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  • 1.
    Röijezon, Ulrik
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Prellwitz, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Innala Ahlmark, Daniel
    van Deventer, Jan
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, EISLAB.
    Nikolakopoulos, George
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, Signaler och system.
    Hyyppä, Kalevi
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, EISLAB.
    A haptic navigation aid for individuals with visual impairments: Indoor and outdoor feasibility evaluations of the LaserNavigator2019Ingår i: Journal of Visual Impairment & Blindness, ISSN 0145-482X, E-ISSN 1559-1476, Vol. 113, nr 2, s. 194-201Artikel i tidskrift (Refereegranskat)
  • 2.
    Nordström, Birgitta
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Prellwitz, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    A pilot study of children and parents experiences of the use of a new assistive device: the electro suit Mollii2019Ingår i: Assistive technology, ISSN 1040-0435, E-ISSN 1949-3614Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Electrical stimulation has been used for many years to treat spasticity in children with cerebral palsy and some improvements have been noted. Building on the benefits of electrical stimulation, a new assistive device, a suit with imbedded electrodes designed to reduce spasticity through electrical stimulation of the antagonistic muscles, has been tested.

    Aim: The aim of this study was to describe experiences from children with cerebral palsy and their parents regarding the use of the suit. Methods: Individual interviews were conducted with six children 5 to 10 years of age and their parents. The interviews were transcribed and analyzed using a qualitative content analysis. Results: The analysis resulted in three themes: (1) the suit’s impact on image, (2) changes that make a difference and (3) dealing with a desire for change. Each of the themes included subthemes. Conclusion: All children reported some impact on their body and self and/or in some activities after the use of the suit. The parents also saw improvements during the trial period. However, the results are inconclusive and a larger study is needed to determine if the suit is useful from a longer perspective and whether it can affect activity and participation in daily activities for children with spasticity.

  • 3.
    Grooten, Liset
    et al.
    Department of Family Medicine and Chronic Care, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.
    Alexandru, Cristina-Adriana
    School of Informatics, University of Edinburgh, Edinburgh, UK.
    Alhambra-Borrás, Tamara
    Polibienestar Research Institute, Universitat de Valencia, Valencia, Spain.
    Anderson, Stuart
    School of Informatics, University of Edinburgh, Edinburgh, UK.
    Avolio, Francesca
    Regional Strategic Agency for Health and Social Affair of Puglia, Bari, Italy.
    Valia Cotanda, Elisa
    Polibienestar Research Institute, Universitat de Valencia, Valencia, Spain.
    Gütter, Zdenek
    Czech National eHealth Center, University Hospital Olomouc, Olomouc, Czech Republic.
    Henderson, Donna
    Scottish Centre for Telehealth and Telecare, NHS 24, Glasgow, UK.
    Kassberg, Ann-Charlotte
    Department of Development, Research and Innovation Unit, Luleå.
    Keenoy, Esteban de Manuel
    Kronikgune, Barakaldo, Spain.
    Lange, Marc
    European Health Telematics Association (EHTEL), Brussels, Belgium.
    Lundgren, Lisa
    Department of Development, Research and Innovation Unit, Luleå.
    Pavlickova, Andrea
    Scottish Centre for Telehealth and Telecare, NHS 24, Glasgow, UK.
    Txarramendieta Suarez, Jon
    Kronikgune, Barakaldo, Spain.
    Whitehouse, Diane
    European Health Telematics Association (EHTEL), Brussels, Belgium.
    Fullaondo Zabala, Ane
    Kronikgune, Barakaldo, Spain.
    Zabala Rementeria, Joseba Igor
    Osakidetza-Basque Health Service, Vitoria-Gasteiz, Spain.
    Vrijhoef, Hubertus Johannes Maria
    Department of Patient and Care, Maastricht University Medical Center, Maastricht, The Netherlands) (Panaxea B.V., Amsterdam, The Netherlands ; Department of Family Medicine and Chronic Care, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.
    A scaling-up strategy supporting the expansion of integrated care: a study protocol2019Ingår i: Journal of Integrated Care, ISSN 1476-9018, Vol. 27, nr 3, s. 215-231Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose

    To ensure that more people will benefit from integrated care initiatives, scaling-up of successful initiatives is the way forward. However, new challenges present themselves as knowledge on how to achieve successful large-scale implementation is scarce. The EU-funded project SCIROCCO uses a step-based scaling-up strategy to explore what to scale-up, and how to scale-up integrated care initiatives by matching the complementary strengths and weaknesses of five European regions involved in integrated care. The purpose of this paper is to describe a multi-method evaluation protocol designed to understand what factors influence the implementation of the SCIROCCO strategy to support the scaling-up of integrated care.

    Design/methodology/approach

    The first part of the protocol focuses on the assessment of the implementation fidelity of the SCIROCCO step-based strategy. The objective is to gain insight in whether the step-based strategy is implemented as it was designed to explore what works and does not work when implementing the scaling-up strategy. The second part concerns a realist evaluation to examine what it is about the SCIROCCO’s strategy that works for whom, why, how and in which circumstances when scaling-up integrated care.

    Findings

    The intended study will provide valuable information on the implementation of the scaling-up strategy which will help to explain for what specific reasons the implementation succeeds and will facilitate further improvement of project outcomes.

    Originality/value

    The expected insights could be useful to guide the development, implementation and evaluation of future scaling-up strategies to advance the change towards more sustainable health and care systems.

  • 4.
    Kottorp, Anders
    et al.
    Division of Occupational Therapy, Karolinska Institutet, Huddinge; Department of Occupational Therapy, University of Illinois at Chicago.
    Malinovsky, Camilla
    Division of Occupational Therapy, Karolinska Institutet, Huddinge.
    Larsson-Lund, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nygård, Louise
    Division of Occupational Therapy, Karolinska Institutet, Huddinge.
    Gender and diagnostic impact on everyday technology use: a differential item functioning (DIF) analysis of the Everyday Technology Use Questionnaire (ETUQ)2019Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, nr 22, s. 2688-2694Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: As the use of everyday technology is increasingly important for participation in daily activities, more in-depth knowledge of everyday technology use in relation to diagnosis and gender is needed. The purpose of this study was to investigate the stability of the perceived challenge of a variety of everyday technologies across different samples of varying diagnoses including both males and females.

    Methods: This cross-sectional study used 643 data records from clinical and research samples, including persons with dementia or related disorders, acquired brain injury, intellectual disability, various mental or medical disorders, and adults without known diagnoses. The Everyday Technology Use Questionnaire, comprising 93 everyday technology artifacts and services (items) measuring the level of everyday technology challenge and relevance of and perceived ability to use these was used for data gathering. A two-faceted Rasch model in combination with differential item functioning (DIF) analyses were used for comparing item hierarchies across samples.

    Results: Only three items (3.2%) demonstrated a clinically relevant DIF by gender, and nine items (9.7%) by diagnosis.

    Discussion: The findings support a stable hierarchy of everyday technology challenge in home and community that can facilitate planning of an accessible and inclusive society from a technological departure point.

    • Implications for Rehabilitation
    • The ability to manage everyday technology is increasingly important for participation in everyday activities at home and in the community for people with and without disabilities.

    • This study demonstrates that differences in perceived challenges in using various everyday technologies across gender and diagnosis are minimal.

    • The findings provide evidence of no or minor systematic bias in testing when using the Everyday Technology Use Questionnaire in clinical practice and research.

    • Empirical knowledge about the perceived challenge of specific everyday technologies of people with variations in gender or diagnosis is still sparse, hence this study can inspire practice and future research.

  • 5.
    Riekkola, Jenni
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Rutberg, Stina
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lilja, Margareta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Isaksson, Gunilla
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Healthcare professionals’ perspective on how to promote older couples’ participation in everyday life when using respite care2019Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, nr 2, s. 427-435Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims

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

    Design and Methods

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

    Findings

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

    Conclusion

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

  • 6.
    Haley, Katarina L.
    et al.
    Department of Allied Health Sciences, University of North Carolina at Chapel Hill.
    Womack, Jennifer L.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Department of Allied Health Sciences, University of North Carolina at Chapel Hill.
    Harmon, Tyson G.
    Department of Allied Health Sciences, University of North Carolina at Chapel Hill.
    McCulloch, Karen L.
    Department of Allied Health Sciences, University of North Carolina at Chapel Hill.
    Richard A., Faldowski
    Department of Allied Health Sciences, University of North Carolina at Chapel Hill.
    Life activity choices by people with aphasia: repeated interviews and proxy agreement2019Ingår i: Aphasiology, ISSN 0268-7038, E-ISSN 1464-5041, Vol. 33, nr 6, s. 710-730Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Person-centered rehabilitation requires that meaningful life activities are identified on a case-by-case basis, but the discovery process can be inaccessible for clients with aphasia. Card-sorting methodology addresses core barriers and help clients communicate their preferences.

    Aims: To characterize life activities that people with aphasia want to do, to estimate consistency in selections over time, and to replicate previous findings about the ability of family members and friends to identify their loved ones’ activity preferences.

    Methods & Procedures:  We administered the Life Interests and Values (LIV) Cards to 26 people with aphasia, asking them which of 95 depicted life activities they wanted to do more in their lives. Half the activity cards were presented again one to ten weeks later. Twenty family members or friends responded as proxies by selecting from a questionnaire with the same items.

    Outcomes & Results: Participants with aphasia selected diverse activities, though as a group they identified significantly more activities from the “social” activity category than from the “home and community”, “creative and relaxing”, or “physical” categories. Across the repeated interviews, they selected identical activities on average 78% of the time. Item-to-item agreement between people with aphasia and their proxy responders was significantly lower at 69%.

    Conclusions: People with aphasia have diverse activity interests and are reliable informants about their preferences. Because significant others have limited ability to predict these choices, their impressions are inadequate substitutes for direct interviews.

