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  • 1. Bergstrom, Aileen
    et al.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    Asaba, Eric
    Erikson, Anette
    Tham, Kerstin
    The lived experience of enacting agency in everyday life after a stroke2014Ingår i: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 28, nr 5-6, s. 674-674Artikel i tidskrift (Övrigt vetenskapligt)
  • 2.
    Bergstrom, Aileen
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, S-14183 Huddinge, Sweden..
    Guidetti, Susanne
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, S-14183 Huddinge, Sweden..
    Tham, Kerstin
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, S-14183 Huddinge, Sweden..
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, S-14183 Huddinge, Sweden.
    Association between satisfaction and participation in everyday occupations after stroke2017Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 24, nr 5, s. 339-348Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Within occupational therapy, it is assumed that individuals are satisfied when participating in everyday occupations that they want to do. However, there is little empirical evidence to show this. Aims: The aim of this study is to explore and describe the relation between satisfaction and participation in everyday occupations in a Swedish cohort, 5 years post stroke. Methods: Sixty-nine persons responded to the Occupational Gaps Questionnaire (OGQ). The questionnaire measures subjective restrictions in participation, i.e. the discrepancy between doing and wanting to do 30 different occupations in everyday life, and satisfaction per activity. Results were analysed with McNemar/chi-square. Results: Seventy percent of the persons perceived participation restrictions. Individuals that did not perceive restrictions in their participation had a significantly higher level of satisfaction (p=.002) compared to those that had restrictions. Participants that performed activities that they wanted to do report between 79 and 100% satisfaction per activity. Conclusion: In this cohort, there was a significant association between satisfaction and participating in everyday occupations one wants to do, showing that satisfaction is an important aspect of participation and substantiates a basic assumption within occupational therapy. The complexity of measuring satisfaction and participation in everyday occupations is discussed.

  • 3. Bergstrom, Aileen L.
    et al.
    Guidetti, Susanne
    Tistad, Malin
    Tham, Kerstin
    von Koch, Lena
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    Perceived occupational gaps one year after stroke: An explorative study2012Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, nr 1, s. 36-42Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To explore and describe factors associated with occupational gaps and to identify factors at 3 months that predict occupational gaps one year post-stroke. A gap, a restriction in participation, is considered to be present when there is a discrepancy between what the individual wants to do and what they actually do in everyday life. Design: Prospective longitudinal study. Subjects: Two hundred persons with stroke. Methods: Data from the Occupational Gaps Questionnaire, one year post-stroke, was used as the dependent variable in 3- and 12-month regression analyses. Domains of the Stroke Impact Scale, global life satisfaction, demographic and medical factors were used as independent variables. Results: At 3 months, activities of daily living abilities, social participation and not being born in Sweden predicted occupational gaps at 12 months. Stroke severity and not being born in Sweden and 3 factors at 12 months: social participation, self-rated recovery, and global life satisfaction were associated with occupational gaps. Conclusion: Activities of daily living ability at 3 months predicted occupational gaps after stroke. Thus, it is possible to identify early on, and provide interventions for, those that risk participation restrictions. Not being born in the country might be an indicator of a risk for participation restrictions.

  • 4.
    Bergström, Aileen L.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Forskning om funktionshinder och habilitering.
    Asaba, Eric
    Erikson, Anette
    Tham, Kerstin
    Complex negotiations: The lived experience of enacting agency after a stroke2015Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 22, nr 1, s. 43-53Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: This qualitative, longitudinal, descriptive study aimed to understand the lived experience of enacting agency, and to describe the phenomenon of agency and the meaning structure of the phenomenon during the year after a stroke. Agency is defined as making things happen in everyday life through one's actions. Methods: This study followed six persons (three men and three women, ages 63 to 89), interviewed on four separate occasions. Interview data were analysed using the Empirical Phenomenological Psychological method. Results: The main findings showed that the participants experienced enacting agency in their everyday lives after stroke as negotiating different characteristics over a span of time, a range of difficulty, and in a number of activities, making these negotiations complex. The four characteristics described how the participants made things happen in their everyday lives through managing their disrupted bodies, taking into account their past and envisioning their futures, dealing with the world outside themselves, and negotiating through internal dialogues. Conclusions: This empirical evidence regarding negotiations challenges traditional definitions of agency and a new definition of agency is proposed. Understanding clients' complex negotiations and offering innovative solutions to train in real-life situations may help in the process of enabling occupations after a stroke.

  • 5.
    Bergström, Aileen L.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Forskning om funktionshinder och habilitering.
    Asaba, Eric
    Erikson, Anette
    Tham, Kerstin
    Complex negotiations: The lived experience of enacting agency after a stroke2015Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 22, nr 1, s. 43-53Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: This qualitative, longitudinal, descriptive study aimed to understand the lived experience of enacting agency, and to describe the phenomenon of agency and the meaning structure of the phenomenon during the year after a stroke. Agency is defined as making things happen in everyday life through one's actions. Methods: This study followed six persons (three men and three women, ages 63 to 89), interviewed on four separate occasions. Interview data were analysed using the Empirical Phenomenological Psychological method. Results: The main findings showed that the participants experienced enacting agency in their everyday lives after stroke as negotiating different characteristics over a span of time, a range of difficulty, and in a number of activities, making these negotiations complex. The four characteristics described how the participants made things happen in their everyday lives through managing their disrupted bodies, taking into account their past and envisioning their futures, dealing with the world outside themselves, and negotiating through internal dialogues. Conclusions: This empirical evidence regarding negotiations challenges traditional definitions of agency and a new definition of agency is proposed. Understanding clients' complex negotiations and offering innovative solutions to train in real-life situations may help in the process of enabling occupations after a stroke.

