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  • 1. Adolfsson, Margareta
    et al.
    Granlund, Mats
    Pless, Mia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Professionals' views of children's everyday life situations and the relation to participation2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 7, p. 581-592Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim was to determine professionals' views of everyday life situations (ELS) of importance for children and to explore how ELS correlate with the construct "Participation". This study was part of a larger work to develop a structured tool with code sets to identify child participation and support children with disabilities to describe what matters most for them in intervention planning.

    Method: The study had a concurrent mixed methods design. Information from one open-ended question and questionnaires were linked to the ICF-CY component Activities and Participation. Two concurrent data sets were compared.

    Results: Proposed ELS were distributed across ICF-CY categories from low to high level of complexity and context specificity. The correlation with participation became stronger for the later chapters of the component (d7-d9). Differences between respondents due to working field, country, and children's ages were explored. Acts and tasks seemed most important for the youngest children, whereas ELS shifted towards societal involvement for adolescents.

    Conclusion: Eleven categories related to ICF-CY chapters d3-d9 emerged as ELS. Two age groups (infants/preschoolers and adolescents) are required to develop code sets for the new tool. The results need triangulation with other concurrent studies to provide corroborating evidence and add a family perspective.

  • 2.
    Adolfsson, Margareta
    et al.
    Högskolan för lärande och kommunikation, Högskolan i Jönköping.
    Malmqvist, Johan
    Högskolan för lärande och kommunikation, Högskolan i Jönköping.
    Pless, Mia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Habilitation and Disability.
    Granuld, Mats
    Identifying child functioning from an ICF-CY perspective: everyday life situations explored in measures of participation2011In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, no 13-14, p. 1230-1244Article in journal (Refereed)
    Abstract [en]

    Purpose. This study was part of a larger work to develop an authentic measure consisting of code sets for self- or proxy-report of child participation. The aim was to identify common everyday life situations of children and youth based on measures of participation.

    Method. The study was descriptive in nature and involved several stages: systematic search of literature to find articles presenting measures for children and youth with disabilities, identifying measures in selected articles, linking items in included measures to the ICF-CY, analysing content in measures presented as performance and participation and identifying aggregations of ICF-CY codes across these measures.

    Results. A large number of measures for children and youth with disabilities were identified but only 12 fulfilled the inclusion criteria. A slight distinction in content and age appropriateness appeared. Measures presented as performance covered all the ICF-CY Activities and Participation chapters, whereas measures presented as participation covered five of nine chapters. Three common everyday life situations emerged from the measures: Moving around, Engagement in play and Recreation and leisure.

    Conclusion. Only a small number of life situations for children and youth emerged from items in selected measures, thus, other sources are needed to identify more everyday life situations.

  • 3.
    Alriksson-Schmidt, Ann I.
    et al.
    Lund Univ, Div Orthopaed, Dept Clin Sci, Lund, Sweden..
    Arner, Marianne
    Karolinska Inst, Dept Clin Sci & Educ, Stockholm, Sweden.;Soder Sjukhuset, Dept Hand Surg, Stockholm, Sweden..
    Westbom, Lena
    Lund Univ, Skne Univ Hosp, Dept Clin Sci, Paediat, Lund, Sweden.;Karolinska Inst, Astrid Lindgren Childrens Hosp, Dept Womens & Childrens Hlth, Stockholm, Sweden..
    Krumlinde-Sundholm, Lena
    Lund Univ, Dept Hlth Sci, Fac Med, Lund, Sweden..
    Nordmark, Eva
    Rodby-Bousquet, Elisabet
    Lund Univ, Div Orthopaed, Dept Clin Sci, Lund, Sweden.;Lund Univ, Dept Hlth Sci Fac Med, Lund, Sweden..
    Hägglund, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Lund Univ, Div Orthopaed, Dept Clin Sci, Lund, Sweden..
    A combined surveillance program and quality register improves management of childhood disability2017In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 39, no 8, p. 830-836Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe a concept for prevention of secondary conditions in individuals with chronic neuromuscular disabilities by using two Swedish developed follow-up-programmes for cerebral palsy (CP; CPUP) and myelomeningocele (MMC; MMCUP) respectively as examples. Method: This paper describes and outlines the rationale, development and implementation of CPUP and MMCUP. Results: Both programmes are multidisciplinary longitudinal follow-up programmes that simultaneously serve as national registries. The programmes are population-based and set in Swedish habilitation clinics. Most children (95%) born 2000 or later with CP are enrolled in CPUP and the recruitment of adults is underway. CPUP has also been implemented in Norway, Denmark, Iceland, Scotland and parts of Australia. In MMCUP, almost all children with MMC born 2007 or later participate and individuals of all ages are now invited. The registries provide epidemiological profiles associated with CP and MMC and platforms for population-based research and quality of care improvement. Conclusions: Through multidisciplinary follow-up and early detection of emerging complications individuals with CP or MMC can receive less complex and more effective interventions than if treatment is implemented at a later stage. Possibilities and challenges to design, implement and continuously run multidisciplinary secondary prevention follow-up programmes and quality registries for individuals with CP or MMC are described and discussed.Implications for rehabilitationIndividuals with disabilities such as cerebral palsy or myelomeningocele are at risk of developing secondary conditions.Multidisciplinary population-based longitudinal follow-up programmes seem effective in preventing certain types of secondary conditions. IMPLICATIONS FOR REHABILITATION Individuals with disabilities such as cerebral palsy or myelomeningocele are at risk of developing secondary conditions. Multidisciplinary population-based longitudinal follow-up programmes seem effective in preventing certain types of secondary conditions.

  • 4.
    Arvidsson, Patrik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Granlund, Mats
    Thyberg, Ingrid
    Thyberg, Mikael
    Important aspects of participation and participation restrictions in people with a mild intellectual disability2014In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, no 15, p. 1264-1272Article in journal (Refereed)
    Abstract [en]

    Purpose: This study explored a possibility to assess the concepts of participation and participation restrictions in the International Classification of Functioning, Disability and Health (ICF) by combining self-ratings of the perceived importance with the actual performance of different everyday activities in people with a mild intellectual disability. Method: Structured interviews regarding 68 items from the ICF activity/participation domain were conducted (n = 69). The items were ranked by perceived importance, performance and by combined measures. Furthermore, the measures were related to a single question about subjective general well-being. Results: Rankings of performance highlighted about the same items as "important participation", while rankings of low performance addressed quite different items compared with "important participation restriction". Significant correlations were found between subjective general well-being and high performance (r = 0.56), high performance/high importance (important participation) (r = 0.56), low performance (r = -0.56) and low performance/high importance (important participation restriction; r -0.55). Conclusions: The results support the clinical relevance of the ICF and the studied selection of 68 items. Although performance only may sometimes be a relevant aspect, knowledge about the relationship between the perceived importance and the actual performance is essential for clinical interventions and for research aiming to understand specific needs regarding participation.

  • 5.
    Bjornsdottir, Sigrun Vala
    et al.
    Univ Iceland, Fac Med, Ctr Publ Hlth Sci, Reykjavik, Iceland;HNLFI Rehabil Clin, Hverageroi, Iceland.
    Triebel, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics. HNLFI Rehabil Clin, Hverageroi, Iceland.
    Arnljotsdottir, Margret
    HNLFI Rehabil Clin, Hverageroi, Iceland.
    Tomasson, Gunnar
    Univ Iceland, Fac Med, Ctr Publ Hlth Sci, Reykjavik, Iceland.
    Valdimarsdottir, Unnur Anna
    Univ Iceland, Fac Med, Ctr Publ Hlth Sci, Reykjavik, Iceland;Harvard Sch Publ Hlth, Dept Epidemiol, Boston, MA USA.
    Long-lasting improvements in health-related quality of life among women with chronic pain, following multidisciplinary rehabilitation2018In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, no 15, p. 1764-1772Article in journal (Refereed)
    Abstract [en]

    Purpose:

    To determine whether observed health-related quality-of-life improvements after four-week traditional multidisciplinary pain management program and additional neuroscience education and mindfulness-based cognitive therapy for chronic pain are sustained at six-month follow-up.

    Method:

    This observational longitudinal follow-up study, with complete follow-up of 75 women, 61.5% of initial traditional approach group (treated 2001-2005) and 56 (62.2%) receiving the new approach (treated 2006-2009). Pain intensity and quality of life were measured at baseline and six months after interventions. Analysis of variance (ANOVA) and paired samples t-tests were used for statistical analysis.

    Results:

    Both groups showed sustained improvements in pain intensity (traditional approach = -10.6 [p < 0.001]; new approach = -14.5 [p < 0.001]) and quality of life (traditional approach = 6.4 [p < 0.001]; new approach = 6.9 [p < 0.001]). Sleep was not sustained among traditional approach group (change = 2.4 [p = 0.066]), whereas all other domains among both groups were sustained. Significant decline was observed from discharge to six month among both groups with the exception of the sleep domain among the traditional approach group, pain intensity among the new approach and financial status among both groups. No baseline differences were revealed between responders and nonresponders.

    Conclusions:

    Multidisciplinary interventions for women with chronic pain conditions improved quality of life and pain intensity with lasting improvements observed half a year after treatment completion.