  • 7.
    Olofsson, Alexandra
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Möjlighet till aktivitet och delaktighet utanför hemmet för personer med förvärvad hjärnskada2019Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Det övergripande syftet med denna avhandling var att öka kunskapen om möjlighet till aktivitet och delaktighet utanför hemmet för personer i yrkesverksam ålder med förvärvad hjärnskada (FHS).

    Studie I syftade till att utforska och beskriva hur personer med FHS erfar engagemang i aktiviteter utanför hemmet. Intervjuer genomfördes med åtta deltagare och data analyserades genom konstant komparativ metod. Resultatet visade att svårigheter att bearbeta intryck, fatigue, förberedelse och upplevda risker var avgörande för deras begräsningar av engagemang i aktiveter. De använde nya strategier för att möjliggöra engagemang i aktiviteter med olika konsekvenser för deras liv. Studie II syftade till att utforska och identifiera problematiska situationer relaterat till aktiviteter utanför hemmet för personer med FHS. Upprepade intervjuer och deltagande observationer genomfördes med två deltagare och genererade data som analyserades med narrativ metod. Deltagarnas berättelser speglar hur det var en ständig kamp att försöka hantera oförutsedda händelser och kontrollera olika situationer de ställdes inför när de engagerade sig i aktiviteter utanför hemmet. Vidare, hur de dragit sig tillbaka från olika platser vilket medförde att deras sociala liv begränsats och att fler aktiviteter utfördes ensam och i hemmet efter skadan. Studie III syftade till att beskriva och jämföra upplevd delaktighet på platser utanför hemmet hos personer med stroke samt relationen mellan det totalt antal platser som besöktes, funktionshindrets svårighetsgrad och sociodemografisk data. Intervjuer genomfördes med sextiotre deltagare med stroke utifrån instrumentet ACT-OUT. Data analyserades med deskriptiv statistik, icke parametriska test, ANOVA och General Linear Model (GLM). Resultatet visade att gruppen med god återhämtning besökte i genomsnitt flest antal platser följt av dem med medelsvårt och svårt funktionshinder och skillnaden mellan grupperna vara signifikant. Skillnader i besökta platser var framförallt relaterat till platser för sociala, kulturella och andliga aktiviteter samt platser för rekreation och fysisk aktivitet. Oavsett funktionhindrets svårighetsgrad önskade deltagarna besöka platser i framtiden som de förnärvarande inte besökte. Funktionshindrets svårighetsgrad och bilkörning var signifikant associerade med det totala antalet besökta platser för aktiviteter utanför hemmet. Studie IV syftade till att utforska mönster av delaktighet på platser för aktiviteter utanför hemmet och om dessa mönster var relaterade till funktionshindrets svårighetsgrad och faktorer i miljön. Intervjuer genomfördes med samma deltagare och instrument som i studie III och analyserades med deskriptiv statistik, icke parametriska test och tvåstegs klusteranalys. Av analysen framkom fem mönster av delaktighet innehållande fyra möjliggörande och hindrande aspekter; upplevt avstånd till platsen, hur frekvent platsen besöktes och hur familjär platsen samt vägen till platsen var. Resultatet visade att det endast fanns signifikanta skillnader mellan mönstren när det gällde transport till och från platsen och socialt stöd.

    Sammanfattningsvis bidrar denna avhandling med kunskap om de mångfacetterade ständigt föränderliga utmaningar och problematiska situationer som personer med FHS erfar vid engagemang i aktiviteter utanför hemmet. Vidare, om strategier i aktivitet som möjliggör att personer med FHS kan återuppta och/eller bibehålla aktiviteter utanför hemmet. Avhandlingen bidrar även med kunskap om samband och mönster som påverkar upplevd delaktighet på platser för aktiviteter utanför hemmet, vilket är av betydelse för att förstå relationen mellan aktiviteter och platser. För att utveckla utformningen av rehabiliteringsinsatser som stärker möjlighet till aktivitet och delaktighet efter FHS behöver såväl aktiviteter som platser utanför hemmet samt aspekter som påverkar relationer dem emellan beaktas.

  • 8.
    Larsson-Lund, Maria
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyman, Anneli
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Occupational challenges in a digital society: A discussion inspiring occupational therapy to cross thresholds and embrace possibilities2019Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 9.
    Womack, Jennifer L.
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. The University of North Carolina at Chapel Hill, USA.
    Lilja, Margareta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Dickie, Virginia
    The University of North Carolina at Chapel Hill, USA.
    Isaksson, Gunilla
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Occupational Therapists’ Interactions With Older Adult Caregivers: Negotiating Priorities and Expertise2019Ingår i: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 39, nr 1, s. 48-55Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 10.
    Riekkola, Jenni
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Older couples' participation in everyday life - when living in changing and shifting contexts2019Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The overall aim of this thesis was to explore and develop an understanding about older couples’ participation in everyday life when living in shifting contexts. To achieve the aim, multiple perspectives were sought and a variety of qualitative methods were applied. Data were generated through interviews and observations with older couples and through focus groups with spousal caregivers, healthcare professionals, and other stakeholders and those data were analyzed through a constant comparative method, content analysis, and narrative analysis.

    From the perspective of spousal caregivers, the findings in study I revealed the complexity and ambiguity that influences participation in everyday life. Being in charge of everyday life was described as challenging in many ways and produced a need for recovery and own time. Interacting with social contexts and being confident with the provided social services, such as respite care, was described as complex. The partner’s wellbeing and participation had an impact on the spousal caregiver’s own participation when living in shifting contexts. The perspective of healthcare professionals related to residential respite care was captured in study II. They described a broad and multifaceted picture of participation in everyday life and how promoting participation for older couples involved building trustworthy relationships, enabling meaningful activities, and arranging a comfortable shared environment. Both of the partners in the older couples needed to be considered by the professionals. In study III, the perspectives of the older couples were explored. In order to understand how meaning and togetherness is created in older couples’ everyday life, the focus has to be on the couples’ whole situation, including their relationship. The results showed that the couples strived to continue living their lives in togetherness. Strategies used by the couples were shifting responsibilities, doing more things together than before, using residential respite care, and rearranging social interactions with family and friends. Study IV offered the perspectives of multiple stakeholders. The findings suggested that the focus has to be on older couples through maintaining abilities and creating comfort. Support is also required from both an engaged civil society and healthcare professionals that are motivated and have both competence and time. Further, social services need to work together to ensure that resources are properly available.

    Overall, this thesis contributes to a deeper understanding about older couples’ participation in everyday life when living in shifting contexts. The findings showed that acknowledging the couples’ relationship, seeing beyond the client and the spousal caregiver, was vital for supporting their participation. Furthermore, living in shifting contexts was multifaceted and the couples strived to continue living their lives in togetherness. The meaning that the change of life situation and context has on a couple’s participation in everyday life is important to consider when supporting aging in place. In light of demographic changes and challenges, bringing together the interests of older couples, professionals, systems of services, and civil society is vital for a sustainable future. Systems and situations that are both closely and remotely related to the older couples’ daily life need to be addressed in an ideal situation of aging in place. Knowledge from this thesis could be valuable for occupational therapists and other healthcare professionals, as well as social services that are supporting older couples to age in place. Consequently, this knowledge could be used to benefit the situations of older couples and their health and wellbeing when aging in place.

  • 11.
    Malinowsky, Camilla
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    Olofsson, Alexandra
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyman, Anneli
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Larsson-Lund, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Patterns of participation: Facilitating and hindering aspects related to places for activities outside the home after stroke2019Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

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

  • 12.
    Kassberg, Ann-Charlotte
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyman, Anneli
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Larsson-Lund, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Perceived occupational balance in people with stroke2019Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The balance of activities in daily life can become disrupted after a stroke; however, previous research has mainly focused on the performance of daily activities. Therefore, it is important to understand the impact that stroke has on various aspects of balance in activities for working-age people. 

    Purpose: To describe how persons with stroke perceived their occupational balance and to explore whether occupational balance was associated with the severity of disability, fatigue and sociodemographic characteristics. 

    Methods: This cross-sectional study included 63 working-age persons with stroke. The Occupational Balance Questionnaire, Glasgow Outcome Scale and Fatigue Severity Scale were used and analyzed statistically. 

    Results: The majority of participants disagreed or strongly disagreed that they perceived occupational balance in most of the investigated aspects. Moreover, few significant associations were found between total summed occupational balance and injury and sociodemographic characteristics. 

    Conclusion: These results demonstrate the importance of considering occupational balance in the rehabilitation of persons with stroke to support their engagement in a variety of meaningful activities that contribute to health. IMPLICATIONS FOR REHABILITATION Rehabilitation need to support persons with stroke to monitor their entire patterns of activities and perceived balance to support wider engagement in meaningful activities and promote health. Balance between all kinds of activities in daily life besides work, needs to be considered in the later phase of rehabilitation in persons with stroke. A majority of the participants with stroke in this study disagreed that they had a satisfying level of occupational balance. Perceived balance between all activities in daily life can together with performance of activities add to the understanding of consequences after stroke.