  • 6. Bergström, Aileen L.
    et al.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    von Koch, Lena
    Tham, Kerstin
    Combined life satisfaction of persons with stroke and their caregivers: associations with caregiver burden and the impact of stroke2011Ingår i: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 9, s. 1-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Little is known about the life satisfaction of the person with stroke combined with their caregiver, i.e. the dyad, despite the fact that life satisfaction is an important rehabilitation outcome. The aim of this study was to describe the dyads combined life satisfaction and to understand this in relationship to the perceived impact of stroke in everyday life and caregiver burden. Methods: In this cross-sectional study, the life satisfaction of persons and their informal caregivers was measured in 81 dyads one year post stroke. Their global life satisfaction, measured with LiSat-11, was combined to a dyad score and the dyads were then categorized as satisfied, dissatisfied or discordant. The groups were compared and analyzed regarding levels of caregiver burden, measured with the Caregiver Burden scale, and the perceived impact of stroke in everyday life, measured with the Stroke Impact Scale (SIS). Results: The satisfied dyads comprised 40%, dissatisfied 26% and those that were discordant 34%. The satisfied dyads reported a significantly lower impact of the stroke in everyday life compared with the dyads that were not satisfied. As expected, dyads that were not satisfied reported a significantly greater caregiver burden compared with the satisfied dyads. The discordant group was further broken down into a group of dissatisfied and satisfied caregivers. The caregivers that were not satisfied in the discordant group perceived a significantly greater level of caregiver burden compared with the satisfied group. Even caregivers who were satisfied with life but whose care recipients were not satisfied reported caregiver burden. Conclusions: Measuring combined life satisfaction provides a unique focus and appears to be a feasible way of attaining the dyads' perspective. The findings suggest that those dyads with a discordant life satisfaction could be vulnerable because of the caregivers' reported caregiver burden. These findings support the importance of a dyadic perspective and add to the understanding of the reciprocal influences between the caregiver and recipient. This knowledge has clinical implications and contributes to the identification of possible vulnerable dyads in need of tailored support.

  • 7. Bergström, Aileen L.
    et al.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    von Koch, Lena
    Tham, Kerstin
    Combined life satisfaction of persons with stroke and their caregivers: associations with caregiver burden and the impact of stroke2011Ingår i: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 9, s. 1-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Little is known about the life satisfaction of the person with stroke combined with their caregiver, i.e. the dyad, despite the fact that life satisfaction is an important rehabilitation outcome. The aim of this study was to describe the dyads combined life satisfaction and to understand this in relationship to the perceived impact of stroke in everyday life and caregiver burden. Methods: In this cross-sectional study, the life satisfaction of persons and their informal caregivers was measured in 81 dyads one year post stroke. Their global life satisfaction, measured with LiSat-11, was combined to a dyad score and the dyads were then categorized as satisfied, dissatisfied or discordant. The groups were compared and analyzed regarding levels of caregiver burden, measured with the Caregiver Burden scale, and the perceived impact of stroke in everyday life, measured with the Stroke Impact Scale (SIS). Results: The satisfied dyads comprised 40%, dissatisfied 26% and those that were discordant 34%. The satisfied dyads reported a significantly lower impact of the stroke in everyday life compared with the dyads that were not satisfied. As expected, dyads that were not satisfied reported a significantly greater caregiver burden compared with the satisfied dyads. The discordant group was further broken down into a group of dissatisfied and satisfied caregivers. The caregivers that were not satisfied in the discordant group perceived a significantly greater level of caregiver burden compared with the satisfied group. Even caregivers who were satisfied with life but whose care recipients were not satisfied reported caregiver burden. Conclusions: Measuring combined life satisfaction provides a unique focus and appears to be a feasible way of attaining the dyads' perspective. The findings suggest that those dyads with a discordant life satisfaction could be vulnerable because of the caregivers' reported caregiver burden. These findings support the importance of a dyadic perspective and add to the understanding of the reciprocal influences between the caregiver and recipient. This knowledge has clinical implications and contributes to the identification of possible vulnerable dyads in need of tailored support.

  • 8.
    Bergström, Aileen L.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    von Koch, Lena
    Andersson, Magnus
    Tham, Kerstin
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    Participation in everyday life and life satisfaction in persons with stroke and their caregivers 3–6 months after onset2015Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, nr 6, s. 508-515Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To explore and describe persons with stroke and their caregivers' restrictions in participation in everyday occupations, i.e. occupational gaps, 3-6 months post-stroke, in relation to life satisfaction, combined life satisfaction, caregiver burden, perceived impact of stroke, and activities of daily living. Design: Cross-sectional study. Subjects: Persons with stroke and their caregivers (105 dyads). Methods: The Occupational Gaps Questionnaire, Life Satisfaction Checklist, Caregiver Burden Scale, Stroke Impact Scale and Barthel Index were used. Correlations were analysed with Spearman's rank, and regression analyses used life satisfaction as the dependent variable. Results: At least one person in 86% of the dyads perceived restrictions in participation, with the most common gap in travelling for pleasure. Correlations were low between the numbers of occupational gaps and life satisfaction (R=-0.33, R=-0.31); however, life satisfaction accounted for occupational gaps both for persons with stroke and for caregivers. A greater number of occupational gaps were perceived in the dyads with combined low levels of life satisfaction compared with those with combined high levels of life satisfaction. Conclusion: Participation in everyday occupations is related to life satisfaction even for caregivers of persons with stroke. The results of this study add to our knowledge about the stroke-caregiver dyad and will help to inform family-centred approaches within stroke rehabilitation.

