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  • 51.
    Gard, Gunvor
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Karlqvist, Lena
    Different working conditions and perceived health at Gender Segregated Workplaces: Can health promotion promote equality in work demands?2013Konferensbidrag (Övrigt vetenskapligt)
  • 52.
    Praestegaard, Jeanette
    et al.
    Department of Physiotherapy Health Sciences, Health Sciences Center, Lund university.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Ethical issues in physiotherapy: reflected from the perspective of physiotherapists in private practice2013Ingår i: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 29, nr 2, s. 96-112Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    An important aspect of physiotherapy professional autonomy is the ethical code of the profession, both collectively and for the individual member of the profession. The aim of this study is to explore and add additional insight into the nature and scope of ethical issues as they are understood and experienced by Danish physiotherapists in outpatient, private practice. Methods: A qualitative approach was chosen and semi-structured interviews with 21 physiotherapists were carried out twice and analyzed, using a phenomenological hermeneutic framework. Results: One main theme emerged: The ideal of being beneficent toward the patient. Here, the ethical issues uncovered in the interviews were embedded in three code-groups: 1) ethical issues related to equality; 2) feeling obligated to do one's best; and 3) transgression of boundaries. Conclusions: In an ethical perspective, physiotherapy in private practice is on a trajectory toward increased professionalism. Physiotherapists in private practice have many reflections on ethics and these reflections are primarily based on individual common sense arguments and on deontological understandings. As physiotherapy by condition is characterized by asymmetrical power encounters where the parties are in close physical and emotional contact, practiced physiotherapy has many ethical issues embedded. Some physiotherapists meet these issues in a professional manner, but others meet them in unconscious or unprofessional ways. An explicit ethical consciousness among Danish physiotherapists in private practice seems to be needed. A debate of how to understand and respect the individual physiotherapist's moral versus the ethics of the profession needs to be addressedai=1rzjm&ui=oxk4&af=T

  • 53.
    Palstam, Annie
    et al.
    Department of Rheumatology and Inflammation Research, Institute of Medicine, University of Gothenburg.
    Gard, Gunvor
    Mannerkorpi, Kaisa
    Department of Rheumatology and Inflammation Research, Institute of Medicine, University of Gothenburg.
    Factors promoting sustainable work in women with fibromyalgia2013Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 35, nr 19, s. 1622-1629Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To examine and describe the factors promoting sustainable work in women with fibromyalgia (FM). Methods: A qualitative interview study. Twenty-seven gainfully employed women with FM participated in five focus group interviews. Their median age was 52 years, ranging from 33 to 62. The interviews were recorded, transcribed verbatim and analysed by qualitative latent content analysis. Results: Four categories were identified describing factors promoting sustainable work: the meaning of work and individual strategies were individual promoters while a favourable work environment and social support outside work were environmental promoters. The meaning of work included individual meaning and social meaning. The individual strategies included handling symptoms, the work day and long-term work life. A favourable work environment included the physical and psychosocial work environment. Social support outside work included societal and private social supports. Conclusions: Promoting factors for work were identified, involving individual and environmental factors. These working women with FM had developed advanced well-functioning strategies to enhance their work ability. The development of such strategies should be supported by health-care professionals as well as employers to promote sustainable work in women with FM.Implications for Rehabilitation

  • 54.
    Karlqvist, Lena
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Health-promoting educational interventions: A one-year follow-up study2013Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, nr 1, s. 32-42Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: The purpose of this study was to describe and analyse the effects of health-promoting educational interventions among employees in a municipality in Sweden. Methods: A randomized controlled educational intervention study was performed with 340 employees. Supervisors and workplace champions took part in two separate educational programmes with focus on health promotion. Intervention groups were teams of supervisors, teams of workplace champions and a mixed group (supervisors and workplace champions). The control group did not take part in any of the activities. Evaluations with physical fitness tests and a self-administrated questionnaire were performed twice. Focus group discussions were held. Results: All groups raised their physical fitness level from baseline to follow-up. Females in the supervisor group had increased their mean maximal oxygen uptake from 32.0 mlO2/kg*min to 34.9 mlO2/kg*min which was more than the others. Supervisors had reached increased knowledge within the area ‘organizational factors’ and behavioural changes had been obtained within the area ‘life-style’. Workplace champions working together with their supervisors had an easier and more motivated situation than workplace champions working by themselves. Conclusions: Coaching supervisors as well as the mixed group seemed to improve the intervention of health promotion most and should be continued.

  • 55.
    Larsson, Agneta
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Karlqvist, Lena
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Westerberg, Mats
    Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, Innovation och Design.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Perceptions of health and risk management among home care workers in Sweden2013Ingår i: Physical Therapy Reviews, ISSN 1083-3196, E-ISSN 1743-288X, Vol. 18, nr 5, s. 336-343Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Municipal home care workers provide high-quality services to an increasing proportion of elderly people living in private homes. The work environments and working conditions of these workers vary to a great extent, implying rapid prioritymaking among both employers and employees to ensure that the work can be performed in a safe way. Objectives: This study aims to examine home care workers perceptions of health, risks, working conditions and risk management within their organisation. Method: The study was based on cross-sectional data collected from home care service staff' in a municipality in the north of Sweden. Nursing assistants and care aides(n=133) replied to a self-administered questionnaire. Descriptive statistics and between-group differences were analysed. Results: Home care work was perceived to require high levels of professional skill and ingenuity, a good psychosocial work situation, but required a high physical workload. The general health, the capacity and self-efficacy of the staff in relation to work were good. Difficulties in performing risk assessments and to follow safety regulations due to lack of time, equipment and information were identified.Conclusion: There is a need to increase participation in risk assessments among the staff, improve management support, structures and cooperation with other divisions of the social services and the medical care organisations.

  • 56.
    Praestegaard, Jeanette
    et al.
    Division of Physiotherapy, Health Sciences Center, Lund University.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Glasdam, Stinne
    Division of Nursing, Health Sciences Center, Lund University.
    Practicing physiotherapy in Danish private practice: an ethical perspective2013Ingår i: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633, Vol. 16, nr 3, s. 555-564Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Despite an increasingly growth of professional guidelines, textbooks and research about ethics in health care, awareness about ethics in Danish physiotherapy private practice seen vague. This article explores how physiotherapists in Danish private practice, from an ethical perspective, perceive to practice physiotherapy. The empirical data consists of interviews with twenty-one physiotherapists. The interviews are analysed from a hermeneutic approach, inspired by Ricoeur's textual interpretation of distanciation. The analysis follows three phases: naïve reading, structural analysis and comprehensive analysis. Four main themes are constructed: Beneficence as the driving force; Disciplining the patient through the course of physiotherapy; Balancing between being a trustworthy professional and a businessperson; The dream of a code of practice. Private practice physiotherapy is embedded in a structural frame directed by both political and economical conditions that shape the conditions for practicing physiotherapy. It means that beneficence in practice is a balance between the patient, the physiotherapists themselves and the business. Beneficence towards the patient is expressed as an implicit demand. Physiotherapeutic practice is expressed as being an integration of professionalism and personality which implies that the physiotherapists also have to benefit themselves. Private practice seems to be driven by a paternalistic approach towards the patient, where disciplining the patient is a crucial element of practice, in order to optimise profit. Physiotherapists wish for a more beneficent practice in the future by aiming at bridging 'to be' and 'ought to be'

  • 57.
    Larsson, Agneta
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Näslund, Annika
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Karlqvist, Lena
    Projekt: Hälsa och säkerhet i vård- och socialt servicearbete, i ett samhällsperspektiv2013Övrigt (Övrig (populärvetenskap, debatt, mm))
    Abstract [sv]

    Syftet med projektet är att utveckla metoder där förebyggande insatser med satsning på ett förbättrat säkerhetsklimat och en ökad fysisk kompetens blandpersonal inom vård- och social service integreras i verksamhetsutvecklingen.