  • 13.
    Calner, Tommy
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Isaksson, Gunilla
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Michaelson, Peter
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Physiotherapy treatment experiences of persons with persistent musculoskeletal pain: A qualitative study2019Ingår i: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 14.
    Sjöblom, Margareta
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Jacobsson, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Öhrling, Kerstin
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Kostenius, Catrine
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Schoolchildren’s play: A tool for health education2019Ingår i: Health Education Journal, ISSN 0017-8969, E-ISSN 1748-8176Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The purpose of this study was to gain more knowledge about the phenomenon of the inner child in relation to health and well-being as reflected in play experienced by schoolchildren. Design/method: Participants were 20 schoolchildren recruited from a primary school in a medium-size city in central Sweden. The children who agreed to participate were 14 girls and 6 boys aged between 9 and 10 years old in grade 3. A hermeneutic phenomenological approach was used to analyse the data consisting of the schoolchildren’s drawings and transcribed interviews. Participants’ verbal reflections on their drawings enabled deeper insight into their lived experiences of play. Results: Findings from this study demonstrate how schoolchildren are influenced by the inner child in childhood to handle conflicts, to cope, to make choices, to build relationships to connect and to dream about the future. The schoolchildren in this study developed their coping skills in conflict situations as part of friendship making. Conclusion: The value play offers for health and well-being reveals how schoolchildren are influenced by the inner child in childhood. Gaining knowledge from schoolchildren’s own voices about play makes a worthwhile contribution to research. In addition, the value play provides to schoolchildren’s health and well-being suggest that play can be an important tool as part of health education.

  • 15.
    Riekkola Carabante, Jenni
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Rutberg, Stina
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lilja, Margareta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Isaksson, Gunilla
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Spousal caregivers’ experiences of participation in everyday life when living in shifting contexts2019Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 25, nr 6, s. 457-465Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

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

  • 16.
    Riekkola, Jenni
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Rutberg, Stina
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lilja, Margareta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Isaksson, Gunilla
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Strategies of older couples to sustain togetherness2019Ingår i: Journal of Aging Studies, ISSN 0890-4065, E-ISSN 1879-193X, Vol. 48, s. 60-66Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 17.
    Tornberg, Anna
    et al.
    Deptartment of Archaeology and Ancient History, Lund University.
    Jacobsson, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Medical Rehabilitation Section, Department of General Medicine, Sunderby Hospital/Kalix Hospital, Luleå, Sweden. Department of Health Sciences, Lund University, Lund, Sweden.
    Care and Consequences of Traumatic Brain Injury in Neolithic Sweden: A case study of ante-mortem skull trauma and brain injury addressed through the bioarchaeology of care2018Ingår i: International journal of osteoarchaeology, ISSN 1047-482X, E-ISSN 1099-1212, Vol. 28, nr 2, s. 188-198Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A number of papers have provided insight in frequencies of violence related trauma, especially skull trauma, in northern European skeletal assemblages dating to the Neolithic and Bronze Age. Although the cases are often well described, they lack further discussion about the consequences of skull trauma for the injured individual and the implications for the surrounding society, especially considering severe skull trauma leading to traumatic brain injuries (TBI). In this paper we address questions of trauma and care for one individual associated with the Swedish-Norwegian Battle Axe Culture who suffered from two severe ante-mortem skull traumas probably leading to brain injuries. These questions are addressed using the web-based application and analytic tool Index of care. We found that daily care, both short term with basic needs like nutrition and grooming, and long term with cognitive impairments, was available in the Neolithic society. Considering the frequent number of ante-mortem skull trauma in Neolithic and Bronze Age skeletal assemblages TBI was probably a common phenomenon. We argue that the care provided was a necessity for survival and maintenance of a socially sustainable society.

  • 18.
    Spinord, Linda
    et al.
    Department of Community Medicine and Rehabilitation, Umeå University.
    Kassberg, Ann-Charlotte
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Department of Research, Region Norrbotten, Luleå.
    Stenberg, Gunilla
    Department of Community Medicine and Rehabilitation, Umeå University.
    Lundqvist, Robert
    Department of Research, Region Norrbotten, Luleå.
    Stålnacke, Britt-Marie
    Department of Community Medicine and Rehabilitation, Umeå University.
    Comparison of two multimodal pain rehabilitation programmes, in relation to sex and age2018Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, nr 7, s. 619-628Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To evaluate patient-reported outcome measures in 2 different multimodal pain rehabilitation programmes and to determine whether outcomes are related to sex or age at 1-year follow-up. Design: Longitudinal retrospective study. Subjects: Patients who had participated in 1 of 2 multimodal pain rehabilitation programmes at 2 rehabilitation centres. A total of 356 women and 83 men, divided into 3 age groups. Methods: Data from the Swedish Quality Registry for Pain Rehabilitation regarding activity and physical functions, pain intensity, health status and emotional functions analysed with descriptive statistics. Results: Significant improvements in activity and physical functions, pain intensity and emotional functions were found in both multimodal pain rehabilitation programmes. Women improved more than men. The older group improved in all emotional functions (depression, anxiety, mental component summary), while the younger group improved only in depression. The intermediate group improved in all variables except anxiety. Conclusion: Patients improved regardless of the design of the multimodal pain rehabilitation programme. Although only small differences were found between men and women and among the 3 age groups in terms of the measured variables, these findings may have clinical relevance and indicate a need to vary the design of the interventions in multimodal rehabilitation programmes for these subgroups.

  • 19.
    Olofsson, Alexandra
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Larsson-Lund, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyman, Anneli
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Everyday activities outside the home are a struggle: Narratives from two persons with acquired brain injury2018Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND

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

    AIM

    To explore and identify problematic situations in everyday activities outside the home for persons with acquired brain injury.MATERIAL AND METHODTwo persons of working age with ABI were included. Data were generated through repeated semi-structured interviews and participant observations. Narrative analysis was used to capture ongoing processes related to problematic situations during engagement in everyday activities outside the home.

    RESULTS

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

    CONCLUSIONS

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

  • 20.
    Jonasson, Stina B.
    et al.
    Department of Health Sciences, Lund University.
    Nilsson, Maria H.
    Department of Health Sciences, Lund University.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Department of Health Sciences, Lund University, .
    Carlsson, Gunilla
    Department of Health Sciences, Lund University.
    Experiences of fear of falling in persons with Parkinson’s disease: a qualitative study2018Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 18, nr 1, artikel-id 44Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Fear of falling is common among persons with Parkinson’s disease and is negatively associated with quality of life. However a lack of in-depth understanding of fear of falling as a phenomenon persists. This qualitative study aimed to explore the experiences of fear of falling in persons with Parkinson’s disease.

    Methods

    Individual interviews were performed with twelve persons with Parkinson’s disease (median age 70 years, median Parkinson duration 9 years, 50% women). The interviews were semi-structured and followed a study-specific interview guide. The transcribed interviews were analyzed using qualitative content analysis.

    Results

    Fear of falling was experienced as a disturbing factor in everyday life. It generated a feeling of vulnerability and made daily activities and everyday environments seem potentially hazardous. Persons also missed performing previous activities. The fear of falling was a varying experience, fueled by an awareness of falls and near falls, Parkinson-related symptoms and disabilities, and by others in their environment. The persons adopted different strategies to handle their fear of falling. Activities were adapted, avoided, performed with help, or carried out despite their fear of falling.

    Conclusions

    The experiences of fear of falling were complex, multifaceted and varied over time and in relation to different activities and environments. This indicates that interventions targeting fear of falling need to be individually tailored for persons with Parkinson’s disease and should focus on several aspects, such as Parkinson-related symptoms and disabilities, activities and environmental factors. This study provides new information that increases the understanding of fear of falling, which has implications for researchers as well as clinicians working with persons with Parkinson’s disease and fear of falling.

  • 21.
    Lynch, Helen
    et al.
    Department of Occupational Science and Occupational Therapy, University College, Cork, Ireland.
    Moore, Alice
    Department of Occupational Science and Occupational Therapy, University College, Cork, Ireland.
    Prellwitz, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    From Policy to Play Provision: Universal Design and the Challenges of Inclusive Play2018Ingår i: Children, Youth and Environments, ISSN 1546-2250, E-ISSN 1546-2250, Vol. 28, nr 2, s. 12-34Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Outdoor environments for children are important sites for social inclusion and play. In the European context, outdoor play provision is typically governed by regional or national policy and informed by international conventions that specifically state that inclusive environments must be made available for all children for their rights to be met. Specifically, universal design is proposed as a way to achieve this goal. However, little is known about national play policy in general, nor the extent to which universal design informs local play provision. This paper focuses on a review of play policy and guidelines carried out in 18 European countries and a national universal design study in Ireland in 2018. Findings identified an overall lack of play policy internationally, and when policy exists, universal design is under-represented. The potential application of the seven principles of universal design to playgrounds is discussed alongside play value principles to maximize successful playspace design. Further exploration of the child's voice in designing for play is warranted to strengthen socio-spatial inclusion and diminish the poverty of experience that many children with disabilities experience in their communities.