  • 9.
    Bergström, Aileen L.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    von Koch, Lena
    Andersson, Magnus
    Tham, Kerstin
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    Participation in everyday life and life satisfaction in persons with stroke and their caregivers 3–6 months after onset2015Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, nr 6, s. 508-515Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To explore and describe persons with stroke and their caregivers' restrictions in participation in everyday occupations, i.e. occupational gaps, 3-6 months post-stroke, in relation to life satisfaction, combined life satisfaction, caregiver burden, perceived impact of stroke, and activities of daily living. Design: Cross-sectional study. Subjects: Persons with stroke and their caregivers (105 dyads). Methods: The Occupational Gaps Questionnaire, Life Satisfaction Checklist, Caregiver Burden Scale, Stroke Impact Scale and Barthel Index were used. Correlations were analysed with Spearman's rank, and regression analyses used life satisfaction as the dependent variable. Results: At least one person in 86% of the dyads perceived restrictions in participation, with the most common gap in travelling for pleasure. Correlations were low between the numbers of occupational gaps and life satisfaction (R=-0.33, R=-0.31); however, life satisfaction accounted for occupational gaps both for persons with stroke and for caregivers. A greater number of occupational gaps were perceived in the dyads with combined low levels of life satisfaction compared with those with combined high levels of life satisfaction. Conclusion: Participation in everyday occupations is related to life satisfaction even for caregivers of persons with stroke. The results of this study add to our knowledge about the stroke-caregiver dyad and will help to inform family-centred approaches within stroke rehabilitation.

  • 10.
    Bertilsson, Ann-Sofie
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Ekstam, Lisa
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Lund Univ, Dept Hlth Sci, Lund, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden .
    Tham, Kerstin
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden.
    Andersson, Magnus
    Karolinska Inst, Dept Clin Neurosci, Solna, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    von Koch, Lena
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    Johansson, Ulla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    A cluster randomized controlled trial of a client-centred, activities of daily living intervention for people with stroke: One year follow-up of caregivers2016Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, nr 8, s. 765-775Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Compare caregiver burden, provision of informal care, participation in everyday occupationsand life satisfaction of caregivers to people with stroke, who either had received a client-centred, activitiesof daily living intervention or usual activities of daily living interventions.

    Design: A multicentre cluster randomized controlled trial in which 16 rehabilitation units were randomlyassigned to deliver a client-centred, activities of daily living intervention or usual activities of daily livinginterventions. Caregiver outcomes were compared cross-sectionally at 12 months and changes inoutcomes between three and 12 months after people with stroke were included in the study.

    Setting: Inpatient and outpatient rehabilitation.

    Participants: Caregivers of people with stroke enrolled in the trial.

    Intervention: A client-centred, activities of daily living intervention aiming to increase agency in dailyactivities and participation in everyday life for people after stroke.

    Main measures: Caregiver Burden Scale, Occupational Gaps Questionnaire, LiSat-11.

    Results: There were no differences in outcomes between caregivers in the client-centred, activities ofdaily living (n = 88) and the usual activities of daily living (n = 95) group at 12 months. The caregiver burdenscore was 42.7 vs. 41.8, p = 0.75, mean occupational gaps were 3.5 vs. 4.0, p = 0.52 and satisfaction with lifewas 53% vs. 50%, p = 0.87. There were no differences in changes between three and 12 months. However,within groups there were significant differences in caregiver burden, factor general strain, for caregivers inthe client-centred, activities of daily living group, and in provision of informal care for the usual activitiesof daily living group.

    Conclusion: The client-centred intervention did not bring about any difference between caregivergroups,but within groups some difference was found for caregiver burden and informal care.

  • 11.
    Bertilsson, Ann-Sofie
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Ekstam, Lisa
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Lund Univ, Dept Hlth Sci, Lund, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden .
    Tham, Kerstin
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden.
    Andersson, Magnus
    Karolinska Inst, Dept Clin Neurosci, Solna, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    von Koch, Lena
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    Johansson, Ulla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    A cluster randomized controlled trial of a client-centred, activities of daily living intervention for people with stroke: One year follow-up of caregivers2016Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, nr 8, s. 765-775Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Compare caregiver burden, provision of informal care, participation in everyday occupationsand life satisfaction of caregivers to people with stroke, who either had received a client-centred, activitiesof daily living intervention or usual activities of daily living interventions.

    Design: A multicentre cluster randomized controlled trial in which 16 rehabilitation units were randomlyassigned to deliver a client-centred, activities of daily living intervention or usual activities of daily livinginterventions. Caregiver outcomes were compared cross-sectionally at 12 months and changes inoutcomes between three and 12 months after people with stroke were included in the study.