  • 58.
    Näslund, Annika
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Larsson, Agneta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Projekt: Pilotprojekt - budo som rehabilitering efter stroke2013Övrigt (Övrig (populärvetenskap, debatt, mm))
  • 59.
    Josefsson, Kristina Areskoug
    et al.
    Department of Health Sciences, Division of Physiotherapy, Lund University.
    Ekdahl, Charlotte
    Department of Health Sciences, Division of Physiotherapy, Lund University.
    Jakobsson, Ulf
    Center for Primary Health Care Research, Lund University, CRC, 20205, Malmö.
    Gard, Gunvor
    Swedish version of the multi dimensional health assessment questionnaire: translation and psychometric evaluation2013Ingår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 14, artikel-id 178Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundHealth assessment measurements for patients with Rheumatoid arthritis (RA) have to be meaningful, valid and relevant. A commonly used questionnaire for patients with RA is the Stanford Health Assessment Questionnaire Disability Index (HAQ), which has been available in Swedish since 1988. The HAQ has been revised and improved several times and the latest version is the Multi Dimensional Health Assessment Questionnaire (MDHAQ). The aim of this study was to translate the MDHAQ to Swedish conditions and to test the validity and reliability of this version for persons with RA. MethodsTranslation and adaption of the MDHAQ were performed according to guidelines by Guillemin et al. The translated version was tested for face validity and test-retest in a group of 30 patients with RA. Content validity, criterion validity and internal consistency were tested in a larger study group of 83 patients with RA. Reliability was tested with test-retest and Cronbach´s alpha for internal consistency. Two aspects of validity were explored: content and criterion validity. Content validity was tested with a content validity index. Criterion validity was tested with concurrent validity by exploring the correlation between the MDHAQ-S and the AIMS2-SF. Floor and ceiling effects were explored. ResultsTest-retest with intra-class correlation coefficient (ICC) gave a coefficient of 0.85 for physical function and 0.79 for psychological properties. Reliability test with Cronbach´s alpha gave an alpha of 0.65 for the psychological dimension and an alpha of 0.88 for the physical dimension of the MDHAQ-S. The average sum of the content validity index for each item was of the MDHAQ-S was 0.94. The MDHAQ-S had mainly a moderate correlation with the AIMS2-SF, except for the social dimension of the AIMS2-SF, which had a very low correlation with the MDHAQ-S. ConclusionsThe MDHAQ-S was considered to be reliable and valid, but further research is needed concerning sensitivity to change.

  • 60.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Aktivitet: E-hälsopromotion via multimodal rehabilitering i primärvården2012Konferensbidrag (Övrig (populärvetenskap, debatt, mm))
  • 61.
    Gard, Gunvor
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Melander-Wikman, AnitaLuleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    E-hälsa: innovationer, metoder, interventioner och perspektiv2012Samlingsverk (redaktörskap) (Övrig (populärvetenskap, debatt, mm))
  • 62.
    Karlqvist, Lena
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Ergonomic conditions and health at gender segregated workplaces2012Ingår i: Ergonomics Open Journal, ISSN 1875-9343, E-ISSN 1875-9343, Vol. 2012, nr 5, s. 10-18Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To investigate working conditions and health at gender segregated (most women, ≥ 60% women or most men, ≥ 60% men) workplaces with a focus on associations of ergonomic exposures with musculoskeletal disorders.Methods: A comprehensive questionnaire was randomly sent to 10 000 inhabitants in three municipalities in the middle of Sweden. The response rate was 50% (4965 men and women). Organisational, physical and psychosocial working conditions and the musculoskeletal symptom panorama as well as general health and psychological well-being were compared between men and women in the gender segregated workplaces.Results: There were significant differences in working conditions between men and women both in female and male dominated workplaces. Most differences concerned physical work environment factors at both workplaces. However, the level of low control and strain were more prevalent among women in male dominated workplaces. A significantly greater share of women, compared to men, reported symptoms in all body parts except in low back and knees at both workplaces. Good general health was reported by 80% of both men and women but men in male dominated workplaces perceived significantly better psychological well-being than the others.Conclusions: Women and men in this region performed different work tasks and a greater share of women than men reported musculoskeletal symptoms. This was the fact also when working in the same type of segregated workplaces.

  • 63.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Focus on psychological factors and body awareness in multimodal musculoskeletal pain rehabilitation2012Ingår i: Physical Therapy Perspectives in the 21st Century: Challenges and Possibilities, Rijeka, Croatia: INTECH, 2012Kapitel i bok, del av antologi (Refereegranskat)
  • 64.
    Mannerkorpi, Kaisa
    et al.
    Department of Rheumatology and Inflammation Research, Institute of Medicine, University of Gothenburg.
    Gard, Gunvor
    Hinders for continued work among persons with fibromyalgia2012Ingår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 13, s. 96-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Work disability is common among women with fibromyalgia (FM). The aim of the study was to investigate what health problems and work-related difficulties lead to hinders for continued work among women with FM. Methods A qualitative interview study. Twenty-seven gainfully employed women with FM participated in five focus group interviews. Their median age was 52 years, ranging from 33 to 62. The transcribed interviews were analyzed by content analysis. Results Health problems and work-related demands were identified. Limited physical capacity, increased stress and an increased need of rest were the major health problems, while physical, psychosocial and work organizational demands were the main work-related problems. Personal factors and factors related to family influenced the strategies used to manage the imbalance between the health problems and work-related demands. Conclusions Limited physical capacity and an increased need of rest made it difficult for these women to manage the physical, psychosocial and organizational work demands. Adjustment of the work tasks and work environment were the main factors influencing whether the women with FM could work or not.

  • 65.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Hälsopromotion i arbetslivet: är IKT ett verktyg för ökad hälsa2012Ingår i: E-hälsa: innovationer, metoder, interventioner och perspektiv, Lund: Studentlitteratur AB, 2012, s. 55-74Kapitel i bok, del av antologi (Övrig (populärvetenskap, debatt, mm))
  • 66.
    Larsson, Agneta
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Karlqvist, Lena
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Westerberg, Mats
    Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, Innovation och Design.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Identifying work ability promoting factors for home care aides and assistant nurses2012Ingår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 13, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In workplace health promotion, all potential resources needs to be taken into consideration, not only factors relating to the absence of injury and the physical health of the workers, but also psychological aspects. A dynamic balance between the resources of the individual employees and the demands of work is an important prerequisite. In the home care services, there is a noticeable trend towards increased psychosocial strain on employees at work. There are a high frequency of work-related musculoskeletal disorders and injuries, and a low prevalence of sustainable work ability. The aim of this research was to identify factors promoting work ability and self-efficacy in care aides and assistant nurses within home care services.This study is based on cross-sectional data collected in a municipality in northern Sweden. Care aides (n = 58) and assistant nurses (n = 79) replied to a self-administered questionnaire (response rate 46%). Hierarchical multiple regression analyses were performed to assess the influence of several independent variables on self-efficacy (model 1) and work ability (model 2) for care aides and assistant nurses separately.Perceptions of personal safety, self-efficacy and musculoskeletal wellbeing contributed to work ability for assistant nurses (R2adj of 0.36, p < 0.001), while for care aides, the safety climate, seniority and age contributed to work ability (R2adj of 0.29, p = 0.001). Self-efficacy was associated with the safety climate and the physical demands of the job in both professions (R2adj of 0.24, p = 0.003 for care aides), and also by sex and age for the assistant nurses (R2adj of 0.31, p < 0.001).The intermediate factors contributed differently to work ability in the two professions. Self-efficacy, personal safety and musculoskeletal wellbeing were important for the assistant nurses, while the work ability of the care aides was associated with the safety climate, but also with the non-changeable factors age and seniority. All these factors are important to acknowledge in practice and in further research. Proactive workplace interventions need to focus on potentially modifiable factors such as self-efficacy, safety climate, physical job demands and musculoskeletal wellbeing.