  • 22.
    Wikberg-Nilsson, Åsa
    et al.
    Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, Människa och teknik.
    Normark, Carl Jörgen
    Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, Människa och teknik.
    Björklund, Cecilia
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Axelsson, Sarianne Wiklund
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    HealthCloud: promoting healthy living through co-design of user experiences in a digital service2018Ingår i: Proceedings of NordDesign: Design in the Era of Digitalization, 2018, 2018Konferensbidrag (Refereegranskat)
    Abstract [en]

    The aim of the interdisciplinary HealthCloud pre-study project was twofold: to further

    knowledge of user experiences of inclusive interface design specifically for an ageing

    population, and to develop a digital service for senior persons with sensory decline to promote

    healthy living and active ageing. A co-design approach was chosen to investigate the project

    aim and knowledge and user experiences was jointly developed and evaluated in three

    sequential steps in a participant-group of senior persons. In the design of the conceptual user

    interface, the identified core aspect involved a strive for utility: quality of appropriateness in

    use, and significance: how designs assume meaning in the ways they are used, as well as

    simplicity: to reduce, organize, and making it enjoyable to use. The digital service outcome

    consists of validation of previous research themes: keeping the family together; enjoying life

    at home; being close to nature; self-development; and promoting conditions for healthy

    ageing. The pre-study project outcomes are prototypes of digital health service content and

    interfaces, aimed for a future digital HealthCloud service. Participants in the reference-group

    found the developed interface easy to use regardless of previous computer skills and they

    were also motivated and stimulated by the developed prototypes for promoting active ageing

    on a daily basis. Participants also expressed a desire to display and recommend such digital

  • 23.
    Derman, Wayne
    et al.
    Institute of Sport and Exercise Medicine, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University. International Olympic Committee (IOC) Research Centre.
    Runciman, Phoebe
    Institute of Sport and Exercise Medicine, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University. International Olympic Committee (IOC) Research Centre.
    Schwellnus, Martin
    International Olympic Committee (IOC) Research Centre. Sport, Exercise Medicine and Lifestyle Institute (SEMLI) and Section Sports Medicine, Faculty of Health Sciences, University of Pretoria.
    Jordaan, Esme
    Biostatistics Unit, Medical Research Council, Parow.
    Blauwet, Cheri
    Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Women's Hospital, Harvard Medical School, Boston, USA.
    Webborn, Nick
    Centre for Sport and Exercise Science and Medicine (SESAME), University of Brighton, Eastbourne.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Department of Health Sciences, Lund University, Sweden. Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Sweden.
    Van de Vliet, Peter
    Medical and Scientific Department, International Paralympic Committee, Bonn.
    Tuakli-Wosornu, Yetsa
    Yale School of Public Health, Department of Chronic Disease and Epidemiology, Department of Orthopaedics and Rehabilitation, Yale University, Connecticut, USA.
    Kissick, James
    Carleton University Sport Medicine Clinic, Department of Family Medicine, Ottawa, Canada.
    Stomphorst, Jaap
    Department of Sport Medicine, Isala Klinieken, Zwolle.
    High precompetition injury rate dominates the injury profile at the Rio 2016 Summer Paralympic Games: a prospective cohort study of 51 198 athlete days2018Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, nr 1, s. 24-31Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES:

    To describe the incidence of injury in the precompetition and competition periods of the Rio 2016 Summer Paralympic Games.

    METHODS:

    A total of 3657 athletes from 78 countries, representing 83.4% of all athletes at the Games, were monitored on the web-based injury and illness surveillance system over 51 198 athlete days during the Rio 2016 Summer Paralympic Games. Injury data were obtained daily from teams with their own medical support.

    RESULTS:

    A total of 510 injuries were reported during the 14-day Games period, with an injury incidence rate (IR) of 10.0 injuries per 1000 athlete days (12.1% of all athletes surveyed). The highest IRs were reported for football 5-a-side (22.5), judo (15.5) and football 7-a-side (15.3) compared with other sports (p<0.05). Precompetition injuries were significantly higher than in the competition period (risk ratio: 1.40, p<0.05), and acute traumatic injuries were the most common injuries at the Games (IR of 5.5). The shoulder was the most common anatomical area affected by injury (IR of 1.8).

    CONCLUSION:

    The data from this study indicate that (1) IRs were lower than those reported for the London 2012 Summer Paralympic Games, (2) the sports of football 5-a-side, judo and football 7-a-side were independent risk factors for injury, (3) precompetition injuries had a higher IR than competition period injuries, (4) injuries to the shoulder were the most common. These results would allow for comparative data to be collected at future editions of the Games and can be used to inform injury prevention programmes.

  • 24.
    Lexell, Jan
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Department of Health Sciences, Lund University, Lund, Sweden. Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Uppsala, Sweden. Department of Neurology and Rehabilitation Medicine, Skane University Hospital, Lund, Sweden.
    Jonasson, Stina B.
    Department of Health Sciences, Lund University, Lund, Sweden. Department of Neurology and Rehabilitation Medicine, Skane University Hospital, Lund, Sweden.
    Brogårdh, Christina
    Department of Health Sciences, Lund University, Lund, Sweden. Department of Neurology and Rehabilitation Medicine, Skane University Hospital, Lund, Sweden.
    Psychometric Properties of Three Fatigue Rating Scales in Individuals With Late Effects of Polio2018Ingår i: Annals of Rehabilitation Medicine, ISSN 2234-0645, Vol. 42, nr 5, s. 702-712Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective

    To evaluate the psychometric properties of the Fatigue Severity Scale (FSS), the Fatigue Impact Scale (FIS), and the Multidimensional Fatigue Inventory (MFI-20) in persons with late effects of polio (LEoP). More specifically, we explored the data completeness, scaling assumptions, targeting, reliability, and convergent validity.

    Methods

    A postal survey including FSS, FIS, and MFI-20 was administered to 77 persons with LEoP. Responders received a second survey after 3 weeks to enable test-retest reliability analyses.

    Results

    Sixty-one persons (mean age, 68 years; 54% women) responded to the survey (response rate 79%). Data quality of the rating scales was high (with 0%–0.5% missing item responses), the corrected item-total correlations exceeded 0.4 and the scales showed very little floor or ceiling effects (0%–6.6%). All scales had an acceptable reliability (Cronbach’s α ≥0.95) and test-retest reliability (intraclass correlation coefficient, ≥0.80). The standard error of measurement and the smallest detectable difference were 7%–10% and 20%–28% of the possible scoring range. All three scales were highly correlated (Spearman’s correlation coefficient rs=0.79–0.80; p<0.001).

    Conclusion

    The FSS, FIS, and MFI-20 exhibit sound psychometric properties in terms of data completeness, scaling assumptions, targeting, reliability, and convergent validity, suggesting that these three rating scales can be used to assess fatigue in persons with LEoP. As FSS has fewer items and therefore is less time consuming it may be the preferred scale. However, the choice of scale depends on the research question and the study design.

  • 25.
    Nolvi, Maria
    et al.
    Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University.
    Brogårdh, Christina
    Department of Health Sciences, Physiotherapy Research Group, Lund University, Lund, Sweden. Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.
    Jacobsson, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden. Department of Rehabilitation Medicine, Sunderby Hospital, Luleå, Sweden.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden. Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden. Department of Rehabilitation Medicine, Sunderby Hospital, Luleå, Sweden.
    Sense of Coherence in persons with late effects of polio2018Ingår i: NeuroRehabilitation (Reading, MA), ISSN 1053-8135, E-ISSN 1878-6448, Vol. 42, nr 1, s. 103-111Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Sense of Coherence (SOC) is important for successful adaptation and mental well-being in people with life-long medical conditions. Late effects of polio (LEoP) often lead to a life-long disability, but no study has assessed SOC in this population.

    OBJECTIVE:

    To assess SOC in persons with LEoP and to explore the association between SOC, demographics (age, gender, marital status and level of education) and variables related to LEoP (age at polio onset, number of years from polio until onset of LEoP and self-rated disability).

    METHOD:

    Ninety-three community-dwelling persons with clinically verified LEoP responded to a postal survey with the Sense of Coherence Scale (SOC-13). A hierarchical multiple regression analysis was performed to explore the associations with SOC.

    RESULTS:

    SOC varied considerably among the participants. The mean and median SOC-13 total sum score was 71.8 and 76 points, which is similar to age-matched non-disabled people. The number of years before onset of LEoP and self-rated disability together with the participants’ marital status and level of education explained 37% (p < 0.001) of the variance in SOC.

    CONCLUSION:

    Persons with LEoP have a level of SOC indicating that they generally have the ability to understand, handle and being motivated when dealing with stressful events and problems arising in their lives as a result of their disability. Being married and having a higher education, living many years before onset of LEoP and perceiving a mild to moderate disability contributed to a strong SOC.

  • 26.
    Malinovsky, Camilla
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy , Karolinska Institutet .
    Fallhapour, Mandana
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Larsson-Lund, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nygård, Louise
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy , Karolinska Institutet .
    Kottorp, Anders
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Stockholm.
    Skill clusters of ability to manage everyday technology among people with and without cognitive impairment, dementia and acquired brain injury2018Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 25, nr 2, s. 99-107Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

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

    AIMS:

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

    MATERIALS AND METHODS:

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

    RESULTS:

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

    CONCLUSIONS AND SIGNIFICANCE:

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

  • 27.
    Derman, Wayne
    et al.
    Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Institute of Sport and Exercise Medicine, Stellenbosch University. International Olympic Committee (IOC) Research Centre.
    Schwellnus, Martin P.
    International Olympic Committee (IOC) Research Centre. Sport, Exercise Medicine and Lifestyle Institute (SEMLI) and Section Sports Medicine, Faculty of Health Sciences, University of Pretoria.
    Jordaan, Esme
    Biostatistics Unit, Medical Research Council of South Africa, Cape Town. Statistics and Population Studies Department, University of the Western Cape.
    Runciman, Phoebe
    Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Institute of Sport and Exercise Medicine, Stellenbosch University. International Olympic Committee (IOC) Research Centre.
    Blauwet, Cheri
    Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Women's Hospital, Harvard Medical School, Boston.
    Webborn, Nick
    Centre for Sport and Exercise Science and Medicine (SESAME), University of Brighton, Eastbourne.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Department of Health Sciences, Lund University. Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Sweden.
    Van de Vliet, Peter
    Medical and Scientific Department, International Paralympic Committee, Bonn.
    Tuakli-Wosornu, Yetsa
    Yale School of Public Health, Department of Chronic Disease and Epidemiology, Department of Orthopaedics and Rehabilitation, Yale University, Connecticut.
    Kissick, James
    Carleton University Sport Medicine Clinic, Department of Family Medicine, Ottawa, Canada.
    Stomphorst, Jaap
    Department of Sport Medicine, Isala Klinieken, Zwolle.
    Sport, sex and age increase risk of illness at the Rio 2016 Summer Paralympic Games: a prospective cohort study of 51 198 athlete days2018Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, nr 1, s. 17-23Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE:

    To describe the epidemiology of illness at the Rio 2016 Summer Paralympic Games.