  • 6.
    Björck-Åkesson, Eva
    et al.
    Högskolan för lärande och kommunikation, Högskolan Jönköping.
    Wilder, Jenny
    Akademin för utbildning, kultur och kommunikation, Mälardalens högskola.
    Granlund, Mats
    Hälsohögskolan, Högskolan Jönköping.
    Pless, Mia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Simeonsson, Rune J.
    University of South Carolina/Chapel Hill.
    Adolfsson, Margareta
    Högskolan för lärande och kommunikation, Högskolan Jönköping.
    Almqvist, Lena
    Akademin för hållbar samhälls- och teknikutveckling, Mälardalens högskola.
    Augustine, Lilly
    Statens Folkhälsoinstitut.
    Klang, Nina
    Akademin för utbildning, kultur och kommunikation, Mälardalens högskola.
    Lillvist, Anne
    Akademin för utbildning, kultur och kommunikation, Mälardalens högskola.
    The International Classification of Functioning, Disability and Health and the version for children and youth as a tool in child habilitation/early childhood intervention: feasibility and usefulness as a common language and frame of reference for practice.2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no S1, p. S125-S138Article in journal (Refereed)
    Abstract [en]

    Early childhood intervention and habilitation services for children with disabilities operate on an interdisciplinary basis. It requires a common language between professionals, and a shared framework for intervention goals and intervention implementation. The International Classification of Functioning, Disability and Health (ICF) and the version for children and youth (ICF-CY) may serve as this common framework and language. This overview of studies implemented by our research group is based on three research questions: Do the ICF-CY conceptual model have a valid content and is it logically coherent when investigated empirically? Is the ICF-CY classification useful for documenting child characteristics in services? What difficulties and benefits are related to using ICF-CY model as a basis for intervention when it is implemented in services? A series of studies, undertaken by the CHILD researchers are analysed. The analysis is based on data sets from published studies or master theses. Results and conclusion show that the ICF-CY has a useful content and is logically coherent on model level. Professionals find it useful for documenting children's body functions and activities. Guidelines for separating activity and participation are needed. ICF-CY is a complex classification, implementing it in services is a long-term project.

  • 7.
    Björck-Åkesson, Eva
    et al.
    Högskolan för lärande och kommunikation, Högskolan Jönköping.
    Wilder, Jenny
    Akademin för utbildning, kultur och kommunikation, Mälardalens högskola.
    Granlund, Mats
    Hälsohögskolan, Högskolan Jönköping.
    Pless, Mia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Simeonsson, Rune J.
    University of South Carolina/Chapel Hill.
    Adolfsson, Margareta
    Högskolan för lärande och kommunikation, Högskolan Jönköping.
    Almqvist, Lena
    Akademin för hållbar samhälls- och teknikutveckling, Mälardalens högskola.
    Augustine, Lilly
    Statens Folkhälsoinstitut.
    Klang, Nina
    Akademin för utbildning, kultur och kommunikation, Mälardalens högskola.
    Lillvist, Anne
    Akademin för utbildning, kultur och kommunikation, Mälardalens högskola.
    The International Classification of Functioning, Disability and Health and the version for children and youth as a tool in child habilitation/early childhood intervention: feasibility and usefulness as a common language and frame of reference for practice.2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no S1, p. S125-S138Article in journal (Refereed)
    Abstract [en]

    Early childhood intervention and habilitation services for children with disabilities operate on an interdisciplinary basis. It requires a common language between professionals, and a shared framework for intervention goals and intervention implementation. The International Classification of Functioning, Disability and Health (ICF) and the version for children and youth (ICF-CY) may serve as this common framework and language. This overview of studies implemented by our research group is based on three research questions: Do the ICF-CY conceptual model have a valid content and is it logically coherent when investigated empirically? Is the ICF-CY classification useful for documenting child characteristics in services? What difficulties and benefits are related to using ICF-CY model as a basis for intervention when it is implemented in services? A series of studies, undertaken by the CHILD researchers are analysed. The analysis is based on data sets from published studies or master theses. Results and conclusion show that the ICF-CY has a useful content and is logically coherent on model level. Professionals find it useful for documenting children's body functions and activities. Guidelines for separating activity and participation are needed. ICF-CY is a complex classification, implementing it in services is a long-term project.

  • 8.
    Björnsdóttir, Sigrún Vala
    et al.
    Univ Iceland, Fac Med, Dept Phys Therapy, Reykjavik, Iceland.;Univ Iceland, Fac Med, Ctr Publ Hlth Sci, Reykjavik, Iceland..
    Arnljotsdottir, Margret
    HNLFI Rehabil Clin, Hverageroi, Iceland..
    Tomasson, Gunnar
    Univ Iceland, Fac Med, Ctr Publ Hlth Sci, Reykjavik, Iceland..
    Triebel, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics. HNLFI Rehabil Clin, Hverageroi, Iceland..
    Valdimarsdottir, Unnur Anna
    Univ Iceland, Fac Med, Ctr Publ Hlth Sci, Reykjavik, Iceland.;Harvard Univ, Sch Publ Hlth, Dept Epidemiol, 665 Huntington Ave, Boston, MA 02115 USA..
    Health-related quality of life improvements among women with chronic pain: comparison of two multidisciplinary interventions2016In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, no 9, p. 828-836Article in journal (Refereed)
    Abstract [en]

    Purpose: To measure the effect of 4 weeks traditional multidisciplinary pain management program (TMP) versus neuroscience education and mindfulness-based cognitive therapy (NEM) on quality of life (HRQL) among women with chronic pain. Method: This observational longitudinal cohort study conducted in an Icelandic rehabilitation centre included 122 women who received TMP, 90 receiving NEM, and 57 waiting list controls. Pain intensity (visual analogue scale) and HRQL (Icelandic Quality of Life scale) were measured before and after interventions. ANOVA and linear regression were used for comparisons. Results: Compared with controls we observed statistically significant changes in pain intensity (p < 0.001) and HRQL (p < 0.001) among women receiving both interventions, while NEM participants reported significant improvements in sleep (8.0 versus 4.4 in TMP; p = 0.008). Head to head comparison between study groups revealed that pain intensity improved more among TMP participants (21.8 versus 17.2 mm; p = 0.013 adjusted). Women with low HRQL at baseline improved more than those with higher HRQL (mean TMP = 13.4; NEM = 12.9 if HRQL <= 35 versus mean TMP = 6.6 and NEM = 7.8 if HQRL > 35). Conclusions: Our non-randomized study suggests that both NEM and TMP programs improve pain and HRQL among women with chronic pain. Sleep quality showed more improvements in NEM while pain intensity in TMP. Longer-term follow-ups are needed to address whether improvements sustain. Implications for Rehabilitation Chronic pain is a debilitating condition affecting quality of life and restricting societal participation. Intensive multidisciplinary bio-psycho-social rehabilitation is essential for this patient group. This study shows improvement in health-related quality of life and pain intensity following such rehabilitation. Emphasizing mindfulness based cognitive therapy and neuroscience patient education improves sleep to more extend than more traditional approach.

  • 9.
    Blom Johansson, Monica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Habilitation and Disability.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Habilitation and Disability.
    Sonnander, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Habilitation and Disability.
    Working with families of persons with aphasia: a survey of Swedish speech and language pathologists2011In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, no 1, p. 51-62Article in journal (Refereed)
    Abstract [en]

    Purpose:The overall aim was to investigate how speech and language pathologists (SLPs), in Sweden are working with people with aphasia and their families and what their professional experiences are.

    Method:A cross-sectional study with a descriptive and comparative design. An 84-item study-specific questionnaire was sent to all Swedish SLPs, affiliated to SLOF (the Swedish professional association and trade union).

    Results:The response rate was 72.5% (n = 758). Thirty per cent worked with people with aphasia and typically met with their families. The participants considered the involvement of families as very important, especially concerning providing information of aphasia and training of communication strategies. However, involvement of families was limited due to a shortage of time, but also to perceived limited skill and knowledge.

    Conclusions:There was an evident discrepancy between what the participants claimed to be an important part of their work, and their actual practice. It is suggested that to facilitate family intervention, this should be explicitly expressed in both local and national guidelines. The content of the SLP education, and the need of further education and implementation of new knowledge into clinical practice also requires consideration.

  • 10.
    Bring, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Söderlund, Anne
    Department of Physiotherapy, School of Health, Care and Social wellfare, Vasteras, Sweden .
    Wasteson, Elisabet
    Division of Psychology, Department of Social Sciences, Mid Sweden University, Östersund, Sweden.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Daily stressors in patients with acute whiplash associated disorders2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 21, p. 1783-1789Article in journal (Refereed)
    Abstract [en]

    Purpose

    Stressors in acute whiplash associated disorders (WAD), as reported on a daily basis, have hitherto been neglected in research. The primary aim of this study was to describe the most stressful daily situation or event reported by individuals with acute WAD within a month of a whiplash trauma. Another aim was to describe the meaning and significance of these daily stressors, i.e. primary appraisal.

    Method

    A descriptive design with a content analysis approach was used. 260 WAD-daily coping assessments (WAD-DCA) generated during 1 week by 51 participants with acute WAD were included in the study. Stressors were analysed using qualitative content analysis.