  • 67.
    Sandberg, Karl W.
    et al.
    Mittuniversitetet.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Innovation och e-innovation inom vård och rehabilitering2012Ingår i: E-hälsa: innovationer, metoder, interventioner och perspektiv, Lund: Studentlitteratur AB, 2012, s. 255-267Kapitel i bok, del av antologi (Övrig (populärvetenskap, debatt, mm))
  • 68.
    Lindqvist, Anna-Karin
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Kostenius, Catrine
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Peers, parents and phones: Swedish adolescents and health promotion2012Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, artikel-id 17726Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Many unhealthy behaviors are created during adolescence and follow the individual into adulthood. In addition, health behaviors often occur in clusters as those who are inactive are more likely to eat unhealthy food and smoke. This makes the early foundation of healthy behaviors vital. The aim was to describe and develop an understanding of adolescents' awareness and experiences concerning health promotion. Data was collected using focus groups with a total of 28 seventh graders and was analysed with latent qualitative content analysis. One main theme was identified; being competent, ambivalent and creative at the same time. The following three subthemes also emerged: being a digital native for better and for worse, knowing what is healthy, and sometimes doing it, and considering change and having ideas of how change could be supported. The main theme elucidates how the majority of students were informed and able but they did not always prioritize their health. The concept of health promotion relies upon the engagement of the individual; however, although the students had clear ideas about how they would like to change their own behaviors, they felt a need for support. Interestingly, the students were able to make several suggestions about the kind of support that would make a difference to their adoption to more healthy modes of living. They suggested information and communication technology (ICT), for example encouraging text messages (SMS), and social support, for example parents setting rules and peers inspiring them to adhere to a healthy behavior. The knowledge gained from this study echoes our view of inclusion and this could be helpful for those who encounter the challenge of promoting health among adolescents

  • 69.
    Josefsson, Kristina Areskoug
    et al.
    Department of Health Sciences, Health Sciences Center, Lund University.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Sexual health in patients with rheumatoid arthritis: experiences, needs and communication with health care professionals2012Ingår i: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 10, nr 2, s. 76-89Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Pain, fatigue and decreased joint mobility caused by rheumatoid arthritis (RA) often decrease sexual health in RA patients. Regular physiotherapy interventions in patients with RA are often aimed at improving those factors. The aim of the present study was to explore the experiences and views of patients concerning the impact of RA on their sexual health, the possible impact of physiotherapy interventions, and communication in clinical situations. A self-administered questionnaire was sent to patients with RA at two rehabilitation clinics in Sweden. The questionnaire included questions concerning the impact of RA on intimate relationships and sexual function, as well as experiences of physiotherapy and sexual health communication with health professionals. The questionnaire was answered by 63 patients. The majority of the patients thought that pain, stiffness, fatigue and physical capacity were related to sexual health. Communication between health professionals and patients about sexual health was less common, even if the desire for communication about sexual health was higher in this study than in other studies. The authors concluded that physiotherapists need to be aware that pain, fatigue, decreased joint mobility and physical capacity can affect sexual health and that physiotherapy can make a difference in sexual health in patients with RA. The impact of RA on sexual health is rarely discussed by health professionals and RA patients, and needs greater attention

  • 70.
    Mattsson, Malin
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Möller, Bozena
    Department of Rheumatology, Sunderby Hospital.
    Stamm, T.
    Division of Rheumatology, Department of Internal Medicine III Medical University of Vienna and Division of Occupational Therapy, Department of Health, University of Applied Sciences - FH Campus Wien.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Boström, C.
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Uncertainty and opportunities in patients with established eystemic Lupus Erythematosus: A qualitative study2012Ingår i: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 10, nr 1, s. 1-12Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Systemic lupus erythematosus (SLE) is a chronic disease which can affect any organ, and the impact of the condition will affect each person differently. There are few qualitative studies including the experiences of both women and men with a diagnosis of SLE corresponding to the American College of Rheumatology (ACR) criteria where both negative and positive impacts of the disease have been presented. Purpose: The aim was to describe how patients with established SLE experience their illness in everyday life, including both negative and positive aspects. Method: Four focus group interviews were conducted with 16 women and three men with SLE according to ACR criteria, with varied disease activity and no or little organ damage. The interviews were tape recorded, transcribed verbatim and analysed using qualitative content analysis. Results: Two themes emerged: multifaceted uncertainty contained the categories 'an unreliable body', 'obtrusive pain and incomprehensible fatigue', 'mood changes and worries', 'reliance on medication and health care'; Focus on health and opportunities included 'learning process implying personal strength', 'limitations and possibilities in activities and work', 'a challenge to explain and receive support' and 'living an ordinary life incorporating meaningful occupations'. Conclusions: While we expected to find a mainly negative impact, positive aspects were also described. Our findings were complex and showed that patients with established SLE can experience both uncertainty and opportunities. This highlights the importance for healthcare professionals of gaining a better understanding of patients' uncertainty, to enable them to support patients, allowing them to focus on health and opportunities. Measurement instruments that capture different aspects of uncertainty and opportunities needs to be developed.

  • 71.
    Stamm, Tanja A.
    et al.
    Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna.
    Mattsson, Malin
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Mihai, Carina
    Internal Medicine and Rheumatology Department, Carol Davila University of Medicine and Pharmacy, Cantacuzino Hospital, Bucharest.
    Stöcker, Juliane
    Department of Rheumatology and Institute for Physical Medicine, University Hospital Zurich.
    Binder, Alexia
    Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna.
    Bauernfeind, Bettina
    Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna.
    Stumvoll, Georg
    Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Hesselstrand, Roger
    Department of Rheumatology, Lund University.
    Sandqvist, Gunnel
    Department of Rheumatology, Lund University.
    Draghicescu, Oana
    Internal Medicine and Rheumatology Department, Carol Davila University of Medicine and Pharmacy, Cantacuzino Hospital, Bucharest.
    Gherghe, Ana Maria
    Internal Medicine and Rheumatology Department, Carol Davila University of Medicine and Pharmacy, Cantacuzino Hospital, Bucharest.
    Voicu, Malina
    Research Institute for Quality of Life, Romanian Academy of Science, Bucharest.
    Machold, Klaus P.
    Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna.
    Distler, Oliver
    Department of Rheumatology and Institute for Physical Medicine, University Hospital Zurich.
    Smolen, Josef S.
    Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna.
    Boström, Carina
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet.
    Concepts of functioning and health important to people with systemic sclerosis: a qualitative study in four European countries2011Konferensbidrag (Refereegranskat)
    Abstract [en]

    Objective To describe the experiences of people with systemic sclerosis (SSc) in different European countries of functioning and health and to link these experiences to the WHO International Classification of Functioning, Disability and Health (ICF) to develop a common understanding from a bio-psycho-social perspective. Method A qualitative multicentre study with focus-group interviews was performed in four European countries: Austria, Romania, Sweden and Switzerland. The qualitative data analysis followed a modified form of 'meaning condensation' and the concepts that emerged in the analysis were linked to the ICF. Results 63 people with SSc participated in 13 focus groups. In total, 86 concepts were identified. 32 (37%) of these were linked to the ICF component body functions and structures, 21 (24%) to activities and participation, 26 (30%) to environmental factors, 6 (7%) to personal factors and 1 (1%) to the health condition itself. 19 concepts (22%) were identified in all four countries and included impaired hand function, household activities, paid work, drugs, climate and coldness, support from others and experiences with healthcare institutions, non-pharmacological treatment, social security and benefits. Conclusion Concepts identified in all four countries could be used for guiding clinical assessment, as well as interdisciplinary team care and rheumatological rehabilitation for patients with SSc. For a full understanding of the aspects of the disease that were most relevant to people with SSc, people with SSc from multiple countries needed to be involved.