    METHODS:

    A total of 3657 athletes from 78 countries, representing 83.5% of all athletes at the Games, were monitored on the web-based injury and illness surveillance system (WEB-IISS) over 51 198 athlete days during the Rio 2016 Summer Paralympic Games. Illness data were obtained daily from teams with their own medical support through the WEB-IISS electronic data capturing systems.

    RESULTS:

    The total number of illnesses was 511, with an illness incidence rate (IR) of 10.0 per 1000 athlete days (12.4%). The highest IRs were reported for wheelchair fencing (14.9), para swimming (12.6) and wheelchair basketball (12.5) (p<0.05). Female athletes and older athletes (35-75 years) were also at higher risk of illness (both p<0.01). Illnesses in the respiratory, skin and subcutaneous and digestive systems were the most common (IRs of 3.3, 1.8 and 1.3, respectively).

    CONCLUSION:

    (1) The rate of illness was lower than that reported for the London 2012 Summer Paralympic Games; (2) the sports with the highest risk were wheelchair fencing, para swimming and wheelchair basketball; (3) female and older athletes (35-75 years) were at increased risk of illness; and (4) the respiratory system, skin and subcutaneous system and digestive system were most affected by illness. These results allow for comparison at future Games.

  • 28.
    Ekstrand, Elisabeth
    et al.
    Department of Health Sciences, Lund University.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Department of Health Sciences, Lund University.
    Brogårdh, Christina
    Department of Health Sciences, Lund University.
    Test-retest reliability of the life satisfaction questionnaire lisat-11 and association between items in individuals with chronic stroke2018Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, nr 8, s. 713-718Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To evaluate the test-retest reliability of the Life Satisfaction Questionnaire (LiSat-11) and the association between items in individuals with chronic stroke. Design: Test-retest design. Subjects: Forty-five individuals (mean age 65 years) with mild to moderate disability at least 6 months post-stroke. Methods: LiSat-11, which includes 1 global item "Life as a whole" and 10 domain-specific items, was rated on 2 occasions, one week apart. Test-retest reliability was evaluated by kappa statistics, the percent agreement (PA) and the Svensson rank-invariant method. The association between items was evaluated with the Spearman's rank correlation coefficient (rho). Results: The kappa coefficients showed good to excellent agreement (0.59-0.97) and the PA <= 1 point was high (> 89%) for all items. According to the Svensson method, a small systematic disagreement was found for "Partner relationship". The other items showed no systematic or random disagreements. All domain-specific items, except one ("Sexual life") were significantly correlated with "Life as a whole" (rhos 0.29-0.80). Conclusion: LiSat-11 is considered reliable and can be recommended for assessing life satisfaction after stroke. The association between items indicates that LiSat-11 measures various aspects that can impact on an individual's life satisfaction.

  • 29.
    Larsson-Lund, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    The digital society: Occupational therapists need to act proactively to meet the growing demands of digital competence2018Ingår i: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 81, nr 12, s. 733-735Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This opinion piece discusses the importance of how occupational therapy practice, research and education responds to and acts proactively in relation to the growing requirement for digital competence placed on citizens. Digital competence will be outlined and scrutinized in relation to occupational therapy's core concerns and with regard to the role of occupational therapists and occupational justice. Changes in peoples’ occupations and occupational patterns due to digitalization will be exemplified. Finally, several questions and suggestions are posed as to how occupational therapy can build capacity and promote its role in the face of ongoing challenges.

  • 30.
    Womack, Jennifer L.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    The Occupation of Caregiving: Moving Beyond Individualistic Perspectives2018Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The overall aim of this research was to illuminate and describe caregiving as an occupation, informed by perspectives from older adult care partners and occupational therapists. An additional aim was to integrate and inform study findings with theoretical constructs that inform occupational therapy practice through occupational science and public health perspectives. Although caregiving was the main construct under consideration, the specific focus was on care situations involving older adults.

    Study 1 considered the narratives of 3 older adult women serving as informal (unpaid) caregivers to friends and family members. All of the women were over the age of 65 and of varied racial/ethnic backgrounds. Data were elicited through story prompts embedded in repeated semi-structured interviews and analyzed using a storyboarding approach and poetic transcription.

    Study 2 was an ethnographic case study considering how care dyads take part in community mobility, a common instrumental activity of daily living, with a particular focus on how the caregiver supports the participation of the care recipient. 3 care dyads (6 participants) over the age of 65 were consented into the study. The researcher employed participant observation, field note journaling and semi-structured interviews followed by thematic qualitative analysis to illuminate strategies used by these care dyads to remain active in community mobility in the context of their care situation.

    Study 3 used a constructivist grounded theory approach to explore the perspectives of occupational therapists regarding their interactions with older adult caregivers. Repetitive focus groups with 11 occupational therapy practitioners, researcher memos and individual reflections from 2 additional participants provided multifaceted data that the researchers analyzed through several levels of coding to construct a grounded theory of occupational therapist-caregiver interactions.

    Study 4 consisted of secondary data analyses of a national survey of adult caregivers conducted in the United States in 2014-2015. Data specific to 482 caregivers age 65+ and older and their care recipients were extracted from the overall sample and considered in relationship to responses to questions regarding support received from healthcare providers. Descriptive and inferential statistical analyses were employed to develop a profile of older adult care situations and predict inquiries of support from healthcare providers based on care situation characteristics.

    Findings from the first two studies highlighted the relational nature of caregiving and an expanded view of the caregiver role. Study 1 also revealed that interactions with health care providers in positions of authority are often challenging and compel caregivers to act in ways they perceive as risky. Study 2 reinforced that caregivers act in ways that are influenced as much or more by the history of their relationships as by caregiving demands, and led to the explication of relational versus individual perspectives. These findings influenced the approaches used in studies 3 and 4, which focused on interactions between healthcare providers and older caregivers, specifically occupational therapists in study 3 and other healthcare professionals in study 4. Findings from study 3 resulted in a theoretical stance that occupational therapists are influenced by biomedical contexts to situate caregivers as paraprofessionals to help meet care recipient goals. This perpetuates an individualistic lens on caregiving, emphasizing the biomedical priorities of the patient over the priorities or support needs of the care situation. Support offered by healthcare providers in the form of inquiries about the needs of older caregivers was found in study 4 to be less than optimal, and appears not to be predicted by any characteristics of the care situation other than the living situation of the care recipient. In sum, individualistic perspectives fail to realize the occupational complexity of caregiving, and provide an opportunity to explore more collective paradigms when supporting older adult care situations.

     

  • 31.
    Lynch, Helen
    et al.
    Department of Occupational Science and Occupational Therapy, University College Cork.
    Prellwitz, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Schulze, Christina
    School of Occupational Therapy, Zurich University of Applied Sciences.
    Moore, Alice H.
    Department of Occupational Science and Occupational Therapy, University College Cork.
    The state of play in children's occupational therapy: A comparison between Ireland, Sweden and Switzerland2018Ingår i: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 81, nr 1, s. 42-50Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction

    Play is viewed as an important occupation in childhood and consequently in children's occupational therapy. However, few studies have explored the place of play in therapy practice. This study aimed to contribute to this knowledge gap by exploring play in occupational therapy in three European countries.

    Method

    A cross-sectional survey of occupational therapists in Ireland, Sweden and Switzerland was conducted to examine the use of play with children under 12 years old. A web-based survey was distributed to 935 occupational therapists, resulting in 338 returned surveys (36%). Responses were analysed using descriptive statistics and content analysis.

    Results

    Results were organised into three themes: (1) demographics and practice context; (2) play education and (3) use of play in practice. Respondents reported that although they valued play as an occupation, their primary focus was on play as a means to achieving other goals. Lack of education on play (research, theory and interventions) and pressures in the workplace were identified as barriers to play-centred practice.

    Conclusion

    Findings indicate that there is a mismatch between therapists valuing play as an occupation and how play is utilised in therapy practice. There is a need to strengthen education and research on play occupation to strengthen play-centred practice.

  • 32.
    Larsson-Lund, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    A new landscape for higher education evolves: How can digital competence be enhanced to match the needs in the  digital society?2017Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    The presentation will give an insight in why and how higher education need to change to improve professionals’ digital competence to better prepare them for future work in the digitized society including health care and social services. Also, in how the digitalization and the increased use of technology influence citizens’ possibilities to activity, participation and health. The presentation will be based on research and experiences from improvement work in higher education focusing on digitalization, digital competence and e-learning. The improvement work includes changes of learning outcomes and learning activities as the use of open educational resources (OER), person learning network (PLN), academic communities, student generated content and other tools in e-learning.

  • 33.
    Fagher, Kristina
    et al.
    Rehabilitation Medicine Research Group, Department of Health Sciences, Lund University.
    Jacobsson, Jenny
    Athletics Research Center, Department of Medical and Health Sciences, Linköping University.
    Dahlström, Örjan
    Athletics Research Center, Department of Medical and Health Sciences, Linkoping University.
    Timpka, Toomas
    Athletics Research Center, Department of Medical and Health Sciences, Linkoping University.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Rehabilitation Medicine Research Group, Department of Health Sciences, Lund University, Lund; Department of Neurology and Rehabilitation Medicine, Skåne University Hospital.
    An eHealth Application of Self-Reported Sports-Related Injuries and Illnesses in Paralympic Sport: Pilot Feasibility and Usability Study2017Ingår i: JMIR Human Factors, ISSN 2292-9495, Vol. 4, nr 4, artikel-id 30Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Sport participation is associated with a risk of sports-related injuries and illnesses, and Paralympic athletes’ additional medical issues can be a challenge to health care providers and medical staff. However, few prospective studies have assessed sports-related injuries and illnesses in Paralympic sport (SRIIPS) over time. Advances in mobile phone technology and networking systems offer novel opportunities to develop innovative eHealth applications for collection of athletes’ self-reports. Using eHealth applications for collection of self-reported SRIIPS is an unexplored area, and before initiation of full-scale research of SRIIPS, the feasibility and usability of such an approach needs to be ascertained.