     Results

    The reported stressors generated 13 categories covering a wide range of stressful situations in daily life related to (i) work, (ii) physical symptoms, (iii) feelings and cognitions, (iv) family and home responsibilities and (v) recreation. The majority of the stressors were appraised as "expected" as well as "disabling". Most threatening stressors were related to work, driving and feelings/cognitions.

    Conclusions

    The wide variety of stressors indicates that it is not only pain itself that influences daily life in acute WAD. Early identification of individual and situation-specific stressors gives new data regarding what bothers individuals suffering from WAD after a collision and may be helpful in understanding the coping process in relation to specific stressors and stressor appraisals.

  • 11.
    Ekeblad, Frida
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Gerdin, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Öster, Caisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Impact of personality disorders on health-related quality of life one year after burn injury2015In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 6, p. 534-540Article in journal (Refereed)
    Abstract [en]

    Purpose: Personality disorders (PDs) are associated with significant distress, disability, and cause great difficulties in life. PDs have been suggested to influence adaptation after major burns, but the potential relationship has not been fully elucidated. This study aimed to describe the prevalence of PDs in 107 patients with major burn injury, and to identify the impact of PDs on perceived patient outcome assessed as health-related quality of life (HRQoL) one year after burn. Methods: One burn-specific instrument (Burn Specific Health Scale-Brief (BSHS-B)) and two generic instruments (EuroQol Five Dimensions and Short Form 36 Health Survey) were used, and Psychiatric Axis I and II disorders were assessed one year post burn. Results: This study identified an above normal prevalence of PDs among individuals afflicted by burn, and participants with PD had a significantly larger lifetime burden of Axis I disorders compared to participants without PD. Participants with PDs scored significantly lower than those without PD in the BSHS-B domain Skin involvement, and the effect of having a PD was related to the subscale Treatment regimens. There was no relationship between the presence of PD and generic HRQoL. Conclusions: An implication of these observations is that special rehabilitation efforts including more tailored interventions must be offered to these patients to ensure that the obstacles they perceive to caring for themselves in this respect are eliminated.

  • 12. Eklund, Elsine
    et al.
    Svensson, Elisabeth
    Häger-Ross, Charlotte
    Hand function and disability of the arm, shoulder and hand in Charcot-Marie-Tooth disease.2009In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, no 23Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of the present study was to examine hand function and disability in persons with Charcot-Marie-Tooth disease (CMT) and to evaluate the possible correlations between hand function and disability.

    METHODS: Nine male, 11 female (24-73 yrs) persons with CMT in northern Sweden and a matched control group of 18 men, 22 women (21-73 yrs) participated in the study. Measurements applied were tests of dexterity (Box and Block Test; Nine-Hole Peg test), grip strength (Grippit), tactile gnosis (Shape Texture Identification test) and upper-limb disability (Disabilities of the Arm Shoulder and Hand questionnaire, DASH).

    RESULTS: Hand function in CMT was reduced (p < 0.001) to about 60% of normal, as indicated by each of the separate outcome measures as well as by a constructed summary index of hand function. DASH score median was 38.8 (range 0-66.7) and was clearly related to hand function (r = 0.64-0.83).

    CONCLUSION: Reduced hand function in CMT was found at different dimensions according to the International Classification of Functioning, Disability and Health (ICF). We suggest that DASH can be used in persons with CMT, though clinicians should be aware that patients might score lower than expected, possibly because of a long process of adaptation when learning to live with a slowly progressive disease.

  • 13. Eriksson, Britt-Marie
    et al.
    Arne, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Ahlgren, Christina
    Keep moving to retain the healthy self: the meaning of physical exercise in individuals with Parkinson's disease2013In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 35, no 26, p. 2237-2244Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to explore and generate an understanding of the meaning of physical exercise in the lives of individuals with Parkinson's disease (PD) participating in an exercise program. Method: A qualitative design, using Grounded Theory methodology, was used. Eleven individuals diagnosed with PD were interviewed. Results: The core category "Keep moving to retain the healthy self" identified the continuing process of maintaining functions and activities in the individuals' lives, in which exercise was a major contribution. Two categories, "Having explicit life goals" and "Having confidence in one's own ability", were important prerequisites for adherence to physical exercise. Four categories - "Taking rational position", "Exercising to slow progression", "Exercising to achieve well-being" and "Using exercise as coping strategy" - were generated as important for starting and maintaining exercise habits. Conclusions: Insights into the process of exercising in view of living with PD were generated, which have implications for strategies in promoting physical exercise in older individuals with PD.

  • 14. Fridberg, Helena
    et al.
    Gustavsson, Catharina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Center for Clinical Research Dalarna. Institutionen för Folkhälso- och vårdvetenskap, Avd för Allmänmedicin och Preventiv medicin.
    Self-efficacy in Activities of daily living and symptom management in people with dizziness: a focus group study.2017In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, p. 1-9Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Self-efficacy is associated with health status, health behaviour and health behaviour change in various chronic health conditions.

    PURPOSE: To describe self-efficacy in relation to Activities of daily living and symptom management in people with dizziness.

    MATERIAL AND METHODS: Thirteen women and three men, aged 45-82 years, with persistent dizziness (duration 4 months to 30 years) were recruited from an outpatient physiotherapy unit. A qualitative study was conducted using four focus groups and one individual interview and was then analysed with qualitative content analysis.

    RESULTS: The participants conveyed, in-depth information concerning two predefined main categories. Self-efficacy in Activities of daily living was related to challenging body positions and motions, environments, social activities, work tasks, and complex cognitive behaviours. Self-efficacy in symptom management was related to distress and aggravated symptoms, unfamiliar environment, and unknown people.

    CONCLUSIONS: People with dizziness describe how self-efficacy for specific activities varies according to the perceived difficulty of the task, the context of the activity, and day-to-day variations in general wellbeing. The results underscore the importance of targeting self-efficacy in the rehabilitation of people with dizziness. Our findings can guide the rehabilitation process by providing a deeper understanding of self-efficacy judgements in relation to Activities of daily living and symptom management in people with dizziness. Implication for rehabilitation This study adds important in-depth knowledge to the rehabilitation area on self-efficacy beliefs in relation to Activities of daily living and symptom management in people with dizziness. Self-efficacy for specific activities varies according to the perceived difficulty of the task, the context in which the activity takes place and day-to-day variations in perceived general well-being. The results can be used as a topic list to guide rehabilitation efforts in exploring and intervening aspects of people's everyday activities that are affected by low self-efficacy judgements. Activities perceived to be crucial to everyday life and important for well-being should be targeted in rehabilitation to increase self-efficacy and thereby activity performance and participation in people with dizziness.

  • 15.
    Granat, Tina
    et al.
    Landstinget i Uppsala län, Habilitering och Hjälpmedel.
    Nordgren, Ingrid
    Landstinget i Uppsala län, Habilitering och Hjälpmedel.
    Rein, George
    Landstinget i Uppsala län, Habilitering och Hjälpmedel.
    Sonnander, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Habilitation and Disability.
    Group intervention for siblings with disabilities: a pilot study in a clinical setting2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 1, p. 69-75Article in journal (Refereed)
    Abstract [en]

    Purpose: To study the effectiveness of a group intervention in a clinical setting designed to increase knowledge of disability and improve sibling relationship among siblings of children with disabilities. Method: A self-selected sample of 54 younger and older siblings with typical development (ages 8-12 years) of children with attention deficit hyperactivity disorder (ADHD) (9), Asperger syndrome (7), autistic disorder (13), physical disability (8) and intellectual disability (17) participated in collateral sibling groups. The Sibling Knowledge Interview (SKI) and Sibling Relationship Questionnaire (SRQ) were administered pre- and post-intervention. Results: SKI scores increased (p < 0.001) from pre- to post-intervention when merged diagnostic groups were compared. Comparisons of SRQ pre- and post-intervention scores across diagnostic sibling groups showed significantly different (p < 0.05) score patterns. Conclusions: The results were encouraging and contribute to further development of interventions meeting the needs of siblings of children with disabilities. In view of the limited empirical research on group interventions for siblings of children with disabilities future work is needed to investigate the effectiveness of such interventions. Particular attention should be given to siblings of children with autism and siblings of children with intellectual disability.

  • 16.
    Haak, Thomas
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Scott, Berit
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    The effect of Qigong on Fibromyalgia (FMS): A controlled randomized study2008In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 30, no 8, p. 625-633Article in journal (Refereed)
    Abstract [en]

    Objective. To evaluate the effect of a seven-week Qigong intervention on subjects with FMS.

    Methods. The study was a controlled randomised study with repeated measures. Fifty-seven female subjects diagnosed with FMS were randomly assigned to an intervention group (n=29) or a waiting-list control group (n=28). After completion of the experimental part, the control group received the same intervention. Collection of data was made at Pre- and Post-treatment and at four-month Follow-up for both groups.

    Results. During the experimental part of the study, significant improvements were found for the intervention group, at Post-treatment, regarding several aspects of Pain, Sleep and Psychological Health and Distress. During the second part of the study, almost identical results were found for the combined group. At four-month Follow-up, the majority of these results were either maintained or improved.