    Setting: Inpatient and outpatient rehabilitation.

    Participants: Caregivers of people with stroke enrolled in the trial.

    Intervention: A client-centred, activities of daily living intervention aiming to increase agency in dailyactivities and participation in everyday life for people after stroke.

    Main measures: Caregiver Burden Scale, Occupational Gaps Questionnaire, LiSat-11.

    Results: There were no differences in outcomes between caregivers in the client-centred, activities ofdaily living (n = 88) and the usual activities of daily living (n = 95) group at 12 months. The caregiver burdenscore was 42.7 vs. 41.8, p = 0.75, mean occupational gaps were 3.5 vs. 4.0, p = 0.52 and satisfaction with lifewas 53% vs. 50%, p = 0.87. There were no differences in changes between three and 12 months. However,within groups there were significant differences in caregiver burden, factor general strain, for caregivers inthe client-centred, activities of daily living group, and in provision of informal care for the usual activitiesof daily living group.

    Conclusion: The client-centred intervention did not bring about any difference between caregivergroups,but within groups some difference was found for caregiver burden and informal care.

  • 12. Bertilsson, Ann-Sofie
    et al.
    Ranner, Maria
    von Koch, Lena
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Forskning om funktionshinder och habilitering.
    Johansson, Ulla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Ytterberg, Charlotte
    Guidetti, Susanne
    Tham, Kerstin
    A client-centred ADL intervention: three-month follow-up of a randomized controlled trial2014Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, nr 5, s. 377-391Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim was to study a client-centred activities of daily living (ADL) intervention (CADL) compared with the usual ADL intervention (UADL) in people with stroke regarding: independence in ADL, perceived participation, life satisfaction, use of home-help service, and satisfaction with training and, in their significant others, regarding: caregiver burden, life satisfaction, and informal care. Methods: In this multicentre study, 16 rehabilitation units were randomly assigned to deliver CADL or UADL. The occupational therapists who provided the CADL were specifically trained. Eligible for inclusion were people with stroke treated in a stroke unit 3 months after stroke, dependent in two ADL, not diagnosed with dementia, and able to understand instructions. Data were collected at inclusion and three months thereafter. To detect a significant difference between the groups in the Stroke Impact Scale (SIS) domain "participation", 280 participants were required. Intention-to-treat analysis was applied. Results: At three months, there was no difference in the outcomes between the CADL group (n = 129) and the UADL group (n = 151), or their significant others (n = 87/n = 93) except in the SIS domain "emotion" in favour of CADL (p = 0.04). Conclusion: The CADL does not appear to bring about short-term differences in outcomes and longer follow-ups are required.

  • 13. Bertilsson, Ann-Sofie
    et al.
    Ranner, Maria
    von Koch, Lena
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Forskning om funktionshinder och habilitering.
    Johansson, Ulla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Ytterberg, Charlotte
    Guidetti, Susanne
    Tham, Kerstin
    A client-centred ADL intervention: three-month follow-up of a randomized controlled trial2014Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, nr 5, s. 377-391Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim was to study a client-centred activities of daily living (ADL) intervention (CADL) compared with the usual ADL intervention (UADL) in people with stroke regarding: independence in ADL, perceived participation, life satisfaction, use of home-help service, and satisfaction with training and, in their significant others, regarding: caregiver burden, life satisfaction, and informal care. Methods: In this multicentre study, 16 rehabilitation units were randomly assigned to deliver CADL or UADL. The occupational therapists who provided the CADL were specifically trained. Eligible for inclusion were people with stroke treated in a stroke unit 3 months after stroke, dependent in two ADL, not diagnosed with dementia, and able to understand instructions. Data were collected at inclusion and three months thereafter. To detect a significant difference between the groups in the Stroke Impact Scale (SIS) domain "participation", 280 participants were required. Intention-to-treat analysis was applied. Results: At three months, there was no difference in the outcomes between the CADL group (n = 129) and the UADL group (n = 151), or their significant others (n = 87/n = 93) except in the SIS domain "emotion" in favour of CADL (p = 0.04). Conclusion: The CADL does not appear to bring about short-term differences in outcomes and longer follow-ups are required.

  • 14. Bertilsson, Ann-Sofie
    et al.
    Ranner, Maria
    von Koch, Lena
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Forskning om funktionshinder och habilitering.
    Johansson, Ulla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Ytterberg, Charlotte
    Guidetti, Susanne
    Tham, Kerstin
    A client-centred ADL intervention: three-month follow-up of a randomized controlled trial2014Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, nr 5, s. 377-391Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim was to study a client-centred activities of daily living (ADL) intervention (CADL) compared with the usual ADL intervention (UADL) in people with stroke regarding: independence in ADL, perceived participation, life satisfaction, use of home-help service, and satisfaction with training and, in their significant others, regarding: caregiver burden, life satisfaction, and informal care. Methods: In this multicentre study, 16 rehabilitation units were randomly assigned to deliver CADL or UADL. The occupational therapists who provided the CADL were specifically trained. Eligible for inclusion were people with stroke treated in a stroke unit 3 months after stroke, dependent in two ADL, not diagnosed with dementia, and able to understand instructions. Data were collected at inclusion and three months thereafter. To detect a significant difference between the groups in the Stroke Impact Scale (SIS) domain "participation", 280 participants were required. Intention-to-treat analysis was applied. Results: At three months, there was no difference in the outcomes between the CADL group (n = 129) and the UADL group (n = 151), or their significant others (n = 87/n = 93) except in the SIS domain "emotion" in favour of CADL (p = 0.04). Conclusion: The CADL does not appear to bring about short-term differences in outcomes and longer follow-ups are required.