  • 72.
    Stamm, Tanja A.
    et al.
    Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna.
    Mattsson, Malin
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Mihai, Carina
    Internal Medicine and Rheumatology Department, Carol Davila University of Medicine and Pharmacy, Cantacuzino Hospital, Bucharest.
    Stöcker, Juliane
    Department of Rheumatology and Institute for Physical Medicine, University Hospital Zurich.
    Binder, Alexia
    Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna.
    Bauernfeind, Bettina
    Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna.
    Stumvoll, Georg
    Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Hesselstrand, Roger
    Department of Rheumatology, Lund University.
    Sandqvist, Gunnel
    Department of Rheumatology, Lund University.
    Draghicescu, Oana
    Internal Medicine and Rheumatology Department, Carol Davila University of Medicine and Pharmacy, Cantacuzino Hospital, Bucharest.
    Gherghe, Ana Maria
    Internal Medicine and Rheumatology Department, Carol Davila University of Medicine and Pharmacy, Cantacuzino Hospital, Bucharest.
    Voicu, Malina
    Research Institute for Quality of Life, Romanian Academy of Science, Bucharest.
    Machold, Klaus P.
    Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna.
    Distler, Oliver
    Department of Rheumatology and Institute for Physical Medicine, University Hospital Zurich.
    Smolen, Josef S.
    Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna.
    Boström, Carina
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet.
    Concepts of functioning and health important to people with systemic sclerosis: a qualitative study in four European countries2011Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 70, nr 6, s. 1074-1079Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective To describe the experiences of people with systemic sclerosis (SSc) in different European countries of functioning and health and to link these experiences to the WHO International Classification of Functioning, Disability and Health (ICF) to develop a common understanding from a bio-psycho-social perspective. Method A qualitative multicentre study with focus-group interviews was performed in four European countries: Austria, Romania, Sweden and Switzerland. The qualitative data analysis followed a modified form of 'meaning condensation' and the concepts that emerged in the analysis were linked to the ICF. Results 63 people with SSc participated in 13 focus groups. In total, 86 concepts were identified. 32 (37%) of these were linked to the ICF component body functions and structures, 21 (24%) to activities and participation, 26 (30%) to environmental factors, 6 (7%) to personal factors and 1 (1%) to the health condition itself. 19 concepts (22%) were identified in all four countries and included impaired hand function, household activities, paid work, drugs, climate and coldness, support from others and experiences with healthcare institutions, non-pharmacological treatment, social security and benefits. Conclusion Concepts identified in all four countries could be used for guiding clinical assessment, as well as interdisciplinary team care and rheumatological rehabilitation for patients with SSc. For a full understanding of the aspects of the disease that were most relevant to people with SSc, people with SSc from multiple countries needed to be involved.

  • 73.
    Stahlhut, Michelle
    et al.
    Department of Health Sciences, Division of Physiotherapy, Lund University.
    Gard, Gunvor
    Aadahl, Mette
    Research Centre for Prevention and Health, Capital Region of Denmark, Copenhagen.
    Christensen, Jette
    Department of Physical Therapy, Copenhagen University Hospital, Hvidovre.
    Discriminative validity of the Danish version of Pediatric evaluation of disability inventory (PEDI)2011Ingår i: Physical & Occupational Therapy in Pediatrics, ISSN 0194-2638, E-ISSN 1541-3144, Vol. 31, nr 1, s. 78-89Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The Pediatric Evaluation of Disability Inventory (PEDI) assesses functional status in children with disabilities aged 0.5-7.5 years. The purpose of this study was to examine if the Danish version of the PEDI was able to discriminate between nondisabled children and children with cerebral palsy (CP) or juvenile idiopathic arthritis (JIA). Convenience sampling was used to select the clinical samples that consisted of 22 children with CP and 14 children with JIA aged 1.5-7.5 years. An additional sample, consisting of 224 nondisabled children aged 1.0-5.9 years, was obtained on the basis of random sampling. The PEDI was administered as a questionnaire completed by the parents. Results from receiver operating characteristics (ROC) analysis showed that in the case of discrimination between children with CP and nondisabled children, the sensitivity and specificity were 77.3 and 97.8%, respectively. In the discrimination between children with JIA and nondisabled children, the sensitivity and specificity were 99.8 and 81.7%, respectively. Study results indicate that the Danish version of the PEDI shows good discriminative validity. Further studies of the discriminative validity are recommended.

  • 74.
    Tibaek, Sigrid
    et al.
    Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Glostrup.
    Dehlendorff, Christian
    Department of DTU Informatics, DTU Data Analysis, Technical University of Denmark.
    Iversen, Helle K
    Department of Neurology, Copenhagen University Hospital, Glostrup.
    Klarskov, Peter
    Department of Urology, Copenhagen University Hospital, Herlev.
    Gard, Gunvor
    Is well-being associated with lower urinary tract symptoms in patients with stroke2011Ingår i: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, E-ISSN 1651-2065, Vol. 45, nr 2, s. 134-142Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. This study aimed to assess self-reported well-being in a clinical sample of stroke patients and to identify possible associations with prevalence, severity and bother of lower urinary tract symptoms (LUTS). Material and methods. A cross-sectional, clinical survey was initiated whereby stroke patients were invited to complete The WHO-Five Well-Being Index (WHO-5) and a LUTS instrument, the Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire. Of 519 stroke patients invited, 482 subjects were eligible and 407 (84%) respondents answered the questionnaires. Results. Poor well-being (sum score <13) was reported by 22% of all stroke patients, for women 29% and for men 14%. Depression (sum score <8) was reported by 10%, for women 11% and for men 8%. Poor well-being was significantly (p < 0.01) associated with severity and bother of LUTS. Likewise, poor well-being was significantly (p < 0.001) associated with the prevalence of four different symptom groups of LUTS. Conclusions. The results indicate that poor well-being is present in stroke patients with LUTS, especially in women. Likewise, the data showed significant association between poor well-being and LUTS. Screening for well-being and LUTS in stroke patients is strongly recommended.

  • 75.
    Larsson, Agneta
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Karlqvist, Lena
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Westerberg, Mats
    Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, Innovation och Design.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Promoting a safety climate and safety activities for health and work ability in home care services workers2011Konferensbidrag (Refereegranskat)
    Abstract [en]

    Purpose: The present study aims to describe home care service workers' perceptions of safety climate and safety activities at work as well as working conditions, self-efficacy, and health and work ability. Relevance: High frequencies of work-related musculoskeletal disorders and injuries and low prevalence of sustainable work ability in home care services workers are of great concern. They are to provide high quality services to an increasingly proportion of elderly people living in private homes. In order to promote health and safety for the home care workers, increased focus should be on organisational, psychosocial and physical factors contributing to a healthy working environment. Participants: 158 nursing assistants and nursing aides divided in 18 work units participated in this study. They all met the criterion of having worked in the same home care services unit in the last 6 months. Their mean age was 46 years, the majority were women, and the distribution of nursing aides and nursing assistants was about 40/60%. Methods: This study is based on cross-sectional data gathered in February 2009 in home care services in a municipality in the North of Sweden. All the home-care work units shared the experiences of using a model for participatory risk management in home care services. Data were obtained through a comprehensive self-administered questionnaire, covering working conditions, safety climate, safety activities, self-efficacy, health and work ability. Analysis: Descriptive statistics as well as data on between-group differences are analysed. Results: In general, the results showed fairly good levels of safety climate but only moderate levels of safety activities and of perceived safety grade at work. These variables differed significantly between work units. Environmental barriers, such as lack of time and equipment, were given as reasons for not complying with safety rules or participating in proactive risk assessment. Besides a high frequency of musculoskeletal symptoms and high physical exposure at work, the home care workers in general reported being in good health and with good work ability. They also expressed high decision making latitude, skill discretion, social support and self-efficacy. Conclusions: To promote health and safety for the home care workers, interventions could build on the high levels of safety climate and proactive activities in single work units, proposing good solutions and safe behaviour. Focus need to be placed on improved safety climate, communication and coordination with all professionals forming the home care services setting. Also, on individuals' and work units' awareness of safe behaviour and on alternatives of actions in critical risk situations at work. This may act preventive on musculoskeletal well-being and a good working environment. Implications: There need to be an increase in means given to physical therapists in occupational health services, to work with these issues. The ergonomic skills and the safety climate of the front-line home care services workers need to be addressed, as well as the organisational prerequisites for workplace safety and health.