    Conclusion. The overall results indicate that participation in the Qigong intervention has reliable and positive effects regarding several relevant dimensions for subjects with FMS. Considering the mean duration of 15 years of the participants’ FMS, the high degree of sick-leave and disability pension, and the amount of previous medical treatment, there are indications of a potential power from this intervention, as these variables are considered to predict poor treatment compliance and prognosis. A high degree of completion, 93 percent, and contentment with the intervention further support the potential of the treatment. The results of the study are encouraging and suggest that this particular Qigong intervention could be a useful complement to medical treatment for subjects with FMS.

  • 17. Hammer, Ann M.
    et al.
    Lindmark, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Responsiveness and validity of the Motor Activity Log in patients during the subacute phase after stroke2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 14, p. 1184-1193Article in journal (Refereed)
    Abstract [en]

    Purpose. To investigate the responsiveness and cross-sectional and longitudinal validity of the Motor Activity Log (MAL) in the subacute phase after stroke. Method. Data were collected pre-intervention, post-intervention, and at 3-month follow-up evaluations from 30 patients with stroke participating in a randomized trial of forced use. Assessments included MAL, the Fugl-Meyer test, the 16-hole peg test, grip strength, the Action Research Arm Test, and the Motor Assessment Scale. Measurements of responsiveness were effect size, standardized response mean (SRM), and responsiveness ratio (RR). Relationships between the MAL and the other measures were determined with Spearman correlations. Results. The MAL is responsive to change, with effect size, SRM, and RR> 1.0 at the 3-month follow-up, and SRM and RR> 1.0 at post-intervention. Correlations at the separate test occasions between MAL and the other measures were mostly close to 0.50, which shows fair to moderate construct validity. Correlations between changes in MAL and in the other measures were weaker than cross-sectional relationships. Conclusions. The MAL is a responsive measure of daily hand use in patients participating in rehabilitation in the subacute phase after stroke. Correlations of construct validity indicate that daily hand use may need to be measured separately from body function and activity capacity, in line with the underlying constructs of International Classification of Functioning, Disability and Health. To strengthen our findings, they should be repeated in larger samples of patients.

  • 18. Hellman, Therese
    et al.
    Jonsson, Hans
    Johansson, Ulla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Tham, Kerstin
    Connecting rehabilitation and everyday life - the lived experiences among women with stress-related ill health2013In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 35, no 21, p. 1790-1797Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim was to describe and understand how connecting rehabilitation experiences and everyday life was characterised in the lived experiences during the rehabilitation in women with stress-related ill health. Method: Five women were interviewed on three occasions during a rehabilitation programme and once 3 months later. Data were analysed using the Empirical, Phenomenological and Psychological method. Results: The participants experienced connections between their rehabilitation and their previous, present and future everyday life influencing both rehabilitation and everyday life in a back-and-forth process. These connections were experienced in mind or in doing, mostly targeting the private arena in everyday life. Connecting rehabilitation experiences to their working situations was more challenging and feelings of frustration and being left alone were experienced. Conclusions: Although the participants described constructive connections between rehabilitation experiences and the private arena in everyday life, they mostly failed to experience connections that facilitated a positive return to work. Recommended support in the return to work process in rehabilitation comprises the provision of practical work-related activities during rehabilitation; being supportive in a constructive dialogue between the participant and the workplace, and continuing this support in follow-ups after the actual rehabilitation period. Implications for Rehabilitation Rehabilitation for persons with stress-related ill health needs to focus on the private arena as well as the work situation in everyday life. Creative activities may enable experiences that inspire connections in mind and connections targeting the private arena in everyday life. The work situation needs to be thoroughly discussed during rehabilitation for enabling the participants to experience a support in the return to work process. Rehabilitation including practical work-related activities, support in a constructive dialogue between the participant and the manager at the workplace, and continued support in follow-ups targeting the workplace might be beneficial for successfully return to work.

  • 19.
    Hellström, Karin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Lindmark, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Fugl-Meyer, A.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    The Falls-Efficacy Scale, Swedish version: does it reflect clinically meaningful changes after stroke?2002In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 24, no 9, p. 471-481Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    The overall aim of this prospective investigation was to evaluate the ability of the Falls Efficacy Scale (Swedish version) (FES(S)) to reflect clinically meaningful changes over time.

    METHOD:

    Changes on the FES(S) scale were compared with changes in two different standardized measures of observer-assessed balance, the Berg Balance Scale (BBS), the Fugl-Meyer balance subscale (FMB), and of motor function and ambulation in 62 stroke patients. Assessments took place on admission for rehabilitation, at discharge and 10 months after the stroke. Indices of effect size were used to evaluate responsiveness of the instruments. Three time periods were studied: admission to discharge (early response), discharge to 10 month follow-up (late response) and admission to follow-up (overall response).

    RESULTS:

    The main findings are that the FES(S) is as responsive as BBS and FMB in detecting changes during the early and overall response periods. Changes in FES(S) scores between admission and discharge correlated significantly with changes in observer-assessed balance, motor function and ambulation scores.

    CONCLUSIONS:

    The present results suggest that measurement of perceived confidence in task performance using the FES(S) scale is responsive to improvement in patients with hemiparesis at an early stage after stroke.

  • 20.
    Hellström, Karin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Zetterberg, Lena
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Automatic control. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Short-term and long-term effects of a progressive resistance and balance exercise program in individuals with chronic stroke: a randomised controlled study2017In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Article in journal (Refereed)
  • 21.
    Ibragimova, Nina
    et al.
    Akademin för utbildning, kultur och kommunikation. Mälardalens högskola.
    Lillvist, Anne
    Akademin för utbildning, kultur och kommunikation. Mälardalens högskola.
    Pless, Mia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Granlund, Mats
    Hälsohögskolan, Högskolan i Jönköping.
    The utility of ICF for describing interaction in non-speaking children with disabilities: caregiver ratings and perceptions.2007In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 29, no 22, p. 1689-1700Article in journal (Refereed)
    Abstract [en]

    Purpose

    The purpose of the study is to explore the utility of the International Classification of Functioning, Disability and Health (ICF) when assessing caregivers' perceptions of interaction and factors related to interaction in non-speaking children with disability.

    Method

    A questionnaire with focus on interaction and related factors was constructed by linking questions in existing instruments to ICF and was completed by 208 professionals and parents of 195 non-speaking children with disabilities in Russia. Caregivers' descriptions of interaction in open-ended questions were qualitatively analysed and compared to selected caregivers' ratings of children's functioning and environment in the questionnaire based on ICF.

    Results

    In the open-ended questions about interaction the caregivers described modes of communication children used, situations in which interactions took place, positive and negative aspects of interactions. Thirty eight respondents described interaction with children negatively, 66 neutrally, and 76 positively. Statistical analyses revealed significant differences among the three groups of respondents concerning their ratings of children's functioning and environment in the ICF-based questionnaire.

    Conclusions

    The ICF-related items in the questionnaire corresponded to caregivers' perceptions of interaction, which shows their relevance for the description of interactions. ICF is feasible in describing of interaction and interaction-related factors in non-speaking children with disabilities in Russia.

  • 22.
    Johansson, Ann-Christin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Linton, Steven J.
    Rosenblad, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Bergkvist, Leif
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Nilsson, Olle
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    A prospective study of cognitive behavioural factors as predictors of pain, disability and quality of life one year after lumbar disc surgery2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 7, p. 521-529Article in journal (Refereed)
    Abstract [en]

    Purpose

    The primary aim of this study was to analyse the predictive value of cognitive and behavioural factors, in relation to pain, disability and quality of life (QoL) one year after lumbar disc surgery.

    Method

    The study design was prospective. Fifty-nine patients scheduled for first time lumbar disc surgery were included. Pain, disability, QoL, coping, fear avoidance beliefs, expected outcome and sick leave were assessed preoperatively and 12 months after surgery. Multiple backward stepwise logistic regression analyses were performed to study the contribution of the preoperatively measured independent behavioural/cognitive factors (coping, fear avoidance beliefs and assessed chance to return to work within 3 months) to the dependent variables pain, disability and quality of life at 12 months after surgery.

    Results

    Low expectations on work return within 3 months after surgery was significantly predictive for residual leg pain, odds ratio (OR) = 8.2, back pain, OR = 9.7, disability, OR = 13.8 and sick leave, OR = 19.5. Low QoL, was best predicted by preoperatively high scores on fear avoidance beliefs OR = 6.6 and being a woman OR = 6.0. The regression model explained 26-40% of the variance in pain, disability, QoL and sick leave.

    Conclusions

    Eliciting patients' expectations on work return after surgery could contribute to early identification of those who run the risk of developing long-term disability and sick-leave.

  • 23. Johansson, Annica E M
    et al.
    Haugstad, Tor
    Berg, Marie
    Johansson, Ulla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Participation in the workforce after a traumatic brain injury: a matter of control2016In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, no 5, p. 423-432Article in journal (Refereed)
    Abstract [en]

    PURPOSE: This study sought to explore individual experience in developing a mastery of daily activities and roles after a traumatic brain injury (TBI) with the objective of returning to work.