  • 15.
    Ehrenfors, Rita
    et al.
    Karolinska Univ, Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    Seiger, Åke
    Karolinska Univ, Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Assessing self-perceived cognitive functioning in everyday life after ABI prior goal-setting in rehabilitation2016Ingår i: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 30, nr 5-6, s. 806-807Artikel i tidskrift (Övrigt vetenskapligt)
  • 16.
    Ehrenfors, Rita
    et al.
    Karolinska Univ, Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    Seiger, Åke
    Karolinska Univ, Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Assessing self-perceived cognitive functioning in everyday life after ABI prior goal-setting in rehabilitation2016Ingår i: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 30, nr 5-6, s. 806-807Artikel i tidskrift (Övrigt vetenskapligt)
  • 17.
    Eriksson, G
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Eriksson, L
    Ottander, A
    Bexell-Brantefors, K
    Lindgren, F
    Moren, L
    I. Situationen för personer med förvärvad hjärnskada. En undersökning om situationen för hjärnskadade personer och deras närstående i Uppsala län (I-III)2000Övrigt (Övrigt vetenskapligt)
  • 18.
    Eriksson, Gunilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Forskning om funktionshinder och habilitering.
    Aasnes, Monica
    Tistad, Malin
    Guidetti, Susanne
    von Koch, Lena
    Occupational Gaps in Everyday Life One Year After Stroke and the Association With Life Satisfaction and Impact of Stroke2012Ingår i: Topics in Stroke Rehabilitation, ISSN 1074-9357, E-ISSN 1945-5119, Vol. 19, nr 3, s. 244-255Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To examine the presence, frequency, and distribution of occupational gaps and to explore whether there are associations between occupational gaps and life satisfaction, self-rated recovery, and functioning and participation in activities of daily living (ADLs) 1 year after stroke.

    Method: Data were collected at onset and at 12 months after stroke from 161 patients admitted to a stroke unit in central Sweden by using Occupational Gaps Questionnaire, LiSat-11, Stroke Impact Scale, Katz ADL Index, and Barthel Index. Spearman rank correlation and Mann Whitney U test were used in the analyses.

    Results: Occupational gaps were reported by 87% of the participants. The number of occupational gaps was moderately associated with participation and self-rated recovery. There was a significant difference in the number of occupational gaps between the participants who were independent in ADLs and those who were not, both at baseline and at 12 months after stroke. There was, however, no significant association between occupational gaps and life satisfaction.

    Conclusions: Occupational gaps 1 year after stroke are very common, particularly among individuals experiencing difficulties in ADLs. Increased efforts are vital to enable individuals to do the activities that are important to them, irrespective of whether these are instrumental ADLs or leisure or social activities. Occupational gaps could be reduced by developing rehabilitation interventions that enable desired activities in different contexts that are crucial for individual patients.

  • 19.
    Eriksson, Gunilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    Baum, Caroline
    Washington University, St Louis, USA.
    Wolf, Timothy
    Washington University, St Louis, USA.
    Connor, Lisa Tabor
    Washington University, St Louis, USA.
    Perceived Participation After Stroke: The Influenceof Activity Retention, Reintegration, andPerceived Recovery2013Ingår i: American Journal of Occupational Therapy, ISSN 1943-7676, Vol. 67, nr 6, s. e131-e138Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE

    We sought to determine the extent to which perceptions of participation in everyday occupationswere affected in a sample of people with predominantly mild stroke. Demographic variables, strokeseverity, community integration, participation in everyday occupations, and perceptions of recovery wereexamined as potential contributors to their perceptions of participation.

    METHOD

    We conducted a cross-sectional study with 116 people with mild to moderate first strokeassessed approximately 6 mo after stroke.

    RESULTS

    Perceptions of participation assessed using the Stroke Impact Scale varied (range 5 19–100),with a mean score of 82. Regression analyses revealed three factors that contributed to perceptions ofparticipation: retention of previous activities, reintegration in home and community, and perception ofstroke recovery.

    CONCLUSION

    Although the majority of participants reported a high level of perceived participation, morethan a third failed to report successful participation.