  • 76.
    Gard, Gunvor
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Dahlgren, Annika Svensson
    Astra Zeneca, Lund.
    Stressreducerande interventioner i dagens arbetsliv: vad fungerar på grupp och organisatorisk nivå2011Konferensbidrag (Övrigt vetenskapligt)
  • 77.
    Praestegaard, Jeanette
    et al.
    Department of Physiotherapy Health Sciences, Health Sciences Center, Lund university.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    The perceptions of danish physiotherapists on the ethical issues related to the physiotherapist-patient relationship during the first session: a phenomenological approach2011Ingår i: BMC Medical Ethics, ISSN 1472-6939, E-ISSN 1472-6939, Vol. 12Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: In the course of the last four decades, the profession of physiotherapy has progressively expanded its scope of responsibility and its focus on professional autonomy and evidence-based clinical practice. To preserve professional autonomy, it is crucial for the physiotherapy profession to meet society's expectations and demands of professional competence as well as ethical competence. Since it is becoming increasingly popular to choose a carrier in private practice in Denmark this context constitutes the frame of this study. Physiotherapy in private practice involves mainly a meeting between two partners: the physiotherapist and the patient. In the meeting, power asymmetry between the two partners is a condition that the physiotherapist has to handle. The aim of this study was to explore whether ethical issues rise during the first physiotherapy session discussed from the perspective of the physiotherapists in private practice. Methods: A qualitative approach was chosen and semi-structured interviews with 21 physiotherapists were carried out twice and analysed by using a phenomenological framework. Results: Four descriptive themes emerged: general reflections on ethics in physiotherapy; the importance of the first physiotherapy session; the influence of the clinical environment on the first session and; reflections and actions upon beneficence towards the patient within the first session. The results show that the first session and the clinical context in private practice are essential from an ethical perspective. Conclusions: Ethical issues do occur within the first session, the consciousness about ethical issues differs in Danish physiotherapy private practice, and reflections and acts are to a lesser extent based on awareness of ethical theories, principles and ethical guidelines. Beneficence towards the patient is a fundamental aspect of the physiotherapists' understanding of the first session. However, if the physiotherapist lacks a deeper ethical awareness, the physiotherapist may reason and/or act ethically to a varying extent: only an ethically conscious physiotherapist will know when he or she reflects and acts ethically. Further exploration of ethical issues in private practice is recommendable, and as management policy is deeply embedded within the Danish public sector there are reasons to explore public contexts of physiotherapy as well.

  • 78.
    Gard, Gunvor
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gtrahn, Birgitta
    FoU Välfärd, Kronoberg County.
    Development of the motivation forchange questionnaire (MSQ)2010Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 42, nr 4, s. 402-Artikel i tidskrift (Övrigt vetenskapligt)
  • 79.
    Gyllensten, Amanda Lundvik
    et al.
    Lund University, Department of Physical Therapy.
    Skär, Lisa
    Miller, Michael
    Department of Clinical Sciences, Division of Rehabilitation Medicine, Lund university.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Embodied identity: a deeper understanding of body awareness2010Ingår i: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 26, nr 7, s. 439-446Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aims of this study were to explore and generate an understanding of the meaning of body awareness through explanations of the experience of body awareness given by professionals and patients in psychiatric rehabilitation. A total of 20 strategically selected healthy informants were interviewed individually and in groups. Thirteen previous interviews with physiotherapists and 11 previous interviews with patients in psychiatric rehabilitation, describing their experiences of body awareness therapy and its effects were reanalyzed and included in the data for this study; in all 44 informants were included. Grounded theory methods guided the data construction and analysis. A theoretical understanding was conceptualised from which a core category of body awareness emerged: the embodied identity. This core category was related to two categories: living in the body and living in relation to others and in society. The subcategory "living in the body" was conceived as an important aspect to become more aware of the body and to experience oneself fromwithin in order to recognize one's needs. A key point was the fact that bodily experiences always exists in the present moment. The experience of the body, the balance, and stability of the physical self were basic experiences that were connected to the conception of well-being and control. To understand one's emotions and needs through the awareness of the body were understood as the base for self-confidence, trust in one-self, and the ability to take care of oneself and one's needs physically and mentally. The subcategory "living in relation to others and in society" was conceived as an important aspect for the embodied self to interact with others and for societal participation. Working with the body in physiotherapy practice should include an understanding that body awareness is inseparable from the identity and may have an impact on the health of the individual. This implies that interventions to address problems in body awareness should be integrated into physiotherapy practice.

  • 80.
    Skjaerven, Liv H.
    et al.
    Department of Physiotherapy, Faculty of Health and Social Sciences, Bergen University College.
    Kristoffersen, Kjell
    Faculty of Health and Sport, University of Agder, Kristiansand.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    How can movement quality be promoted in clinical practice?: a phenomenological study of physical therapist experts2010Ingår i: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 90, nr 10, s. 1479-1492Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background In recent years, physical therapists have paid greater attention to body awareness. Clinicians have witnessed the benefits of supporting their patients' learning of movement awareness through the promotion of their movement quality. Objective The aim of this study was to investigate how physical therapist experts promote movement quality in their usual clinical settings. Design A phenomenological research design that included a sampling strategy was devised. Using specific criteria, 6 lead physical therapists nominated a group of physical therapist experts from the fields of neurology, primary health care, and mental health. Fifteen informants, 5 from each field, agreed to participate. Methods In-depth interviews were conducted with a semistructured interview guide. The informants were invited to simply describe what they had experienced to be successful therapeutic processes for promoting movement quality. Each interview was audiotaped and transcribed. The data analysis was based on a multistep model. Results Three main themes emerged from the data. First, the physical therapists' embodied presence and movement awareness served as a precondition and an orientation for practice. Embodied presence is a bodily felt sense, a form of personal knowing that evokes understanding and fosters meaning. Second, creating a platform for promoting movement quality revealed implementation of psychological attitudes. Third, action strategies for promoting movement quality suggested a movement awareness learning cycle and components for clinical use. Conclusions This study demonstrated specific attitudes and skills used by physical therapist experts to promote movement quality in their clinical practice. These results may serve as a therapeutic framework for promoting movement quality in clinical physical therapy, although further research is needed.

  • 81.
    Piippola, Saila
    et al.
    Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, Arbetsvetenskap.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Opportunities and barriers for women as innovative entrepreneurs: a Swedish case2010Konferensbidrag (Övrigt vetenskapligt)
  • 82.
    Larsson, Ingalill
    et al.
    Division of Physiotherapy, Department of Health Sciences, Lund University.
    Liljedahl, Kerstin
    Habilitation & Assistive Technology Services, Region Skåne.
    Gard, Gunvor
    Physiotherapists' experience of client participation in physiotherapy interventions: A phenomenographic study2010Ingår i: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 12, nr 4, s. 217-223Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the study was to describe, using qualitative phenomenographic interviews, how physiotherapists experience client participation in physiotherapy interventions. The objective of phenomenographic research is to identify and describe various ways of experiencing the investigated phenomenon. Eleven respondents were strategically selected according to the maximum variation strategy with variations in: gender, seniority and areas of physiotherapy. Three qualitatively different descriptive categories were indentified with critical variations in paradigms of health and goal-setting procedures - A: Collaboration, i.e. an experience of client participation from a biopsychosocial collaborative view of intervention in which the client enter into equal partnership with the physiotherapist and thereby are jointly responsible for intervention, goal-setting and outcome; B: Guidance, i.e. an experience of client participation from a guided biomedical view of intervention, in which the client is guided by the physiotherapist in an unequal partnership in intervention and goal-setting; and C: Expertise, i.e. an experience of client participation from a paternalistic, biomedical view of intervention, in which the client sees the physiotherapist as an expert, who decides and controls the intervention and goal-setting. The results have made some earlier tacit professional physiotherapy knowledge explicit and may increase the understanding of how different experiences of client participation influence interventions