    Objective: The aim of this study was to perform a 4-week pilot study and (1) evaluate the monitoring feasibility and system usability of a novel eHealth application for self-reported SRIIPS and (2) report preliminary data on SRIIPS.

    Methods: An eHealth application for routine collection of data from athletes was developed and adapted to Paralympic athletes. A 4-week pilot study was performed where Paralympic athletes (n=28) were asked to weekly self-report sport exposure, training load, general well-being, pain, sleep, anxiety, and possible SRIIPS. The data collection was followed by a poststudy use assessment survey. Quantitative data related to the system use (eg, completed self-reports, missing responses, and errors) were analyzed using descriptive statistics. The qualitative feasibility and usability data provided by the athletes were condensed and categorized using thematic analysis methods.

    Results: The weekly response rate was 95%. The athletes were of the opinion that the eHealth application was usable and feasible but stated that it was not fully adapted to Paralympic athletes and their impairments. For example, it was difficult to understand how a new injury or illness should be identified when the impairment was involved. More survey items related to the impairments were requested, as the athletes perceived that injuries and illnesses often occurred because of the impairment. Options for description of multifactorial incidents including an injury, an illness, and the impairment were also insufficient. Few technical issues were encountered, but athletes with visual impairment reported usability difficulties with the speech synthesizer. An incidence rate of 1.8 injuries and 1.7 illnesses per 100 hours of athlete exposure were recorded. The weekly pain prevalence was 56% and the impairment contributed to 20% of the reported incidents.

    Conclusions: The novel eHealth-based application for self-reported SRIIPS developed and tested in this pilot study was generally feasible and usable. With some adaptation to accommodate Paralympic athletes’ prerequisites and improved technical support for athletes with visual impairment, this application can be recommended for use in prospective studies of SRIIPS.

  • 34.
    Sirkka, Marianne
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Larsson-Lund, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Zingmark, Karin
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Arbetsterapeuters erfarenheter av förbättringsarbete: en resa mot hållbar evidensbaserad praktik2017Konferensbidrag (Refereegranskat)
    Abstract [sv]

    Bakgrund: Arbetsterapeuter har skyldighet att bedriva en evidensbaserad verksamhet baserad på bästa tillgängligavetenskapliga kunskap, professionens expertkunnande, patienternas erfarenheter och tillgängliga resurser. Forskningvisar dock att implementering av evidensbaserade åtgärder kan vara besvärliga att omsätta i praktiken och påbörjadeförbättringsarbeten kan vara svåra att få hållbara över tid. Det har även visat sig att praxismodeller där de används gerförutsättningar för ett evidensbaserat arbetssätt men användandet har studerats i begränsad omfattning.Syfte: var att utforska arbetsterapeuters erfarenheter av att delta i ett långsiktigt förbättringsarbete baserad påOccupational Therapy Intervention Process Model (OTIPM).Metod: Data utgjordes av semistrukturerade intervjuer med 19 arbetsterapeuter i tre fokusgrupper år 2006 ochuppföljande tre fokusgruppsintervjuer år 2011. Materialet analyserades med kvalitativ innehållsanalys.Resultat/preliminärt resultat: Det långsiktiga förbättringsarbetet beskrevs som en resa mot en hållbar ochevidensbaserad praktik. Resultatet visar på en förändringsresa med tre sammanflätade perspektiv; 1) omvandla tankaroch handlingar genom återkommande kollegial reflektion, 2) hantera den upplevda dubbelheten av förändring, 3)utveckla en ömsesidigt professionell kultur.Slutsats: Studien visar hur ett reflekterande kollegialt förhållningssätt och användning av en arbetsterapeutisk praxismodell kan leda till implementering av evidensbaserad kunskap som stödjer kontinuerliga hållbara förbättringar ipraktiken.

  • 35.
    Olofsson, Alexandra
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Larsson-Lund, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyman, Anneli
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Att leva som förut är inte ett alternativ: Berättelser från två personer med förvärvad hjärnskada2017Konferensbidrag (Refereegranskat)
    Abstract [sv]

    Aktiviteter utanför hemmet kan vara utmanande för personer med förvärvad hjärnskada (FHS) och måste betraktas i förhållande till personens hela repertoar av aktiviteter. Vi vet idag lite om den komplexitet av interagerande faktorer som kan orsaka problematiska situationer för personer med FHS vilket gör att dessa är svåra att förutse. För att hantera pågående förändringar i aktivitetssituationer krävs stödjande strategier. Mer kunskap behövs därför om den ömsesidiga relationen mellan person och kontext för att bättre förstå hur det påverkar personens agerande och hur de influerar tillgång till platser samt aktiviteter utanför hemmet. Syftet med studien var att utforska och identifiera problematiska situationer relaterat till aktiviteter utanför hemmet. Metod: Berättelser från två personer med FHS användes för att illustrera hur de agerade i och reflekterade över problematiska situationer. Data samlades in via kvalitativa intervjuer och deltagande observationer som genomfördes vid upprepade tillfällen. En narrativ metod användes för att kunna fånga pågående processer relaterat till hur deltagarna agerade och reflekterade kring problematiska situationer relaterat till deras engagemang i aktiviteter utanför hemmet. Resultatet: visar hur deltagarna på olika sätt ställs inför problematiska situationer i samband med att de engagerar sig i aktiviteter utanför hemmet. Att leva ett liv som tidigare är inte längre ett alternativ och de kämpar för att upprätthålla men också finna nya vanor och rutiner som får vardagen att fungera. Det är en ständigt pågående kamp att försöka hantera oförutsedda händelser och försöka kontrollera olika situationer de ställs inför. Då de inte längre yrkesarbetar blir aktiviteter utanför hemmet än viktigare än tidigare men deras berättelser speglar hur deras aktivitetsrepertoar minskar och hur de dragit sig tillbaka från olika arenor vilket medfört att deras sociala värld har krympt och de utför fler aktiviteter ensam och i hemmet.

  • 36.
    Larsson-Lund, Maria
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyman, Anneli
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Begreppen delaktighet och aktivitet: utmaningar och möjligheter för utbildning, praxis och forskning2017Konferensbidrag (Refereegranskat)
    Abstract [sv]

    Aktivitetsbegreppet är och har varit centralt inom arbetsterapi sedan professionens begynnelse. Dock har fokus på aktivitet varit mer eller mindre tydligt under olika paradigm inom arbetsterapi och i det framväxande och nutida aktivitetsparadigmet framhålls utmaningar att arbeta utifrån en aktivitetsfokuserad och aktivitetsbaserad praxis. Det är därför intressant att reflektera över hur begrepp som relateras till arbetsterapins teoribildning kommit att influera vår utbildning, praxis och forskning. Ett sådant begrepp är delaktighet. Begreppet delaktighet har kommit att influera arbetsterapi framförallt efter introduktionen av den internationella klassifikationen för funktionstillstånd, funktionshinder och hälsa (ICF). Begreppet delaktighet kom snabbt därefter att, på olika sätt, inkluderas och eller relateras till praxismodeller i arbetsterapi. En reflektion av hur delaktighetsbegreppet knyts an till praxismodeller kan identifiera utmaningar och möjligheter relaterat till arbetsterapins unika fokus på aktivitet. Syftet med workshopen är att generera en diskussion inom arbetsterapi kring användningen av begreppen delaktighet och aktivitet i utbildning, forskning och yrkesutövning. Tillvägagångssätt: Reflektion och diskussion i grupp utifrån frågeställningar som baseras på en granskning av begreppen delaktighet och aktivitet i praxismodeller i arbetsterapi. Förväntat resultat En ökad medvetenhet om hur begreppen används och kan stödja en aktivitetsfokuserad och aktivitetsbaserad praxis och forskning.

  • 37.
    Schulze, Christina
    et al.
    Zurich University of Applied Science, School of Health Professions, Institute of Occupational Therapy, Research and Development, Winterthur, Switzerland.
    Page, Julie P.
    Zurich University of Applied Science, School of Health Professions, Institute of Occupational Therapy, Research and Development, Winterthur, Switzerland.
    Lilja, Margareta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Kottorp, Anders
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Stockholm.
    Cross-cultural validity of the German version of the Pediatric Evaluation of Disability Inventory (PEDI-G): a Rasch model application2017Ingår i: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 43, nr 1, s. 48-58Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM:

    The aim of this study was to evaluate the cross-cultural validity of the German version of the Pediatric Evaluation of Disability Inventory (PEDI-G) when used in Austria, Germany and Switzerland.

    METHOD:

    A total of 118 girls and 144 boys participated in this study; 198 of the children (75.6%) had a developmental disability and 64 (24.4%) were without a known disability. The mean age was four years (range 11 months to 10 years and six months, SD 1.91). Item goodness of fit, differential item functioning (DIF) and differential test functioning (DTF) were evaluated by use of a Rasch model.

    RESULTS:

    Twenty-four (11.6%) out of 206 items of the Functional Skills Scale and one (5%) out of 20 items of the Caregiver Assistance Scale demonstrated misfit according to the Rasch model. Thirty-four (16.5%) out of 206 items of the Functional Skills Scale and no item from the Caregiver Assistance Scale demonstrated DIF. Almost half (46%) of the items demonstrating misfit also demonstrated DIF, indicating an association between them. The DIF by country only demonstrated a minimal impact on the person measures of the PEDI-G.

    INTERPRETATION:

    Even though some items did not meet the statistical and clinical criteria set, the PEDI-G can be used, on a preliminary basis as a valid tool to measure activities of daily living of children with and without a disability in these countries. Further larger studies are needed to evaluate more psychometric item properties of the PEDI-G in relation to context.  