  • 20.
    Eriksson, Gunilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Eriksson, L
    Organisation - rehabilitering, stöd och service till personer med förvärvad hjärnskada.2001Ingår i: Svensk Rehabilitering, Vol. 3, s. 47-Artikel i tidskrift (Övrigt vetenskapligt)
  • 21.
    Eriksson, Gunilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Eriksson, Lars
    Patienter och anhörigaefter förvärvad hjärnskada2001Ingår i: Svensk Rehabilitering, s. 43-Artikel i tidskrift (Övrigt vetenskapligt)
  • 22.
    Eriksson, Gunilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Eriksson, Lars
    Ottander, Anneli
    Bexell-Brantefors, Karin
    Lindgren, Frances
    Morén, Lars
    Organisation av omhändertagande, rehabilitering, stöd och service till personer med förvärvad hjärnskada.En undersökning om situationen för hjärnskadade personer och deras närstående i Uppsala län (I-III) rapport nr 32000Övrigt (Övrigt vetenskapligt)
  • 23.
    Eriksson, Gunilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Eriksson, Lars
    Ottander, Anneli
    Bexell-Brantefors, Karin
    Lindgren, Frances
    Morén, Lars
    Situationen för närstående till personer med förvärvad hjärnskada.En undersökning om situationen för hjärnskadade personer och deras närstående i Uppsala län (I-III) rapport nr 22000Övrigt (Övrigt vetenskapligt)
  • 24.
    Eriksson, Gunilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Hellman, Therese
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Nilsson, A. O.
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Johansson, Ulla
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Ekbladh, E.
    Linkoping Univ, Dept Social & Welf Studies, Linkoping, Sweden.
    Bernspang, B.
    Umea Univ, Dept Community Med & Rehabil, Umea, Sweden.
    The return to work process after stroke changes over time while participating in a newly designed person-centred rehabilitation programme2018Ingår i: International Journal of Stroke, ISSN 1747-4930, E-ISSN 1747-4949, Vol. 13, s. 31-31Artikel i tidskrift (Övrigt vetenskapligt)
  • 25.
    Eriksson, Gunilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    Kottorp, Anders
    Borg, Jörgen
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    Tham, Kerstin
    Relationship between occupational gaps in everyday life, depressive mood and life satisfaction after acquired brain injury2009Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, nr 3, s. 187-194Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To explore the relationship between occupational gaps, depressive mood and life satisfaction in persons who have acquired a brain injury during the past 1-4 years and to test the Occupational Gaps Questionnaire. Design: A cross-sectional study. Subjects: A total of 116 persons with traumatic brain injury or subarachnoid haemorrhage acquired 1-4 years previously. Methods: A postal survey with questions on occupational gaps, focusing on the domains instrumental activities of daily living, social life, leisure and work (Occupational Gaps Questionnaire), life satisfaction (LiSat-11 checklist) and depressive mood (Hospital Anxiety and Depression Scale). Rasch analyses and principal component analyses were performed to ensure that data from the LiSat-11 and Occupational Gaps Questionnaire could be used subsequently as valid unidimensional measures in regression and correlational analyses. Results: Calibration of the Occupational Gaps Questionnaire and the LiSat-11 revealed that the items and persons demonstrated acceptable goodness-of-fit to the Rasch models respectively, supporting internal scale validity and person-response validity. In addition, principal component analyses revealed that the measures could be used as valid uni-dimensional estimations of occupational gaps and life satisfaction. There was a strong relationship between the extent of occupational gaps and perceived life satisfaction, a weaker relationship with depressive mood and a non-significant relationship with the aetiological diagnoses and life satisfaction. The factors explained 32% (occupational gaps), 6% (depressive mood), and 2% (diagnosis), respectively, of the total explained variance (40%). Conclusion: There was a strong correlation between participation in desired everyday occupations and life satisfaction 1-4 years after an acquired brain injury. This indicates that individually perceived occupational gaps, as recorded by the for tailored interventions in order to improve life satisfaction among clients with acquired brain injuries.

  • 26.
    Eriksson, Gunilla M.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    Chung, Jenny C. C.
    Beng, Lim Hua
    Hartman-Maeir, Adina
    Yoo, Eunyoung
    Orellano, Elsa M.
    van Nes, Fenna
    de Jonge, Desleigh
    Baum, Carolyn M.
    Occupations of Older Adults: A Cross Cultural Description2011Ingår i: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 31, nr 4, s. 182-192Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Participation in everyday occupations influences people's health and well-being. To enable individuals to do the activities they want and need to do is the main concern of occupational therapy practice. Many daily occupations are universal, but they also depend on culture. The development of the Activity Card Sort in eight countries has offered the opportunity to describe occupations across cultures. In the developmental process of culturally relevant versions of the Activity Card Sort by occupational therapists in each country, the instrument versions included samples of older adults (N = 468). These data are used in the current description with the aim of identifying central activities across cultures and central activities for Asian and Western cultures. Ten activities were identified as being central across cultures (i.e., more than half of the older adults in all eight countries performed them). They were the following: shopping in a store, doing grocery shopping, doing dishes, doing laundry, reading books or magazines, sitting and thinking, watching television, listening to radio or music, visiting with friends and relatives, and talking on the telephone. Further, 16 additional activities central to Asian culture and 18 activities central to Western culture were identified. The identification of central activities deepens knowledge of activities with cultural significance. This knowledge is needed in clinical practice and multicultural research. This description provides a starting point for further exploration of everyday occupations among older adults.

  • 27.
    Eriksson, Gunilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    Tham, Kerstin
    The Meaning of Occupational Gaps in Everyday Life in the First Year After Stroke2010Ingår i: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 30, nr 4, s. 184-192Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This longitudinal study identified how occupational gaps were characterized in people's lived experiences of performing everyday occupations during the first year after stroke. Four participants were interviewed four times during the year after stroke. The data were collected and analyzed using the Empirical, Phenomenological, Psychological method. Five main characteristics were identified: (1) encountering occupational gaps in formerly taken-for-granted activities, (2) striving to narrow gaps in desired occupations, (3) recognizing oneself in doing, (4) searching for a new sense of self through doing, and (5) creating strategies to enable doing. The findings show the importance of being able to preserve some sense of self in everyday doings after a life course disruption caused by stroke. Important implications for clinical practice include sensitivity to clients' experiences during this process, enablement of experiences in occupations promoting recognition, and support of clients in recapturing desired occupations.