  • 83.
    Larsson, Agneta
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Karlqvist, Lena
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Safety climate and participatory safety activities in municipal home care services2010Konferensbidrag (Övrigt vetenskapligt)
  • 84.
    Larsson, Agneta
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Karlqvist, Lena
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    To Tailor health promoting interventions to user needs: effects of work ability and health promoting interventions for women with musculoskeletal symptoms2010Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 42, nr 4, s. 402-403Artikel i tidskrift (Övrigt vetenskapligt)
  • 85.
    Romé, Åsa
    et al.
    Department of Health Sciences, Division of Physiotherapy, Lund University.
    Persson, Ulf
    Swedish Institute for Health Economics (IHE).
    Ekdahl, Charlotte
    Department of Health Sciences, Division of Physiotherapy, Lund University.
    Gard, Gunvor
    Willingness to pay for health improvements of physical activity on prescription2010Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 38, nr 2, s. 151-159Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To estimate the willingness to pay for health improvements among participants in the programme ‘‘Physical Activity on Prescription''. The objective was also to examine predictors such as income, education level, health status, activity level and BMI, differences for long- and short-term health effects of physical activity and differences between a high- and low-intensity activity group. Methods: Willingness to pay (WTP) data were collected alongside a randomized, controlled trial in Sweden 2007, and 128 sedentary individuals, 20-80 years old (intervention/high-intensity group n = 71, control/low-intensity group n = 57), with lifestyle-related health problems answered open-ended questions in this contingent valuation study. Results: The highest mean WTP (59/SEK 552) was stated for an immediate health improvement, but no significant differences compared with long-term health improvements. The high-intensity group showed higher WTP-values for all health improvements, but without significant differences compared with a low-intensity group. Regression analyses show strong associations between a higher level of education and the WTP for improved well-being and improved health, and also between income and the WTP for improved well-being. There are significant correlations between the WTP and the variables BMI, income and education level, as expected from economic theories. Conclusions: The willingness to pay for the health improvements of exercise is influenced by a higher education level, income and BMI. The highest WTP for a health outcome of physical activity is for an immediate health improvement. The results of this randomized controlled trial in primary health care may be of interest to decision makers when evaluating different approaches to promoting physical activity among people who are sedentary.

  • 86.
    Josefsson, Kristina Areskoug
    et al.
    Department of Health Sciences, Health Sciences Center, Lund University.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Women's experiences of sexual health when living with Rheumatoid Arthritis: an explorative qualitative study2010Ingår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 11, s. 240-247Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The ICF core sets for patients with Rheumatoid Arthritis (RA) acknowledge sexual function and intimate relationships as important since the patients' sexual health can be affected by the disease. About 36-70% of all RA-patients experience a reduced sexual health, and their perceived problems are directly or indirectly caused by their disease. Physiotherapy is often used as non-pharmacological treatment for RA. Mobility treatment, pain reduction, and physical activities are often included in physiotherapy for patients with RA. The aim of the study was to explore sexual health in relation to physiotherapy in women living with RA. Method: An explorative qualitative interview study with a phenomenological approach was performed. The study consisted of ten interviews with women with RA. The analysis was performed according to Giorgi. Results: The main theme that emerged in the material was that the body and the total life situation affected sexual health. Three categories were included in the theme: 1) sexual health - physical and psychological dimensions, 2) Impacts of RA, and 3) Possibilities to increase sexual health - does physiotherapy make a difference?. Conclusions: Sexual health was affected by RA in different ways for the informants. Possibilities to improve sexual health were improved partner communication and physiotherapy. Physiotherapy can play an active role in improving sexual health for patients with RA

  • 87.
    Tibaek, Sigrid
    et al.
    Department of Health Sciences, Division of Physiotherapy, Lund University.
    Gard, Gunvor
    Klarskov, Peter
    Department of Urology, Copenhagen University Hospital, Herlev.
    Iversen, Helle K.
    Department of Neurology, Copenhagen University Hospital, Glostrup.
    Dehlendorff, Christian
    Informatics and Mathematical Modelling, Section for Statistics, Lyngby, Technical University of Denmark.
    Jensen, Rigmor
    Department of Neurology, Copenhagen University Hospital, Glostrup.
    Are activity limitations associated with lower urinary tract symptoms in stroke patients?: A cross-sectional, clinical survey2009Ingår i: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, E-ISSN 1651-2065, s. 383-389Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To assess self-reported activity limitations in a clinical sample of stroke patients and to identify their association with prevalence, severity and impact on daily life of lower urinary tract symptoms (LUTS). Material and methods . A cross-sectional, clinical survey was initiated whereby stroke patients were invited to complete four activity limitations measurements: Barthel Index, mobility velocity, mobility distance, mobility aids and one LUTS measurement: the Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire. Of 519 stroke patients, 482 subjects were eligible. Results . The response rate was 84%. The activity limitations were reported by 17-34% depending on the measurement. Mobility velocity was highly significantly associated (p=0.01) with severity of LUTS. In the LUTS incontinence symptom group, Barthel Index and mobility velocity were significantly associated with prevalence [p=0.03, odds ratio (OR) 2.08 and p=0.05, OR 1.87, respectively]. Barthel Index and mobility distance were also associated with severity (p=0.03 and p=0.04, respectively) and Barthel Index was associated with the prevalence of bother (p=0.02, OR 2.12). Conclusion . This study indicate for the first time that activity limitations are closely related to LUTS in stroke patients and that rehabilitation should also be directed towards the treatment of LUTS.

  • 88.
    Mattsson, Malin
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Möller, Bozena
    Sunderby sjukhus, Luleå, Department of Rheumatology, Sunderby Hospital.
    Hesselstrand, Roger
    Department of Rheumatology, Lund University.
    Sandqvist, Gunnel
    Department of Rheumatology, Lund University.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Smolen, Josef S.
    Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna.
    Bauernfeind, Bettina
    Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna.
    Stamm, Tanja A.
    Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna.
    Boström, C.
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Focus groups in international multi-centre qualitative studies2009Konferensbidrag (Refereegranskat)
  • 89.
    Romé, Åsa
    et al.
    Department of Health Sciences, Division of Physiotherapy, Lund University.
    Persson, Ulf
    Swedish Institute for Health Economics (IHE).
    Ekdahl, Charlotte
    Department of Health Sciences, Division of Physiotherapy, Lund University.
    Gard, Gunvor
    Physical activity on prescription (PAP): costs and consequences of a randomized, controlled trial in primary health care2009Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 27, nr 4, s. 216-222Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To analyse costs and consequences of changing physical activity behaviour due to the "Physical Activity on Prescription" (PAP) programme. DESIGN: A randomized controlled trial with a four-month intervention, with comparison between intervention and control group. Intervention. The PAP programme, with exercise twice a week, education, and motivational counselling. SUBJECTS: 525 sedentary individuals, 20-80 years (intervention group n = 268, control group n = 257), with lifestyle-related health problems. A total of 245 returned for the four-month assessment. MAIN OUTCOME MEASURE: Programme costs based on intention-to-treat estimations, direct and indirect costs of inactivity, and physical activity behaviour analysed with IPAQ (International Physical Activity Questionnaire), self-reported physical activity, and measures of functional capacity. RESULTS: The intention-to-treat programme costs for the four-month programme period was SEK (Swedish Kronor) 6475 (euro [Euro] 684) for the intervention group and SEK 3038 (euro 321) for the control group. Of this, healthcare providers' costs were 24% in the intervention group, and 31% in the control group. The physical activity behaviour was significantly improved in both groups, but no differences were found between the groups. Implications. The largest share of the PAP programme costs was the participants' costs. Significant improvements were shown in physical activity behaviour in both groups, but no differences were found between the intervention and control groups. Due to many non-completers, the potential for improvements of the motivating assignment with sedentary individuals in primary healthcare is obvious. Long-term follow-up can determine the sustainability of the results, and can be used in a future cost-effectiveness analysis.

  • 90.
    Eriksson, Lisbeth
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Innovation och ehälsa.
    Lindstöm, Britta
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Luleå tekniska universitet, Institutionen för hälsovetenskap, Innovation och ehälsa.
    Lysholm, Jack
    Department of Orthopaedics, Surgical and Perioperative Sciences, Umeå University.
    Physiotherapy at a distance: a controlled study of rehabilitation at home after a shoulder joint operation2009Ingår i: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, ISSN 1357-633X, Vol. 15, nr 5, s. 215-220Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We explored the benefit of video communication in home rehabilitation after shoulder joint replacement and compared it to referral for physiotherapy in the conventional way. A total of 22 patients were included in the study. The intervention group (n = 10) had training at home under the supervision of a physiotherapist at the hospital using videoconferencing. The control group (n = 12) had physiotherapy training in a conventional way in their home town. All patients had the same postoperative, three-phase-programme for two months. The outcome measures were a Visual Analogue Scale (VAS) for pain, range of motion (ROM), shoulder function ability (Constant score and SRQ-S) and health-related quality of life (SF-36). Questions about areas of priority for improvement and general satisfaction with the shoulder were also included. The telemedicine group received a greater number of treatments compared to the control group. After the intervention, there were significant improvements in VAS-pain, Constant score and SRQ-S for both groups. The telemedicine group improved significantly more in all three measurements than the control group (P < 0.001 for all). When changes from baseline to follow-up were compared, the telemedicine group improved significantly more in terms of decrease in pain (P = 0.004) and vitality (P = 0.001) than the control group. Despite some limitations, there seem to be clear benefits from physiotherapy at a distance with a telemedicine technique that allows patients to obtain access to physiotherapy at home.