  • 38.
    Womack, Jennifer L.
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lilja, Margareta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Isaksson, Gunilla
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Crossing a Line: A narrative of risk-taking by older women serving as caregivers2017Ingår i: Journal of Aging Studies, ISSN 0890-4065, E-ISSN 1879-193X, Vol. 41, s. 60-66Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

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

    Aim

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

    Methods

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

    Results

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

    Conclusion and significance

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

  • 39.
    Jörgensen, Sophie
    et al.
    Department of Health Sciences, PO Box 157, Lund University.
    Martin Ginis, Kathleen A.
    School of Health and Exercise Sciences, University of British Columbia, Okanagan Campus, Kelowna, BC.
    Iwarsson, Susanne
    Department of Health Sciences, Lund University.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Depressive symptoms among older adults with long-term spinal cord injury: Associations with secondary health conditions, sense of coherence, coping strategies and physical activity2017Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, nr 8, s. 644-651Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES:

    To assess the presence of depressive symptoms among older adults with long-term spinal cord injury and investigate the association with sociodemographic and injury characteristics; and to determine how potentially modifiable factors, i.e. secondary health conditions, sense of coherence, coping strategies and leisure-time physical activity, are associated with depressive symptoms.

    DESIGN:

    Cross-sectional study.

    SUBJECTS:

    A total of 122 individuals (70% men, injury levels C1-L5, American Spinal Injury Association Impairment Scale A-D), mean age 63 years, mean time since injury 24 years.

    METHODS:

    Data from the Swedish Aging with Spinal Cord Injury Study, collected using the Geriatric Depression Scale-15, the 13-item Sense of Coherence Scale, the Spinal Cord Lesion-related Coping Strategies Questionnaire and the Physical Activity Recall Assessment for people with Spinal Cord Injury. Associations were analysed using multivariable linear regression.

    RESULTS:

    A total of 29% reported clinically relevant depressive symptoms and 5% reported probable depression. Sense of coherence, the coping strategy Acceptance, neuropathic pain and leisure-time physical activity explained 53% of the variance in depressive symptoms.

    CONCLUSION:

    Older adults with long-term spinal cord injury report a low presence of probable depression. Mental health may be supported through rehabilitation that strengthens the ability to understand and confront life stressors, promotes acceptance of the injury, provides pain management and encourages participation in leisure-time physical activity.

  • 40.
    Brogårdh, Christina
    et al.
    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.
    Flansbjer, Ulla-Britt
    Lunds universitet, Lund University, Department of Rehabilitation Medicine, Skåne University Hospital.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Determinants of falls and fear of falling in ambulatory persons with late effects of polio2017Ingår i: PM&R, ISSN 1934-1482, E-ISSN 1934-1563, Vol. 9, nr 5, s. 455-463Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundFalls and fear of falling (FOF) are common in persons with late effects of polio but there is limited knowledge of associated factors.ObjectiveTo determine how knee muscle strength, dynamic balance and gait performance (adjusted for gender, age and BMI) are associated with falls and FOF in persons with late effects of polio.DesignA cross-sectional study.SettingA university hospital outpatient clinic.ParticipantsEighty-one ambulatory persons with verified late effects of polio (43 men; mean age 67 years).Main Outcome MeasurementsNumber of falls the past year, Falls Efficacy Scale –International (FES-I) to assess FOF, a Biodex dynamometer to measure knee muscle strength, the Timed Up and Go (TUG) test to assess dynamic balance and the Six Minute Walk test (6MWT) to assess gait performance. Univariate and multivariate logistic regression analyses were used for falls (categorical data) and linear regression analyses for FOF (continuous data) as dependent variables.ResultsFifty-nine % reported at least one fall during the past year and 79% experienced FOF. Reduced knee muscle strength in the more affected limb and gait performance were determinants of falls. An increase of 10 Nm in knee flexor and knee extensor strength reduced the OR between 0.70 and 0.83 (P=.01), and an increase of 100 meter in 6MWT reduced the OR to 0.41 (P=.001). All factors were determinants of FOF; reduced knee muscle strength in the more and less affected limbs explained 17% to 25% of the variance in FOF, dynamic balance 30% and gait performance 41%. Gender, age and BMI only marginally influenced the results.ConclusionsReduced gait performance, knee muscle strength and dynamic balance are to a varying degree determinants of falls and FOF in ambulatory persons with late effects of polio. Future studies need to evaluate if rehabilitation programs targeting these factors can reduce falls and FOF in this population. 

  • 41.
    Larsson, Ellinor
    et al.
    Department of Community Medicine and Rehabilitation, Occupational Therapy, Umeå University.
    Larsson-Lund, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nilsson, Ingeborg
    Department of Community Medicine and Rehabilitation, Occupational Therapy, Umeå University.
    Developing social contact and participation insocial activities: Seniors’ experiences from asocial internet-based intervention process2017Ingår i: Gerontechnology, ISSN 1569-1101, E-ISSN 1569-111X, Vol. 16, nr 2, s. 101-108Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective To explore seniors’ experiencesof the intervention process after participating in a social internet-based occupationaltherapy intervention. Method A qualitative interview study was conducted.Twelve women and 3 men (66–87 years old), from the completed intervention studyparticipated. The study was placed in northern Sweden. Data were collected throughsemi-structured interviews. The interviews were analyzed using the constant comparativemethod, and two categories with subcategories were generated in the analysis. ResultsThe seniors experienced a need to participate in social internet-based activities (SIBAs)due to their decline in social activities and the ever-increasing digitalization of society. Inthe intervention process, the seniors’ experiences reflected two divergent directions. Thefirst consisted of seniors who had experiences of being hampered in participating in theSIBAs in the intervention process. They did not completely reach their intervention goals,but they did describe increased ability to use SIBAs and increased self-reliance. The otherdirection of the process reflected experiences of reaching their goals in the intervention,and they developed habitual participation in SIBAs as well as increased participation insocial activities outside the Internet. Conclusion The social internet-based interventioncan support seniors to overcome the obstacles that prevent them from participating inSIBAs. By participating in SIBAs, the seniors might enrich their social activities and socialcontacts both on the Internet and outside, if the intervention is individually targeted tomeet their needs.

  • 42.
    Larsson-Lund, Maria
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyman, Anneli
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Digitaliseringen i samhället: Nya möjligheter för människans aktivitet, professionen, utbildningen och forskningen?2017Konferensbidrag (Refereegranskat)
    Abstract [sv]

    Workshop

    Digitaliseringen i samhället: Nya möjligheter för människans aktivitet, professionen, utbildningen och forskningen?

    Bakgrund: Digitaliseringen har bidragit till en ökad användning av teknik i våra aktiviteter i hem, skola, på arbetsplatser  och i samhället Digital kompentens har följaktligen blivit en viktig förutsättning för ett självständigt, aktivt liv, för delaktighet och inklusion i samhället, för hälsa och välbefinnande hos de klientgrupper arbetsterapeuten möter. Det här förändrar delvis arbetsterapeutens (framtida) arbetsinnehåll och arbetssätt. Likaså bidrar digitaliseringen till en ständig utveckling av digitala verktyg och tjänster samt ny e- hälsa teknik, vilka kommer att förändra arbetssätten inom hälso-och sjukvård.  Digital kompetens är följaktligen av stor vikt för arbetsterapeuter liksom andra yrkesgrupper inom hälso- och sjukvård. Såväl nationellt som internationellt påtalas vikten av att utbildning reorganiseras så att digitaliseringen och den tekniska utvecklingen tillvaratas för att motsvara (framtida) behov i samhället och för att öka utbildningens kvalité.  I linje med detta definieras digital kompetens av EU som en av nyckel komponenterna för livslångtlärande.  Mot bakgrund till denna utveckling i samhället behöver utvecklingsområden för kunskaper i arbetsterapi identifieras. Kunskaper om digitaliseringen, kvalitets kriterier för e- lärande, teorier/ modeller för digital kompetens och e-lärande samt digitala verktyg kan utgöra ett stöd i detta utvecklingsarbete.

    Syftet med workshopen är att bidra till en ökad insikt i digitaleringens betydelse för människors aktiviteter, för professionen arbetsterapeut, vår utbildning och forskning.

    Förväntat resultat: Avsikten är att stärka deltagarnas digitala kompetens kring de effekter digitaliseringen kan få för människans aktiviteter och skapa bättre beredskap för att möta utmaningar och möjligheter som digitaliseringen medför.  Vidare att ge ökad förståelse för den kompetens som kommer krävas av framtidens arbetsterapeuter och behovet av livslångt lärande.