  • 28.
    Eriksson, Gunilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    Tham, Kerstin
    Borg, Jörgen
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    Occupational gaps in everyday life 1-4 years after aquired brain injury2006Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 38, nr 3, s. 159-65Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To explore adaptation, by examining the occupational gaps occurring between what individuals want to do and what they actually do in terms of their everyday activities before and after brain injury. In addition, the relationships between occupational gaps and impairment/activity limitations and the time lapse since the brain injury were explored. Design: A cross-sectional study. Subjects: A total of 187 persons, affected by traumatic brain injury or subarachnoid haemorrhage 1–4 years previously. Methods: A postal questionnaire encompassing questions concerning gaps in the performance of activities in everyday life before and after the brain injury and perceived impairment/activity limitations. Results: The numbers of occupational gaps increased after the injury, with the number of gaps having increased from 46% to 71%. The number of occupational gaps was significantly related to executive impairment/activity limitations, and motor impairment/activity limitations and other somatic impairments, such as headache, also had an impact. The time lapse since the brain injury had no significant effect on the number of occupational gaps. Conclusion: The results suggests that there is a need for adaptation in everyday activities, even several years after a brain injury, which indicates that follow-up and access to individualized rehabilitation interventions in the long-term are required.

  • 29.
    Eriksson, Gunilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap. rehabiliteringsmedicin.
    Tham, Kerstin
    Fugl-Meyer, Axel R
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap. Rehabiliteringsmedicin.
    Couples' happiness and its relationship to functioning in everyday life after brain injury2005Ingår i: Scandinavian Journal of Occupational Therapy, Vol. 12, s. 40-48Artikel i tidskrift (Refereegranskat)
  • 30.
    Eriksson, Gunilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Forskning om funktionshinder och habilitering.
    Tham, Kerstin
    Kottorp, Anders
    A cross-diagnostic validation of an instrument measuring participation in everyday occupations: The Occupational Gaps Questionnaire (OGQ)2013Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, nr 2, s. 152-160Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to validate the Occupational Gaps Questionnaire (OGQ) when used in samples of people with acquired brain injuries (ABI), stroke, stress-related disorders, concussion, and persons receiving rehabilitation after ABI to investigate whether the OGQ could be used as a generic scale. A total of 601 individuals answered the OGQ at various time points after illness/injury. A Rasch analysis was performed on the data to evaluate evidence of internal scale validity and person response validity, and the capability of the OGQ to separate people into different levels of participation in everyday occupations. The results provided evidence that the OGQ is a valid measure across different diagnostic groups. A generic version of the OGQ can separate at least two levels of perceived occupational gaps and is therefore recommended as a screening tool to be used by occupational therapists working with different diagnostic groups.

  • 31.
    Eriksson, Gunilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.
    Öst Nilsson, Annika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden;Uppsala Univ Reg Gavleborg, Ctr Res & Dev, Gavle, Sweden.
    Asaba, E.
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.
    Johansson, Ulla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.
    Hellman, Therese
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Being a co-worker or a manager of a colleague returning to work after stroke: a challenge facilitated by cooperation and flexibility2018Ingår i: International Journal of Stroke, ISSN 1747-4930, E-ISSN 1747-4949, Vol. 13, s. 31-31Artikel i tidskrift (Övrigt vetenskapligt)
  • 32. Eriksson, Therese
    et al.
    Jonsson, Hans
    Tham, Kerstin
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    A comparison of perceived occupational gaps between people with stress-related ill health or musculoskeletal pain and a reference group2012Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 19, nr 5, s. 411-420Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To describe and compare how occupational gaps were reported in everyday occupations in a rehabilitation group of people with musculoskeletal pain or stress-related ill health and in a reference group from the Swedish population.

    Method: Seventy-two persons with musculoskeletal pain or stress-related ill health and 261 people from the Swedish population were included. The Occupational Gaps Questionnaire, measuring to what extent individuals perceive a discrepancy between what they want to do and what they actually do, was completed by the participants. Descriptive statistics were used to analyse the data.

    Results: Occupational gaps were reported more often in the rehabilitation group. Leisure activities were the gaps reported most often. The occupational repertoire seemed to decrease over time as the number of activities was decreasing, particularly leisure and work-related activities. Instrumental ADL were more desirable as the length of sick leave extended.

    Conclusions: Being on sick leave appears to start a process towards occupational deprivation where the areas that remain in the occupational repertoire become more important. Our study highlights the need to emphasize the whole occupational repertoire in rehabilitation and to facilitate engagement in valued activities to create a sound base for the process of returning to work.