    METHOD: Eight 30-60-year-old men, employed at the time of injury, were each interviewed three times over a 6-month period. Ten to 21 months after the injuries, four participants had returned to work at least part time. Grounded theory was adapted for analyses.

    RESULTS: A single core category emerged: a desire for control: focusing on high-priority issues. Still, 2 years after injury, the participants were uncertain about their abilities with respect to what was expected of them at work. They felt they would do better as time progressed.

    CONCLUSIONS: The participants' uncertainty about their efficacy cast doubt on their beliefs in improving their skills, balancing daily activities and work. They wondered about the sustainability of their health and efficacy at work. Wanting to control their own improvement, the participants asked for counselling in strategies and techniques to help with their progress. This issue could be taken into account in follow-up rehabilitation programmes. Additionally, the workplace might be the ideal context in which to develop the structures and routines necessary to master life in general. Implications for Rehabilitation Two years after injury, the participants remained uncertain about their abilities with respect to what was expected of them at work. The participants felt they would do better as time progressed. The participants, wanting to control their own improvement, sought counselling to help sort out their priorities and found it could contribute to help with their progress in finding a suitable balance between daily activities and work. A consequence of our main finding, in a multidisciplinary context, is that counselling in structures and routines with respect to work-related tasks should be considered to be an integral part of any rehabilitation programme after TBI.

  • 24. Laakso, Katja
    et al.
    Markström, Agneta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Havstam, Christina
    Idvall, Markus
    Hartelius, Lena
    Communicating with individuals receiving home mechanical ventilation: the experiences of key communication partners2014In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, no 11, p. 875-883Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of the study was to explore the communication experiences of key communications partners (CPs) of individuals receiving home mechanical ventilation (HMV), with particular emphasis on the possibilities, difficulties and limitations CPs experienced in communication, possible support given to facilitate communication and exploring what made a skilled communicator. Method: A qualitative research design using interviews was used. The participants included 19 key CPs of individuals receiving HMV. Results: The analysis resulted in five themes: Encountering communication limitations, Functional communication strategies, Being a communication facilitator, Role insecurity and Emotional reactions and coping. The findings revealed that CPs needed to develop partly new reference frames for communication. In particular, participants emphasised the need to understand and interpret subtle details in the communicative interaction. Conclusions: The findings are discussed in the light of previous research, in particular an earlier study exploring another perspective; the ventilator-supported individuals' experiences of communication. Issues relating to the educational needs of CPs of individuals receiving HMV are discussed. The results are intended to enhance understanding of the challenges that individuals receiving HMV and their CPs face with communication, which should be of relevance not only to speech therapists, but for all healthcare practitioners in the field of HMV.

  • 25. Langhammer, Birgitta
    et al.
    Lindmark, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    General motor function assessment scale: reliability of a Norwegian version2014In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, no 20, p. 1704-1712Article in journal (Refereed)
    Abstract [en]

    Purpose: The General Motor Function assessment scale (GMF) measures activity-related dependence, pain and insecurity among older people in frail health. The aim of the present study was to translate the GMF into a Norwegian version (N-GMF) and establish its reliability and clinical feasibility. Methods: The procedure used in translating the GMF was a forward and backward process, testing a convenience sample of 30 frail elderly people with it. The intra-rater reliability tests were performed by three physiotherapists, and the inter-reliability test was done by the same three plus nine independent colleagues. The statistical analyses were performed with a pairwise analysis for intra- and inter-rater reliability, using Cronbach's alpha, Percentage Agreement (PA), Svensson's rank transformable method and Cohen's kappa. Results: The Cronbach's alpha coefficients for the different subscales of N-GMF were 0.68 for Dependency, 0.73 for Pain and 0.75 for Insecurity. Intra-rater reliability: The variation in the PA for the total score was 40-70% in Dependence, 30-40% in Pain and 30-60% in Insecurity. The Relative Rank Variant (RV) indicated a modest individual bias and an augmented rank-order agreement coefficient r(a) of 0.96, 0.96 and 0.99, respectively. The variation in the kappa statistics was 0.27-0.62 for Dependence, 0.17-0.35 for Pain and 0.13-0.47 for Insecurity. Inter-rater reliability: The PA between different testers in Dependence, Pain and Insecurity was 74%, 89% and 74%, respectively. The augmented rank-order agreement coefficients were: for Dependence r(a) = 0.97; for Pain, r(a) = 0.99; and for Insecurity, r(a) = 0.99. Conclusion: The N-GMF is a fairly reliable instrument for use with frail elderly people, with intra-rater and inter-rater reliability moderate in Dependence and slight to fair in Pain and Insecurity. The clinical usefulness was stressed in regard to its main focus, the frail elderly, and for communication within a multidisciplinary team.

  • 26. Lindbäck, Camilla
    et al.
    Nordgren, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Mälardalens högskola.
    To be on sick-leave due to heart failure: a qualitative perspective2015In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 18-19, p. 1732-1738Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of the present study was to explore and describe meanings of being on sick leave due to heart failure.

    Methods: The study was conducted in Sweden during 2011-2012. Five men and one woman, aged 46 to 62, were interviewed. A reflective life-world research approach based on phenomenological philosophy was used. The result of the analysis is presented in three themes.

    Results: To be on sick leave due to heart failure implies a life situation characterized by anxiety, insecurity and uncertainty. When rehabilitation professionals do not take on their professional responsibility, sick listed people with heart failure perceive they are dismissed and abandoned. If rehabilitation professionals take on their professional responsibility it can be experienced as supportive.

    Conclusions: People who are on sick leave due to heart failure are abandoned by rehabilitation professionals and they lack opportunities to participate in their own sick leave/rehabilitation processes. Rehabilitation professionals need to take more responsibility and allow the patients to participate by connecting and recognizing patients as equal human beings. The present results can be used by rehabilitation professionals to reflect on and discuss the needs of people on sick leave due to heart failure. Implications for Rehabilitation Heart failure is a chronic condition implying a complicated life-situation. People with heart failure experience abandonment by rehabilitation professionals and lack participation in their own rehabilitation process. In order to support people on sick leave due to heart failure collaboration and coordination between rehabilitation professionals are needed.

  • 27. Mosallanezhad, Z
    et al.
    Salavati, M
    Hellström, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Sotoudeh, GR
    Nilsson Wikmar, L
    Frändin, K
    Cross-cultural adaptation, reliability and validity of the Persian version of the modified Falls Efficacy Scale2011In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, no 25-26, p. 2446-2453Article in journal (Refereed)
    Abstract [en]

    Purpose. To translate the Swedish version of the Falls Efficacy Scale (FES), the FES(S), into Persian, and to determine reliability and validity of the scale to be used for Persian speaking elderly people. Method. The 'forward-backward' procedure was applied to translate the FES(S) into Persian. A methodological study was then carried out to determine the psychometric properties of the Persian version of the scale. Eighty-one community-dwelling elderly persons (≥65 years) were included. Results. Both reliability and validity of the Persian FES(S) were found to be acceptable (Cronbach's α = 0.75, interclass correlation coefficients = 0.99, p < 0.001 and standard errors of measurements = 1.82). Low to moderate negative correlations of the total score of the scale with the age of the participants and number of falls in the past year were shown. There were also low to moderate correlations between the Persian FES(S) score and the Mini-Mental State Examination score, duration of walks and physical fitness. The participants who took a daily walk, felt healthy, reported no general tiredness and who had had no fall during the past year rated their self-efficacy higher than did their peers. Conclusions. The present study verified that the Persian FES(S) is a culturally relevant, valid and reliable tool for measuring self-perceived confidence in Iranian older adults.

  • 28.
    Mosallanezhad, Zahra
    et al.
    KI.
    Salavati, Mahyar
    Hellström, Karin
    Sotoudeh, Gholam Reza
    Nilsson Wikmar, Lena
    Frändin, Kerstin
    Cross-cultural adaption, reliability and validity of Persian version of the modified Falls Efficacy Scale2011In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, no 25-26, p. 2446-2453Article in journal (Refereed)
    Abstract [en]

    Purpose.To translate the Swedish version of the Falls Efficacy Scale (FES), the FES(S), into Persian, and to determinereliability and validity of the scale to be used for Persian speaking elderly people.Method.The ‘forward-backward’ procedure was applied to translate the FES(S) into Persian. A methodological study wasthen carried out to determine the psychometric properties of the Persian version of the scale. Eighty-one community-dwelling elderly persons (65 years) were included.Results.Both reliability and validity of the Persian FES(S) were found to be acceptable (Cronbach’sa¼0.75, interclasscorrelation coefficients¼0.99,p50.001 and standard errors of measurements¼1.82). Low to moderate negativecorrelations of the total score of the scale with the age of the participants and number of falls in the past year were shown.There were also low to moderate correlations between the Persian FES(S) score and the Mini-Mental State Examinationscore, duration of walks and physical fitness. The participants who took a daily walk, felt healthy, reported no generaltiredness and who had had no fall during the past year rated their self-efficacy higher than did their peers.Conclusions.The present study verified that the Persian FES(S) is a culturally relevant, valid and reliable tool for measuringself-perceived confidence in Iranian older adults.