  • 43.
    Sirkka, Marianne
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Zingmark, Karin
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Larsson-Lund, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    En process för utveckling av hållbar evidensbaserad arbetsterapi2017Konferensbidrag (Refereegranskat)
    Abstract [sv]

    Bakgrund: För att uppnå hög kvalitet inom arbetsterapi måste ny kunskap hela tiden övervägas, reflekteras ochintegreras i det dagliga arbetet. Implementering av ny kunskap kräver ett långsiktigt förbättringsarbete med struktur, stödoch tid för att lyckas. Professionsanpassade modeller och ramverk avser att stödja arbetsterapeutisk intervention ochutveckla professionell kompetens. När modellerna används ger det förutsättningar för hållbart förbättringsarbete ochevidensbaserat arbetssätt men har i mycket begränsad utsträckning studerats ur detta perspektiv.Syfte: att utforska och beskriva hur ett långsiktigt förbättringsarbete vid en arbetsterapienhet baserat på OccupationalTherapy Intervention Process Model (OTIPM) utvecklades.Metod: Studien var en kvalitativ beskrivande studie av skriftliga dokument från långsiktigt förbättringsarbete. Dokumentenbestod av a) enhetsplaner, b) dokumentering från förbättringsarbetet, c) resultat av genomförda patientenkäter, d)resultat av genomförda journalgranskningar, e) ett generellt arbetsterapiprogram och sju specifika arbetsterapiprogram(både aktuella och reviderade versioner), f) aktuell journalföringsmanual, g) 20 patientinformationer, h) 90 rutindokument.Data analyserdes med mönsterjämförelser (pattern matching).Resultat/preliminärt resultat: Analysen av dokumenten bildade tre huvudmönster: a) omorientering mot OTIPM, b)implementeringen av OTIPM, c) säkerställande av hållbarheten av implementeringen. Varje mönster innehöll ett antalfaser som beskrev skälen till varför varje fas påbörjades, vad som påbörjades i varje fas och vad förbättringsarbetetresulterade i, flera av faserna blev startpunkter för nya förbättringar som fortsatte kontinuerligt genom åren.Slutsats: Resultatet visar hur en arbetsterapeutisk praxismodell som till exempel OTIPM, kan vägleda enförbättringsprocess och hålla den pågående under en länge tid och därigenom stödja hållbara kontinuerliga förbättringar ien arbetsterapi verksamhet

  • 44.
    Brogårdh, Christina
    et al.
    Department of Health Sciences, Lund University.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Sjödahl Hammarlund, Catharina
    Department of Health Sciences, Lund University.
    Experiences of falls and strategies to manage the consequences of falls in persons with late effects of polio: a qualitative study2017Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, nr 8, s. 652-658Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE:

    To explore how persons with late effects of polio experience falls and what strategies they use to manage the consequences of falls.

    DESIGN:

    A qualitative study with face-to-face interviews. Data were analysed by systematic text condensation.

    PARTICIPANTS:

    Fourteen ambulatory persons (7 women; mean age 70 years) with late effects of polio.

    RESULTS:

    Analysis resulted in one main theme, "Everyday life is a challenge to avoid the consequences of falls", and 3 categories with 7 subcategories. Participants perceived that falls were unpredictable and could occur anywhere. Even slightly uneven surfaces could cause a fall, and increased impairments following late effects of polio led to reduced movement control and an inability to adjust balance quickly. Physical injuries were described after the falls, as well as emotional and psychological reactions, such as embarrassment, frustration and fear of falling. Assistive devices, careful planning and strategic thinking were strategies to prevent falls, together with adaptation and social comparisons to mitigate the emotional reactions.

    CONCLUSION:

    Experiences of falls greatly affect persons with late effects of polio in daily life. To reduce falls and fall-related consequences both problem-focused and emotion-focused strategies are used. In order to increase daily functioning, these findings should be included in a multifaceted falls management programme.

  • 45.
    Kottorp, Anders
    et al.
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Stockholm.
    Malinovsky, Camilla
    2Sektionen for Arbetsterapi, Karolinska Institutet.
    Fallhapour, Mandana
    3Sektionen for Arbesterapi, Karolinska Instiutet, Huddinge.
    Larsson-Lund, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nygård, Louise
    2Sektionen for Arbetsterapi, Karolinska Institutet.
    Färdigheter i teknikanvändning bland äldre med/utan kognitiv nedsättning eller förvärvad hjärnskada: en klusteranalys2017Konferensbidrag (Refereegranskat)
    Abstract [sv]

    Bakgrund: För att kunna utveckla stödjande interventioner till personer med svårigheter i användning av vardagstekniksåsom mobiltelefoner, biljettautomater och mikrovågsugnar så behövs en detaljerad information om styrkor ochbegränsningar i specifika färdigheter i teknikanvändning.Syfte: Att undersöka om (a) olika distinkta kluster av färdigheter som krävs för att använda vardagsteknik kan identifierasi en blandad grupp av teknikanvändare samt (b) om dessa färdighetskluster är kopplade till ålder, kön, diagnos samt typav vardagsteknik.Metod: 661 bedömningar av hanterande av vardagsteknik med Management of Everyday Technology Assessment(META) från 203 personer (äldre med/utan kognitiv nedsättning eller förvärvad hjärnskada) användes för en retrospektivanalys. Ward’s metod i kombination med en modell for hierarkisk klusteranalys användes för att fastställa och definierafärdighetsklustren. Hypotesprövande parametrisk statistik användes för sambandsanalyser.Resultat/preliminärt resultat: Fyra distinkta kluster av färdigheter kunde identifieras i data. Varje person uppvisade oftastflera olika klusterprofiler i sitt hanterande av vardagsteknik och färdighetsklustren var inte kopplade till diagnos, kön ellertyp av vardagsteknik.Slutsats: Fynden från studien stödjer ett mer dyadiskt baserat person-vardagsteknik tillvägagångssätt i bedömningen avvardagsteknikanvändning. Informationen från de definierade klustren kan också användas for att utveckla fokuseradeguider for intervention och design i vardagsteknikanvändning.

  • 46.
    Wiklund Axelsson, Sarianne
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Björklund, Cecilia
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Wikberg Nilsson, Åsa
    Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, Innovation och Design. Luleå University of Technology.
    Normark, Carl Jörgen
    Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, Innovation och Design.
    HealthCloud: Participatory design of user interfaces for senior people's active aging2017Rapport (Övrig (populärvetenskap, debatt, mm))
    Abstract [en]

    The aim of the HealthCloud project has been twofold: to develop knowledge of user needs for interface design specifically for an ageing population, and also to develop a user interface design specially designed for senior persons with sensory decline to promote healthy living through five Core Health Projects. A participatory approach was chosen to investigate the aim of the project and data was collected and analysed in three sequential steps. A reference-group with senior citizens recruited from retirement organizations interactively evolved data for the project during three workshops. The continuous interaction with the reference group resulted in a conceptual user interface design aimed for the digital HealthCloud service. In the design of the conceptual user interface, the identified core factors were a strive for simplicity: to reduce, organize, and make it enjoyable to use. Participants in the reference-group found the developed interface easy to use regardless of previous computer skills and they were also motivated and stimulated by the interface to start using the computer for promoting their health om a daily basis. Participants also wanted to display and recommend this interface to other members of retirement organizations.

  • 47.
    Calner, Tommy
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Isaksson, Gunilla
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Michaelson, Peter
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    I know what I want but I’m not sure how to get it: expectations of physiotherapy treatment of persons with persistent pain2017Ingår i: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, nr 3, s. 198-205Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 48.
    Larsson-Lund, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Improving digital competence in Europe: how can it be accomplished to make use of the benefits of the new digital technology2017Konferensbidrag (Övrigt vetenskapligt)
  • 49.
    Jörgensen, Sophie
    et al.
    Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University.
    Martin Ginis, K.A.
    School of Health and Exercise Sciences, University of British Columbia, Okanagan Campus, Kelowna, BC.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Leisure time physical activity among older adults with long-term spinal cord injury2017Ingår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 55, nr 9, s. 848-856Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    STUDY DESIGN:

    Cross-sectional.

    OBJECTIVES:

    To describe participation in leisure time physical activity (LTPA) (amount, intensity and type) among older adults with long-term spinal cord injury (SCI), and to investigate the associations with sociodemographics, injury characteristics and secondary health conditions (SHCs).

    SETTING:

    Home settings in southern Sweden.

    METHODS:

    Data from the Swedish Aging with Spinal Cord Injury Study (SASCIS). The physical activity recall assessment for people with SCI was used to assess LTPA among 84 men and 35 women (mean age 63.5 years, mean time since injury 24 years, injury levels C1-L5, American Spinal Injury Association Impairment Scale A-D). Associations were analyzed statistically using hierarchical multivariable regression.

    RESULTS:

    Twenty-nine percent reported no LTPA, whereas 53% performed moderate-to-heavy intensity LTPA. The mean minutes per day of total LTPA was 34.7 (±41.5, median 15, range 0-171.7) and of moderate-to-heavy LTPA 22.5 (±35.1, median 5.0, range 0-140.0). The most frequently performed activities were walking and wheeling. Sociodemographics, injury characteristics and SHCs (bowel-related and bladder-related problems, spasticity and pain) explained 10.6% and 13.4%, respectively, of the variance in total and moderate-to-heavy LTPA. Age and wheelchair use were significantly, negatively associated with total LTPA. Women, wheelchair users and employed participants performed significantly less moderate-to-heavy LTPA than men, those using walking devices/no mobility device and unemployed participants.

    CONCLUSION:

    Many older adults with long-term SCI do not reach the amount or intensity of LTPA needed to achieve fitness benefits. Research is needed on how to increase LTPA and to identify modifiable factors that could enhance their participation.Spinal Cord advance

  • 50.
    Olofsson, Alexandra
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyman, Anneli
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Larsson-Lund, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Occupations outside the home: Experiences of people with acquired brain injury2017Ingår i: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 80, nr 8, s. 486-493Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction

    Understanding those occupations outside the home that people with acquired brain injury find difficult, including the influencing factors, may help to develop appropriate support. The aim of this paper was to explore and describe how people with acquired brain injury experience engagement in occupations outside the home.

    Method

    This qualitative study included repeated semi-structured interviews with eight working-age persons with acquired brain injury, which were analysed by a constant comparison analysis.

    Findings

    The findings indicated that there were three influencing factors that had a critical effect on the participants’ changes in their engagement in occupations, the strategies they adopted, and the consequences for their lives. The categories reflected how the different changes in occupations outside the home were influenced by their struggles with sensory processing and fatigue, difficulties with completing preparations, and occupational risks.

    Conclusion

    The findings indicate that to improve engagement in occupations outside the home for people with acquired brain injury, professionals need to identify the different factors that are critical for each person’s engagement. The findings also indicate the importance of considering not only occupations outside the home but also preparations required at home and recovery afterward, and how engagement outside the home is influenced by the entire occupational repertoire.