of patients participation in multimodal pain rehabilitation. Patients and methods: A total of 17 patients who had completed multimodal rehabilitation for persistent pain were interviewed. The interviews were analysed using qualitative content analysis. RESULTS: One theme, Being in an exchange process, and 4 categories emerged. The theme depicted patient participation as a continuous exchange of emotions, thoughts and knowledge. The category Fruitful encounters represented the basic prerequisites for patient participation through dialogue and platforms to meet. Patients’ emotional and cognitive resources and restrictions, as well as knowledge gaps, were conditions influencing patient participation in the category Inequality in co-operation. Mutual trust and respect were crucial conditions in patient’s personal relationships with the health professionals, forming the category Confidence-inspiring alliance. In the category Competent health professionals, the health professionals’ expertise, empathy and personal qualities, were emphasized to favour patient participation. CONCLUSION: Patient participation can be understood as complex and individualized. A confidence-inspiring alliance enables a trusting relationship to be formed between patients and health professionals. Patients emphasized that health professionals need to play an active role in building common ground in the interaction. Understanding each patient’s needs in the participation process may favour patient participation.

  • 50.
    Areskoug-Josefsson, Kristina
    et al.
    Department of Health Sciences, Division of Physiotherapy, Lund University.
    Ekdahl, Charlotte
    Department of Health Sciences, Division of Physiotherapy, Lund University.
    Jakobsson, Ulf
    Center for Primary Health Care Research, CRC, Lund University.
    Gard, Gunvor
    Detecting decreased sexual health with MDHAQ-S2013In: Health, ISSN 1949-4998, E-ISSN 1949-5005, Vol. 5, no 6B, p. 38-47Article in journal (Refereed)
    Abstract [en]

    There are instruments that measure sexual function or sexual health for persons with RA, but since sexual health is a sensitive issue, the hypothesis is that it would be easier to have a standard questionnaire that could indicate the need for communication about sexual health issues instead of an extra questionnaire with more detailed questions on sexual health. The aim of the study is to find out whether sexual health difficulties can be screened by factors included in the MDHAQ-S for persons with RA. This study explores the relation between factors included in the MDHAQ-S and the Sexual Health Questionnaire (QSH) using a mixed methods design combining quantitative and qualitative data. The MDHAQ-S covers sexual health issues, not only by using the question on sexual health, but also on other factors included in the questionnaire such as increased pain, fatigue, depression, anxiety, physical capacity, level of physiccal activity and body weight. To explore decreased sexual arousal, decreased sexual satisfaction and decreased sexual well-being, in-depth interviews must be held with persons with RA, either using a sexual health questionnaire or in a clinical interview.

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