  • 29. Niemi, Tuuli
    et al.
    Johansson, Ulla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    The lived experience of engaging in everyday occupations in persons with mild to moderate aphasia2013In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 35, no 21, p. 1828-1834Article in journal (Refereed)
    Abstract [en]

    Purpose: Impairment of language ability, aphasia, can cause barriers to communication and hence impact on participation in many life situations. This study aimed to describe and explore how persons with aphasia following stroke experience engaging in everyday occupations. Method: Six persons from Southwest Finland who had aphasia due to stroke one to four years previously were interviewed for the study. A modified form of the empirical phenomenological psychological method was used for data analysis. Results: Three main characteristics of experiences of engaging in everyday occupations were identified: (1) encountering new experiences in everyday occupations, (2) striving to handle everyday occupations and (3) going ahead with life. The participants had experienced an altering life-world. Engagement in occupations affected their perceptions of competence and identity, and experiences of belonging and well-being. It was also through engagement in everyday occupations that they had discovered and learnt to handle changes in their everyday life. Conclusion: Aphasia can have a long-term impact on engagement in everyday occupations and participation in society, but conversely, engagement in meaningful occupations can also contribute to adaptation to disability and life changes. Implications for Rehabilitation Aphasia can have a long-term impact on engagement in everyday occupations and participation in society. Health care professionals need to determine what clients with aphasia think about their occupations and life situations in spite of difficulties they may have verbalizing their thoughts. Experiences of engaging in meaningful occupations can help clients with aphasia in reconstructing their life stories, thereby contributing to adaptation to disability and life changes.

  • 30.
    Nordgren, Lena
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Mälardalens högskola.
    Söderlund, Anne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy. Mälardalens högskola.
    Associations between socio-demographic factors, encounters with healthcare professionals and perceived ability to return to work in people sick-listed due to heart failure in Sweden: a cross-sectional study2016In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, no 2, p. 168-173Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of this study was to investigate associations between socio-demographic factors, experiences of positive/negative encounters with healthcare professionals, and the encounters' impact on the ability to return to work in a population of people on sick leave due to heart failure.

    METHODS: This was a cross-sectional study. Data were collected from two official registries in Sweden and from a postal questionnaire. In all, 590 people with heart failure responded to the questionnaire. Associations between variables were calculated with bivariate correlation analyses and logistic regression analyses.

    RESULTS: For people on sick leave due to heart failure, positive encounters with healthcare professionals are associated with being Swedish-born, female gender, and high income. People with high income are more likely to be supported back to work by positive encounters with healthcare professionals. To perceive that healthcare professionals believe in person's ability to return to work can be facilitating.

    CONCLUSIONS: Women, people who are not foreign-born, and people with high income are more likely to perceive encounters with healthcare professionals as positive. Healthcare professionals who work with rehabilitation for people with heart failure need to be aware of social inequalities and that being on sick leave is a process of change. Implications for Rehabilitation A failing heart limits everyday life implying risk for long-term sick leave. Even though there are rehabilitation programs for people with heart failure, vocational rehabilitation is often over-looked. The knowledge about factors associated with sick leave due to heart failure is scarce. Experiences of positive encounters with healthcare professionals were associated with being Swedish-born, female gender, and high income. People with high income were more likely to be supported back to work by positive encounters with healthcare professionals. Healthcare professionals who work with rehabilitation for people with heart failure can support patients with heart failure by showing them confidence and trust. However, they need to be aware that sick leave implies a process of change.

  • 31.
    Pettersson, Susanne
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Bring, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Stressful events and coping related to acute and sub-acute whiplash-associated disorders2017In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 39, no 6, p. 578-585Article in journal (Refereed)
    Abstract [en]

    Purpose To describe daily stressors affecting and coping strategies employed by individuals with whiplash-associated disorders (WAD) immediately to one month (acute) and three to four months (sub-acute) after injury events using a daily coping assessment. Levels of pain, anxiety, depressed mood and activity are also compared between phases. Method A descriptive prospective design with a content analysis approach was used. Participants completed daily coping assessments for one week during both acute and sub-acute phases. Main measure was whiplash-associated disorders-daily coping assessment (WAD-DCA). Results Nine participants used words describing recovery in the sub-acute phase; 31 described stressful events during both phases. Most frequently reported stressors were related to "symptoms", "emotions" and "occupations/studies". These were equally reported during both phases. Cognitive coping strategies were employed more often during the sub-acute phase (p = 0.008). The only behavioral strategy that increased in prevalence over time was the "relaxed" strategy (p = 0.001). Anxiety levels declined over time (p = 0.022). Conclusion The reported stressors were largely uniform across both acute and sub-acute phases; however, the use of cognitive coping strategies increased over time. The WAD-DCA captures individual stressors and coping strategies employed during a vulnerable phase of rehabilitation and can thus provide information that is useful to clinical practice. Implications for rehabilitation The WAD-DCA provides valuable information for clinical practice when employed during early phases of whiplash-associated disorder development. Reported stressors during the acute and sub-acute phases are essentially the same, whereas cognitive coping strategies grow in prevalence over time. Tailored treatments in early phases of whip-lash associated disorders may benefit from strategies aimed at matching patient-specific stressors with contextually adapted coping strategies.

  • 32.
    Sandborgh, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Lindberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Denison, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    The Pain Belief Screening Instrument (PBSI): Predictive validity for disability status in persistent musculoskeletal pain2008In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 30, no 15, p. 1123-1130Article in journal (Refereed)
    Abstract [en]

    Purpose. To evaluate the predictive validity of a screening instrument measuring disability, self-efficacy, fear of movement and catastrophizing, for disability status in patients with musculoskeletal pain in primary health care physical therapy. Development over time of pain-related disability, pain intensity, self-reported work capacity and overall daily function for subgroups of patients was also investigated. Method. Prospective and correlational study, where patients (n = 168) with a pain-duration of 4 weeks or more completed the questionnaires and their cases were followed for 8 months to assess the variables of interest. For predictive validity of the screening instrument discriminant analyses were conducted. The development over time for subgroups was analysed by comparing scores at the first and second measurement. Results. The PBSI correctly classified 72% of the subjects as High-disabled (n = 33) or Low-disabled (n = 110), as measured with the Pain Disability Index (Wilks' lambda = 0.848, p < 0.005). For pain intensity, self-reported changes in work capacity and overall daily function the discriminant analyses were not significant. The High-disability group had increased disability, unchanged pain intensity and decreased work capacity and daily function after 8 months. Conclusion. The predictive validity of the PBSI for disability was confirmed. In clinical use the PBSI could serve as a mean to obtain supplementary and clinically useful information.

  • 33.
    Silvemark, Annika J
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Källmén, Håkan
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Portala, Kamilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Molander, Carl
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Life satisfaction in patients with long-term non-malignant pain - relation to demographic factors and pain intensity2008In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 30, no 25, p. 1929-1937Article in journal (Refereed)
    Abstract [en]

    Purpose. Life satisfaction can be defined as a measure of a patient's perception of the difference between his reality and his needs or wants. Here we compare life satisfaction in patients with long-term pain to a reference group sampled from the normal population, and   relate the results to pain intensity and to demographic factors. Method. Questionnaires containing the Life satisfaction (LiSat-11) checklist, a visual analogue scale (VAS) for pain, and questions on demographic background. Results. The prevalence of responders with low level of life satisfaction was larger among the patients than in the reference group. In particular, patients born outside Northern Europe scored significantly lower than patients born in Northern Europe in many of the LiSat-11 domains. Pain intensity did not correlate well to the level of life satisfaction, except for weak negative correlations to satisfaction with physical health and with financial situation. Conclusion. Long-term pain is strongly associated with low life satisfaction. In order to increase life satisfaction, interventions   related to social factors seem to be important.

  • 34. Sjöquist, Emma S.
    et al.
    Almqvist, Lena
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Lampa, Jon
    Opava, Christina H.
    Physical-activity coaching and health status in rheumatoid arthritis: A person-oriented approach2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 10, p. 816-825Article in journal (Refereed)
    Abstract [en]

    Purpose

     No interventions to promote physical activity can succeed for all participants. Insights into the specific characteristics of those who do succeed are needed. One aim was to investigate whether a selection of correlates of general health perception creates cluster typologies in individuals with rheumatoid arthritis (RA). Another was to evaluate whether magnitude of change in health status differs between clusters after a 1-year coaching intervention targeting health-enhancing physical activity.

    Method

     Two hundred and twenty-eight patients (74% women, mean age 56 years, disease duration 1 year) with RA, from 10 rheumatology clinics in Sweden, participated. The patients were assigned at random to intervention or control. The intervention group underwent 1 year of coaching to adopt health-enhancing physical activity (moderately intensive, 30 min/day, > 4 days/week). The cluster analysis included five correlates of general health perception: disease activity; pain; timed standing; activity limitation; and self-reported physical activity. The primary outcome of the coaching intervention was self-reported health status.

    Results

     One-hundred and forty-six patients were eligible for inclusion in the cluster analysis. The eight clusters identified both at baseline and post interventions were operationalized according to the number of cluster variables affected: less (LE) affected or more (MO) affected, respectively. Clusters with I F. affected variables had significantly better general health perception at baseline than those with MO affected variables. Further, coached individuals in MO affected clusters significantly improved self-reported health status compared both to those coached in LE affected clusters and to those in MO affected clusters in the control group.