  • 91.
    Dalgren, Annika Svensson
    et al.
    Department of Design Sciences, Faculty of Engineering, Lund University.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Soft values with hard impact: a review of stress reducing interventions on group and organisational level2009Ingår i: Physical Therapy Reviews, ISSN 1083-3196, E-ISSN 1743-288X, Vol. 14, nr 6, s. 369-381Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim of this study was to review stress reducing interventions on group and organisational levels in organisations and analyse the studies according to quality of design, results and employee participation and learning.Methods: A literature review was carried out, with data search in the databases Current Contents, Embase, PsycINFO, Ovid MEDLINEH. Results: Nineteen interventions had a high quality design. An action research and participatory research design was the best design to reduce work related stress on group and organisational levels. The studies with the most effective results were based on a contract with the organisation, had supportive supervisors and managers and an individual and organisational stressor reduction process. They also identified work constraints and implemented an action plan using problem-based learning. There were six studies which met the criteria for the highest level of participation, which is official participation in problem solving and development activities. There were four studies which met the criteria for the highest level of learning, creative learning. Discussion: Researchers working with stress reducing interventions on group and organisational levels need to ecommend high-quality design on each level. A successful group and organisational intervention needs to have a strategy that guarantees top management's commitment and methods that create effective participation, individual and organisational learning, social support, and empowerment of employees.

  • 92.
    Hansson, Lars
    et al.
    Lund University, Department of Design Sciences, Ergonomics.
    Sperling, Lena
    Lund University, Department of Design Sciences, Industrial Design.
    Gard, Gunvor
    Ipsen, Staffan
    Lund University, Department of Health Sciences, Divison of Physiotherapy.
    Vergara, Cindy Olivares
    Lund University, Department of Health Sciences, Divison of Physiotherapy.
    Swedish anthropometrics for product and workplace design2009Ingår i: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 40, nr 4, s. 797-806Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The present study describes the anthropometrics of the Swedish workforce, aged 18-65, and compares the measurements with data collected four decades earlier. This anthropometric information is based on measurements of a total of 367 subjects, 105 males and 262 females. Of the 367 subjects, 268 responded to advertisements (Study A) and 99 were randomly selected from a community register (Study B). Subjects were scanned in four positions. Manual measuring equipment was used for hands, feet, head and stature. As differences between significant measurements in Studies A and B were negligible, the data were merged. Anthropometric descriptive statistics of women and men are presented for 43 body dimensions. Participants represent the Swedish population fairly well when compared with national statistics of stature and weight. Comparing new anthropometric data with old shows that the breadth, depth, height, and length measurements of Swedes as well as weight have increased and that Swedish anthropometric homogeneity has decreased. The results indicate that there is a need to update ergonomic recommendations and adjust products and workplaces to the new information.

  • 93.
    Skjerven, Liv H.
    et al.
    Bergen University College.
    Kristofferssen, Kjell
    University of Bergen.
    Gard, Gunvor
    An eye for movement quality: a phenomenological study of movement quality reflecting a group of physiotherapists` understanding of the phenomenon2008Ingår i: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 24, nr 1, s. 13-27Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Movement quality is a phenomenon frequently used by physiotherapists in oral language, written text, and clinical practice, with little clarification. The purpose was to investigate the lived experiences of a group of expert physiotherapists, searching for essential features and characteristics of the phenomenon. A phenomenological study, using in-depth interviews was chosen. Ten copies of Fine Art were used to stimulate the description of the phenomenon. The informants were 15 peer-designated physiotherapists, five from each field of neurology, psychosomatic/psychiatry and primary health care. They were nominated by physical therapist leaders in the region. The interviews were audiotaped and transcribed. Giorgis' recommendation concerning analysis of the interview data was followed. Four main themes were developed, seeing movement quality as biomechanical, physiological, psycho-socio-cultural, and existential, all interacting processes. Each theme includes preconditions to movement quality and movement characteristics. Movement quality in general was seen as a unifying phenomenon, representing a synthesis of the four themes. The outcome of the study is the Movement Quality Model (MQM) illuminating essential features and characteristics of the phenomenon. Further research is needed for clarification and application in clinical practice

  • 94.
    Grahn, Birgitta
    et al.
    R&D Welfare of Southern Småland.
    Gard, Gunvor
    Content and concurrent validity of the motivation for change questionnaire2008Ingår i: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 18, nr 1, s. 68-78Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Musculoskeletal disorders (MSD) are nowadays seen within a biopsychosocial framework, including salutogenic factors, motivation factors, and coping ability. Such a framework recognizes the importance of motivational factors in health promotion and in rehabilitation. The Motivation for Change Questionnaire (MCQ) has been developed to measure the strength of individuals' motivation for change in life, MCQ part 1, and work situation, MCQ part 2. The purpose of the study was to test the content and concurrent validity of the MCQ on patients with prolonged musculoskeletal disorders referred to interdisciplinary rehabilitation as a basis for use in medical and occupational rehabilitation. METHODS: Content validity was studied among an expert group of 20 rehabilitation professionals at a rehabilitation centre, and with 10 individuals suffering from prolonged MSD in the south of Sweden. The experts evaluated the clinical relevance of each question in MCQ. Concurrent validity was studied on 58 patients with prolonged MSD at an interdisciplinary rehabilitation centre in the south of Sweden. They answered MCQ, QPS Nordic questionnaire, KASAM and the Action theory questionnaire. Spearman's rank correlation coefficient was used in the analyses. RESULTS: The MCQ covered and measured areas of relevance according to content validity. No floor effects in any of the subscales of MCQ part 1 were seen. In MCQ part 2, floor effects were seen in two sub indexes. As for concurrent validity subscales of MCQ correlated significantly with QPS Nordic questionnaire and KASAM. CONCLUSIONS: Findings so far indicate the instrument to be valid for use within the present patient group. The questionnaire can be used to identify patient's motivating factors for change in life and work, as a basis for motivational work within rehabilitation.

  • 95.
    Winkel, A.
    et al.
    Department of Neurology, Hillerod Hospital.
    Ekdahl, Charlotte
    Gard, Gunvor
    Early discharge to therapy-based rehabilitation at home in patients with stroke: a systematic review2008Ingår i: Physical Therapy Reviews, ISSN 1083-3196, E-ISSN 1743-288X, Vol. 13, nr 3, s. 167-87Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Early discharge and home rehabilitation (EDHR) for stroke patients seems logical as an alternative to rehabilitation in stroke units, as these patients often show impaired ability to perform activities of daily living. The objective of this review is to present the effects of EDHR for stroke patients on health, quality of life and costs, and to describe the physiotherapy provided. Seventeen randomised controlled trials were included, assessed with the PEDro scale and rated using Sackett's rules of scientific evidence. The results showed that EDHR can reduce the length of time spent in hospital. It might improve basic activities of daily living, but is more likely to improve patients' instrumental activities of daily living and quality of life. The context is a core issue for the physiotherapy intervention. Early discharge and home rehabilitation seems to be cost-effective if rehabilitation at home is provided by a multidisciplinary team from a hospital. It is important to consider patients' coping capacities and possible strain on caregivers as contributing factors to the efficacy of EDHR.