    Conclusion

     This person-based approach contributed more than did the results in a previous randomized controlled trial to the understanding of which patients benefit most from the present physical-activity coaching intervention. The intervention may thus be most beneficial for individuals more severely affected by their disease at baseline.

  • 35.
    Spörndly-Nees, Søren
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Igelström, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Lindberg, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Martin, Cathrin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Facilitators and barriers for eating behaviour changes in obstructive sleep apnoea and obesity: a qualitative content analysis2013In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, no 1, p. 74-81Article in journal (Refereed)
    Abstract [en]

    Purpose:

    Obesity is a major risk factor for obstructive sleep apnoea syndrome, a condition known causing lack of sleep continuity and daytime sleepiness. Weight loss interventions are recommended, however knowledge on what facilitate and impede eating behaviour change is lacking for this particular population. The aim of this study was to identify personal conceptions of prerequisites for eating behaviour change.

    Method:

    A qualitative study on 15 patients with obstructive sleep apnoea syndrome (OSAS; apnoea-hypopnoea index >15) and obesity (Mean body mass index 38.2). Semi-structured interviews were conducted and data were transcribed and analysed using qualitative content analysis with researcher triangulation for trustworthiness.

    Results:

    Data were organised according to barriers and facilitators for changing eating behaviour. Identified barriers were desire and reward, cravings and emotional control, low self-confidence, insufficient support, taxing behaviours, cost, lack of knowledge about healthy eating strategies, perceived helplessness and low susceptibility. Identified facilitators were positive expectations, fear of negative consequences, experience of success, support and follow-up, accessibility, applied skills for healthy eating, personal involvement and challenged self-image.

    Conclusion:

    This study adds knowledge on important barriers and facilitators of eating behaviour change according to individuals with obesity and OSAS. Information used to inform a tailored behavioural medicine intervention targeting eating behaviours. Implications for Rehabilitation Patients with obstructive sleep apnoea syndrome (OSAS) benefit from weight loss and eating behaviour changes are recommended. Patients' views on prerequisites for eating behaviour change are important to plan, conduct and tailor behaviour change interventions. These aspects have hitherto not been elaborated in patients with OSAS. Considerations on patient's self-image and perceived susceptibility along with providing strategies for controlling the desire and rewarding feeling associated with eating are emphasised.

  • 36.
    Sundgren, Elisabet
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Hallqvist, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Fredriksson, Lennart
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. CFUG centrum för forskning och utveckling Uppsala Universitet/Region Gävleborg.
    Health for smokers with schizophrenia: a struggle to maintain a dignified life2016In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, no 5, p. 416-422Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To investigate the health and lifestyle habits of smokers with schizophrenia and describe their experience of smoking in relation to health.

    METHODS: Semi-structured interviews with 10 smokers with schizophrenia were conducted in Sweden from May to October 2013. A hermeneutic phenomenological approach was used to describe and interpret respondents' experiences.

    FINDINGS: Good health for a person with schizophrenia was defined as accepting their mental illness, having strategies to gain control over psychotic symptoms, and engaging in activities and good relationships. Lifestyle habits were described as structures in the respondents' daily life: arising in the morning, taking a cigarette, reading the newspaper, eating breakfast and doing the things planned for the day.

    CONCLUSION: The meaning of health for smokers with schizophrenia is not the same as being well or ill. Rather, health is an experience of a struggle to maintain a dignified life, including self-acceptance of the mental illness and control over the psychotic symptoms. People with schizophrenia have high willingness but low motivation to stop smoking because they fear that cigarette withdrawal will increase their psychotic symptoms. Therefore, they find it difficult to stop smoking. To succeed with health care intervention, health care providers must understand the life style habits and experiences specific to smokers with schizophrenia and the unique experience of health and life style habits that people with schizophrenia experience.

  • 37.
    Sépulchre, Marie
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Research about Citizenship and Disability: a Scoping Review2017In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 39, no 10, p. 949-956Article in journal (Refereed)
    Abstract [en]

    Purpose: To identify the characteristics of peer-reviewed literature on citizenship and disability publishedin English from 1985 to 2015. Method: A scoping review was conducted using the Arksey and O’Malleyframework. Several databases were searched for peer-reviewed journal articles including the terms citizenshipand disability, impairment or handicap in their abstract or title; published between 1985 and 2015; inEnglish. Results: A total of 295 articles were included. Key findings are (1) the number of articles about disabilityand citizenship increased dramatically over the past three decades, (2) the meaning of citizenship isoften left undiscussed, (3) citizenship is more often discussed in terms of access to social rights and less soin regards to contributions to society and participation in family life, technology and culture, (4) disabledpeople tend to be represented as a homogeneous category, (5) most studies are qualitative and non-participatory.Conclusions: To broaden knowledge about the situation, membership and participation of personswith disabilities in society, further research should develop the conceptual use of citizenship inrelation to disability, explore different research designs, investigate various citizenship sectors and take intoaccount the complexity of personal and social situations of persons with disabilities.

  • 38.
    Söderlund, Anne
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    The mediating role of self-efficacy expectations and fear of movement and (re)injury beliefs in two samples of acute pain2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 25, p. 2118-2126Article in journal (Refereed)
    Abstract [en]

    PURPOSE

     The overall aim of this study was to estimate the possible mediating role of self-efficacy, catastrophic thinking and fear of movement and (re)injury between pain intensity and pain-related disability in two samples of acute pain patients, i.e. patients with musculoskeletal injuries and patients with whiplash injury.

    METHOD:

    A cross sectional design with data-collection after an acute injury was used. Subjects were recruited at an emergency department. Sixty-four patients with acute whiplash associated disorders (WAD) and 74 patients with musculoskeletal injury completed the questionnaires.

     RESULTS

     Self-efficacy was found to be a mediator between pain intensity and pain-related disability in the WAD group, whereas fear of movement and (re)injury appeared as mediator in the musculoskeletal-injury group. The strength of association between variables was weaker in the musculoskeletal-injury group compared to the WAD group.

    CONCLUSIONS

     It is important to assess fear of movement beliefs in patients with musculoskeletal injuries. Similarly, patients with acute WAD expressing low self-efficacy beliefs should be identified. An early detection of these beliefs may improve management at the acute phase and possibly reduce risks for slow improvements.

  • 39. Thyberg, Mikael
    et al.
    Arvidsson, Patrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Thyberg, Ingrid
    Nordenfelt, Lennart
    Simplified bipartite concepts of functioning and disability recommended for interdisciplinary use of the ICF.2015In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 9, p. 1783-1792Article in journal (Refereed)
    Abstract [en]

    Abstract Purpose: To argue for and propose bipartite concepts of functioning and disability, to tally with the structure of the ICF classification list, concepts of social models and clinical needs. Method: The ICF concepts are discussed in relation to the history of ideas regarding disability concepts and the needs for such concepts in interdisciplinary rehabilitation. Results: Bipartite concepts are presented; they refer to actual functioning, simply body functions/structures and participation, including functioning in standardized environments. Participation refers to actually performed "activities", with "activities" simply denoting things that people may do. Bipartite concepts are congruent with the ICF classification and the structure of social models of disability, suitable for clinical and interdisciplinary use and easy to understand. The issue of standardized environments represents a methodological issue rather than the conceptual issue of defining functioning and disability. An individual perspective on activity and activity limitations, i.e. the middle part of the tripartite ICF concept, is somewhat similar to concepts of traditional language that were regarded as too generalizing already in 1912, when the interactional concept of "disability in a social sense" was introduced in rehabilitation practices. Conclusion: Bipartite concepts of functioning and disability are recommended for interdisciplinary use of the ICF. Implications for Rehabilitation The ICF classification is useful, but the ICF concept of activities in an individual perspective is confusing. We suggest a use of the term "activities" simply to denote things that people may do and "participation" to denote actually performed activities. Estimations of ability should be explicit about how they are related to environmental factors.

  • 40.
    Vahlberg, Birgit
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Lindmark, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Zetterberg, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Hellström, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Short-term and long-term effects of a progressive resistance and balance exercise program in individuals with chronic stroke: a randomized controlled trial2017In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 39, no 16, p. 1615-1622Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To evaluate the effects of progressive resistance and balance (PRB) exercises on physical and psychological functions of post-stroke individuals.

    MATERIALS AND METHODS: In a randomized controlled trial with follow-up at 3, 6 and 15 months, 67 community-living individuals (76% male; 65-85 years) with a stroke 1-3 years previously were allocated to an intervention group (IG, n = 34; PRB exercises combined with motivational group discussions twice weekly for 3 months) or a control group (CG, n = 33). The primary outcomes were balance (Berg Balance Scale, 0-56 points) and mobility (Short Physical Performance Battery, 0-12 points) at 3 months. The secondary outcomes were 10 m comfortable walking speed, physical activity levels, health-related quality of life, depression and fall-related self-efficacy.