  • 96.
    Larsson, Agneta
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Karlqvist, Lena
    Department of Health Sciences, Mid Sweden University, Östersund.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Effects of work ability and health promoting interventions for women with musculoskeletal symptoms: a 9-month prospective study2008Ingår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 9Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Women working in the public human service sector in 'overstrained' situations run the risk of musculoskeletal symptoms and long-term sick leave. In order to maintain the level of health and work ability and strengthen the potential resources for health, it is important that employees gain greater control over decisions and actions affecting their health - a process associated with the concept of self-efficacy. The aim of this study was to describe the effects of a self-efficacy intervention and an ergonomic education intervention for women with musculoskeletal symptoms, employed in the public sector. MethodsThe design of the study was a 9-month prospective study describing the effects of two interventions, a comprehensive self-efficacy intervention (n = 21) and an ergonomic education intervention (n = 21). Data were obtained by a self-report questionnaire on health- and work ability-related factors at baseline, and at ten weeks and nine months follow-up. Within-group differences over time were analysed. ResultsOver the time period studied there were small magnitudes of improvements within each group. Within the self-efficacy intervention group positive effects in perceived work ability were shown. The ergonomic education group showed increased positive beliefs about future work ability and a more frequent use of pain coping strategies. ConclusionBoth interventions showed positive effects on women with musculoskeletal symptoms, but in different ways. Future research in this area should tailor interventions to participants' motivation and readiness to change.

  • 97.
    Mannerkorpi, Kaisa
    et al.
    Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, Göteborg University.
    Rivano-Fischer, Marcelo
    Department of Rehabilitation, Lund University.
    Ericsson, Anna
    Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, Göteborg University.
    Nordeman, Lena
    Primary Health Care, Alingsås.
    Gard, Gunvor
    Experience of physical activity in patients with fibromyalgia and chronic widespread pain2008Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 30, nr 3, s. 213-221Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose. Patients with fibromyalgia (FM) and chronic widespread pain (CWP) find physical activity troublesome. The purpose was to develop a questionnaire to investigate the experience of physical activity in FM and CWP populations. Method. A questionnaire was developed from a qualitative study. After that, a total of 204 patients with FM or CWP completed the questionnaire. A factor analysis was conducted and the internal consistency was investigated. The relationship between the factors and pain, health status (the Fibromyalgia Impact Questionnaire, FIQ), distress (the Hospital Anxiety and Distress scale, HAD) and leisure time physical activity (the Leisure Time Physical Activity Instrument, LTPAI) was investigated. Results. Five factors were identified: Physical Relaxation (PR), Well-being (WB), Activity Beliefs (AB), Activity-related Symptoms (AS) and Activity Habits (AH). Cronbach's alpha ranged from 0.57 to 0.86. The PR showed a correlation (rho 0.28, p < 0.01) with the FIQ Pain. The AS showed a correlation (rho 0.25, p < 0.01) with the FIQ total score, while the AH showed a correlation with the HAD Depression (0.26, p < 0.01) and with strenuous physical activity (LTPAI) (-0.32, p < 0.01). Conclusion. A new instrument was developed to study the experience of physical activity in persons with long-lasting pain. Five factors were identified using factor analysis, and three of them showed fair associations with FM symptoms, distress or physical activity

  • 98.
    Gyllensten, Amanda Lundvik
    et al.
    Lunds universitet.
    Gard, Gunvor
    Om kroppsmedvetande och kroppsuppfattning2008Ingår i: Fysioterapi, ISSN 1653-5804, nr 10, s. 38-45Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

    I denna artikel beskrivs vad kroppsmedvetande och kroppsuppfattning är, vilken betydelse det kan ha i rehabilitering, samt vilka vetenskapliga effekter som finns dokumenterade av insatser för olika patientgrupper. Det har i forskning visat sig att ökat kroppsmedvetande är ett viktigt inslag i tillfrisknandet för många olika patientgrupper med till exempel långvarig smärta, ångest, depression, vegetativa besvär eller besvär om man varit sexuellt utnyttjad. Vi har valt att belysa forskningsinsatser i syfte att förbättra kroppsmedvetande och kroppsuppfattning från olika områden och olika traditioner inom sjukgymnastik. Författarna gör inga anspråk på att heltäckande belysa kunskapsområdet. Det finns omfattande forskning inom vissa områden, som till exempel ätstörningsområdet. Vi har istället valt att försöka visa på bredden och ta fram resultat av gjorda interventioner inom olika områden.

  • 99.
    Tibaek, Sigrid
    et al.
    Copenhgen University Hospital, Department of Geriatrics and Rheumatology.
    Gard, Gunvor
    Klarskov, Peter
    Glostrup Hospital, Department of Urology.
    Iversen, Helle K.
    University of Copenhagen, Department of Neurology, Gentofte Hospital.
    Dehlendoff, Christian
    Technical University of Denmark.
    Jensen, Rigmor
    Copenhgen University Hospital, Department of Neurology.
    Prevalence of lower urinary tract symptoms (LUTS) in stroke patients: a cross-sectional clinical study2008Ingår i: Neurourology and Urodynamics, ISSN 0733-2467, E-ISSN 1520-6777, Vol. 27, nr 8, s. 763-771Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: The aims of this study were primarily to investigate the prevalence, severity and impact on daily life of Lower Urinary Tract Symptoms (LUTS) in a clinical sample of stroke patients and secondly to identify factors associated with LUTS. MATERIALS AND METHODS: This was a cross-sectional, hospital based survey whereby stroke patients were invited by letter to complete The Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire at least 1 month following their stroke. Subjects were asked to report the frequency and severity of their symptoms (symptom score) and the impact of each symptom on their daily life (bother score) over the previous fortnight. Of 519 stroke patients invited, 482 subjects were eligible. RESULTS: The response rate was 84%. The period prevalence of at least one symptom was 94%; the most frequent symptom was nocturia (76%) followed by urgency (70%) and daytime frequency (59%). The most severe symptom was urgency followed by nocturia and daytime frequency. Among respondents who had at least one symptom, the prevalence of bother was 78%. Likewise the most frequent bothersome symptom was nocturia (53%), followed by urgency (48%) and daytime frequency (40%). Paresis in legs, symptoms of urinary incontinence on admission, and use of analgesics were significantly associated with severity, whereas the prevalence and bother of LUTS could not be associated with other patient characteristics. CONCLUSION: LUTS are highly prevalent in stroke patients and have a major impact on daily life

  • 100.
    Mattsson, Malin
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Möller, Bozena
    Sunderby sjukhus, Luleå.
    Lundberg, I.E.
    Department of Rheumatology Unit, Department of Medicine, Karolinska University Hospital.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Boström, C.
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet.
    Reliability and validity of the Fatigue Severity Scale in Swedish for patients with systemic lupus erythematosus2008Ingår i: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 37, nr 4, s. 269-277Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim was to translate, test, and describe aspects of reliability and validity of the Fatigue Severity Scale (FSS) in Swedish (FSS-Swe) in patients with systemic lupus erythematosus (SLE). Methods: Patients with stable SLE, low or moderate disease activity, and low organ damage were included. Forward and back translations of the FSS were performed. Construct validity was tested with 32 women using a first Swedish translation. Feasibility, ceiling and floor effects, internal consistency, test-retest reliability, and content validity were tested on a slightly modified final version of the FSS-Swe in a non-selected group of patients (n=23). Results: There were correlations (p≤0.05) between the FSS-Swe and overall disease activity according to the Systemic Lupus Activity Measure (SLAM) (rs=0.48) and the SLAM Visual Analogue Scale (SLAM-VAS) (rs=0.46); between the FSS-Swe and eight subscales of the Swedish 36-Item Medical Outcomes Study Short-Form Health Survey (SF-36) (rs=-0.41 to -0.65) and between the FSS-Swe and age (rs=-0.35). All patients answered all FSS-Swe questions at both test and retest. There was one ceiling effect in one question on one occasion. The Kolmogorov-Smirnov test indicated normal distribution. Cronbach's alpha was 0.94 and corrected item-to-total correlation exceeded 0.3. There were no significant systematic test-retest differences, and the median-weighted kappa coefficient was 0.75. Twenty patients understood the questions in FSS-Swe, 18 considered they were relevant, reflected their fatigue, and that none should be excluded. Five items were suggested to be included. Conclusions: The FSS-Swe supports construct validity, is feasible, has no important ceiling or floor effects, has satisfactory internal consistency, substantial test-retest reliability, and satisfactory content validity in the SLE patients studied. However, its sensitivity to change needs to be tested.

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