    RESULTS: At 3 months, the IG exhibited significant improvements in balance (MD 2.5 versus 0 points; effect size [ES], 0.72; p < 0.01) and comfortable walking speed (MD 0.04 versus -0.05 m/s; ES, 0.68; p = 0.01) relative to the CG. A faster walking speed persisted at 6 months. No differences were found for the other outcomes.

    CONCLUSIONS: In chronic stroke patients, 3 months of PRB exercises and motivational discussions induced improvements in balance at 3 months and in walking speed at 3 and 6 months. Implications for Rehabilitation A progressive resistance and balance exercise program supported by motivational group discussions and one home-based exercise appears to be an effective means of improving the short-term balance and the walking speed in individuals with chronic stroke. People with poor balance and motor function discontinued the study more often and may require additional support. There is a need for powerful and cost-effective strategies that target changes in behavior to obtain long-term changes in physical function after exercising.

  • 41.
    Vahlberg, Birgit
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Lindmark, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Zetterberg, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Hellström, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Body composition and physical function after progressive resistance and balance training among older adults after stroke: an exploratory randomized controlled trial2017In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 39, no 12, p. 1207-1214Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To evaluate whether improvements in physical function are related to changes in body composition after a three-month progressive resistance and balance exercise program among individuals approximately one to three years after stroke.

    METHODS: In this randomized controlled trial, 43 community-dwelling subjects (65-85 years, mean age 73 ± 5 years, 73% men) were allocated to a progressive resistance and balance exercise program twice weekly for three months (intervention group [IG], n = 20) or a control group (n = 23). The main outcome measures were fat mass (kg) and fat-free mass (kg), as measured by bioelectrical impedance analyses (Tanita®). Physical function was measured using the six-minute walk test.

    RESULTS: Complete case analyses revealed reduced fat mass in the IG compared with the control (-1.5 vs. (0).13% of body weight, respectively; effect size =0.62; p = 0.048). In contrast, no between-group difference in fat-free mass was observed. The six-minute walk test was improved (25 vs. -10 m, respectively, effect size =0.69, p = 0.039) at three months in favor of the IG. The reduced fat mass was associated with an improved six-minute walk test (r = 0.48, p = 0.038) in the IG.

    CONCLUSIONS: Three-month progressive resistance and balance training was associated with reduced fat mass, which was related to improvements in walking capacity in older adults approximately one year after stroke.

    Implications for rehabilitation - This three-month PRB group exercise program supported by motivational discussions and daily home-based exercises indicate the following:

    • Improved walking capacity was associated with a reduction in fat mass.

    • IGF-1 is reduced, possibly indicating improved insulin sensitivity.

  • 42.
    von Granitz, Heléne
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Reine, Ieva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Sonnander, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Winblad Spångberg, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Do personal assistance activities promote participation for persons with disabilities in Sweden?2017In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 39, no 24, p. 2512-2521Article in journal (Refereed)
    Abstract [en]

    ABSTRACT

    Purpose: To examine how the right to participation according to Article 19 of the United Nations’ Convention on the Rights of Persons with Disabilities (UNCRPD) is promoted by personal assistance use in Sweden across age, gender and eligible person categories.

    Method: Register data and data from a questionnaire were used (N¼15,289). Principal component analysis was performed and the internal consistency was tested. Descriptive statistics (v2 test) were used across age, gender and eligible person categories and components.

    Results: An uneven distribution of personal assistance across the components Health and Care; Home, Leisure and Social Interaction; and Daily Occupation was found. Significant differences in personal assistance reported were found between children and adults, men and women and between the three eligible person categories.

    Conclusions: The discrepancy between reported and expected outcome of personal assistance indicates that Article 19 of the UNCRPD has not been met. The unequal access to participation across age, gender and eligible person categories would seem to further signify that the Act concerning Support and Service for Persons with Certain Functional Impairments is promoting activities of a caring nature rather than fulfilling Article 19 of the UNCRPD, i.e. ensuring full participation in society.

  • 43.
    Wandin, Helena
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Lindberg, Per
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Sonnander, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Communication intervention in Rett syndrome: a survey of speech language pathologists in Swedish health services2015In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 15, p. 1324-1333Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate communication intervention that speech language pathologists (SLPs) provide to people with Rett syndrome. Methods: A web-based survey targeting all Swedish SLPs working with people currently receiving support from habilitation services. Results: The SLPs reportedly followed recommended practice in the following aspects: (1) Information on communicative function was collected from several sources, including observation in well-known settings and reports from the client s social network, (2) Multimodal communication was promoted and, (3) Responsive partner strategies were largely targeted in the intervention. However, few instruments or standard procedures were used and partner instruction was given informally. Most SLPs used communication aids in the intervention and their general impression of using communication aids was positive. Further, augmentative and alternative communication (AAC) was estimated to increase and clarify communicative contributions from the person. Conclusions: Communication aids were reported to have a positive influence on communicative functions. Swedish SLP services followed best practice in several aspects, but there are areas with potential for development. Tools and best practice guidelines are needed to support SLPs in the AAC process for clients with Rett syndrome.

  • 44.
    Westman, Anders
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Linton, Steven J.
    Öhrvik, John
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Wahlén, Petra
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Theorell, Tores
    Leppert, Jerzy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Controlled 3-year follow-up of a multidisciplinary pain rehabilitation program in primary health care2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 4, p. 307-316Article in journal (Refereed)
    Abstract [en]

    Purpose. The high prevalence of musculoskeletal pain generates significant costs for primary health care and the whole of society. The development of appropriate interventions is therefore necessary. The aim of this effectiveness study was to assess the long-term effects of a primary health care multidisciplinary rehabilitation program in Sweden. Methods. An experimental group comprising 89 patients from two primary health care units received individualised treatment interventions after a multidisciplinary investigation. A control group of 69 patients with the same inclusion criteria from four other primary health care units were treated according to routine. All participants completed questionnaires measuring pain, sick leave, quality of life, health care utilisation, drug consumption and psychosocial factors at baseline and at 3-year follow-up. Results. After 3 years, utilisation of primary health care was significantly lower in the experimental group and work capacity was slightly but not significantly higher. The control group showed a trend of having a higher risk of high consumption after 3 years compared to the intervention group. There was no significant difference between the two groups concerning remaining variables such as function, catastrophising and pain. Conclusion. Both groups demonstrated considerable improvement over the course of 3 years. The experimental group had lower health care utilisation and a reduced risk of using large amounts of medication at the 3-year follow-up, indicating that compared with participants in the control group they were coping in a better way with pain.

  • 45. Wiitavaara, Birgitta
    et al.
    Bjorklund, Martin
    Nilsson, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    An initial factor analysis of prominent aspects of health experiences for women with neck-shoulder pain2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 11, p. 934-942Article in journal (Refereed)
    Abstract [en]

    Purpose: The prospect of adequate comparisons is essential to decide on the effectiveness of different treatments. As there is a lack of unity in choice of questionnaires and included measures concerning musculoskeletal disorders, further investigations based on international recommendations are of interest. The intention of present study was to initiate the development of a clinically useful short-form questionnaire. The aim was to select items that capture prominent health aspects for women with neck-shoulder pain and thereby reduce the number of items to a clinically more convenient amount, and to determine the underlying structure of included items.

    Method: Data were collected in a randomised controlled trial including women with non-specific neck-shoulder pain > 3 months (n = 117). Data collection included three core domains: pain intensity, physical and emotional functioning, and analysis was performed using Principal component analysis, and Varimax rotation.

    Results: The resulting 9-factor solution included interference, solicitous/distracting responses, mood and feelings about self and relations, pain intensity, punishing responses, personal growth, life control, sleep, and appetite (29 items).

    Conclusions: The results will contribute to the development of a reduced battery of questions representing core dimensions. Such questionnaire would lighten the assessment load in the clinic as well as in research.

  • 46.
    Wikehult, Björn
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Psychiatry, University hospital.
    Kildal, Morten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Lannerstam, Kurt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Fugl-Meyer, Axel R
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Psychiatry, University hospital.
    Gerdin, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Use of healthcare a long time after severe burn injury: relation to perceived health and personality characteristics2005In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Disability and Rehabilitation, ISSN 0963-8288, Vol. 27, no 15, p. 863-870Article in journal (Refereed)
    Abstract [en]

    Purpose. The aim of the study was to evaluate which factors are associated with the use of healthcare a long time after severe burn injury.

    Method. After a review process based on clinical reasoning, 69 former burn patients out of a consecutive group treated at the Uppsala Burn Unit from 1980 – 1995 were visited in their homes and their use of care and support was assessed in a semi-structured interview. Post-burn health was assessed with the Burn-Specific Health Scale-Brief (BSHS-B) and personality was assessed with the Swedish universities Scales of Personality (SSP).

    Results.  The participants were injured on average eight years previously. Thirty-four had current contact with healthcare due to their burn injury and had significantly lower scores on three BSHS-B-domains: Simple Abilities, Work and Hand function, and significantly higher scores for the SSP-domain Neuroticism and the SSP-scales Stress Susceptibility, Lack of Assertiveness, and lower scores for Social Desirability. There was no relation to age, gender, time since injury, length of stay, or to the surface area burned.

    Conclusions. A routine screening of personality traits as a supplement to long-term follow-ups may help in identifying the patient's need for care.

1 - 46 of 46
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