  • 33.
    Fors, Uno
    et al.
    Stockholm Univ, Dept Comp & Syst Sci DSV, Stockholm, Sweden.
    Kamwesiga, Julius T.
    Uganda Allied Hlth Examinat Board, Kampala, Uganda;Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Forskning om funktionshinder och habilitering. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    von Koch, Lena
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden;Karolinska Univ Hosp, Theme Neuro, Stockholm, Sweden.
    Guidetti, Susanne
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    User evaluation of a novel SMS-based reminder system for supporting post-stroke rehabilitation2019Ingår i: BMC Medical Informatics and Decision Making, ISSN 1472-6947, E-ISSN 1472-6947, Vol. 19, artikel-id 122Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: According to WHO stroke is a growing societal challenge and the third leading cause of global disease-burden estimated using disability-adjusted life years. Rehabilitation after stroke is an area of mutual interest for health care in many countries. Within the health care sector there is a growing emphasis on ICT services to provide clients with easier access to information, self-evaluation, and self-management. ICT-supported care programs possible to use in clients' home environments are also recommended when there are long distances to the health care specialists. The aim of this study was to evaluate the technical usability of a SMS-based reminder system as well as user opinions when using such a system to assist clients to remember to perform daily rehabilitation activities, to rate their performance and to allow Occupational therapists (OT's) to track and follow-up clients' results over time.

    Methods: Fifteen persons with stroke were invited to participate in the study and volunteered to receive daily SMS-based reminders regarding three activities to perform on a daily basis as well as answer daily SMS-based questions about their success rate during eight weeks. Clients, a number of family members, as well as OTs were interviewed to evaluate their opinions of using the reminder system.

    Results: All clients were positive to the reminder system and felt that it helped them to regain their abilities. Their OTs agreed that the reminder and follow-up system was of benefit in the rehabilitation process. However, some technical and other issues were limiting the use of the system for some clients. The issues were mostly linked to the fact that the SMS system was based on a Swedish phone number, so that all messages needed to be sent internationally.

    Conclusion: In conclusion, it seems that this type of SMS-based reminder systems could be of good use in the rehabilitation process after stroke, even in low income counties where few clients have access to Internet or smart phones, and where access to healthcare services is limited. However, since the results are based on clients', OTs' and family members' expressed beliefs, we suggest that future research objectively investigate the intervention's beneficial effects on the clients' physical and cognitive health.

  • 34. Guidetti, Susanne
    et al.
    Ytterberg, Charlotte
    Ekstam, Lisa
    Johansson, Ulla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Forskning om funktionshinder och habilitering.
    Changes in the impact of stroke between 3 and 12 months post-stroke, assessed with the Stroke Impact Scale2014Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, nr 10, s. 963-968Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To examine data collected using the Stroke Impact Scale 3.0 (SIS) at 3 and 12 months post-stroke, and to explore any clinically meaningful changes in everyday life in relation to age, gender and stroke severity. Design: Prospective longitudinal study. Methods: A total of 204 persons were assessed using the SIS at 3 and 12 months after onset of stroke. Changes in domain scores were calculated over time and in relation to age, gender and stroke severity. Results: The Strength, Hand Function and Participation domains had the highest perceived impact at 3 and 12 months, indicating problems in everyday life. Stroke recovery was perceived to be significantly higher at 12 than at 3 months irrespective of stroke severity, age or gender. The impact on the Strength and Emotion domains was significantly lower at 12 months than at 3 months. Most clinically meaningful changes, both positive and negative ( 15 points), were seen in the Participation domain and in Stroke recovery. Few changes were associated with age, gender or stroke severity. Conclusion: Both positive and negative clinically meaningful changes related to impact of stroke were found between 3 and 12 months post-stroke. Therefore it is important to pay close attention to patients' perceptions of their everyday life situation during rehabilitation and at discharge.

  • 35. Guidetti, Susanne
    et al.
    Ytterberg, Charlotte
    Ekstam, Lisa
    Johansson, Ulla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Forskning om funktionshinder och habilitering.
    Changes in the impact of stroke between 3 and 12 months post-stroke, assessed with the Stroke Impact Scale2014Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, nr 10, s. 963-968Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To examine data collected using the Stroke Impact Scale 3.0 (SIS) at 3 and 12 months post-stroke, and to explore any clinically meaningful changes in everyday life in relation to age, gender and stroke severity. Design: Prospective longitudinal study. Methods: A total of 204 persons were assessed using the SIS at 3 and 12 months after onset of stroke. Changes in domain scores were calculated over time and in relation to age, gender and stroke severity. Results: The Strength, Hand Function and Participation domains had the highest perceived impact at 3 and 12 months, indicating problems in everyday life. Stroke recovery was perceived to be significantly higher at 12 than at 3 months irrespective of stroke severity, age or gender. The impact on the Strength and Emotion domains was significantly lower at 12 months than at 3 months. Most clinically meaningful changes, both positive and negative ( 15 points), were seen in the Participation domain and in Stroke recovery. Few changes were associated with age, gender or stroke severity. Conclusion: Both positive and negative clinically meaningful changes related to impact of stroke were found between 3 and 12 months post-stroke. Therefore it is important to pay close attention to patients' perceptions of their everyday life situation during rehabilitation and at discharge.

  • 36.
    Gustavsson, Martha
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden.
    Guidetti, Susanne
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden.
    von Koch, Lena
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden;Karolinska Univ Hosp, Theme Neuro, Stockholm, Sweden.
    Ytterberg, Charlotte
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Physiotherapy, Huddinge, Sweden;Karolinska Univ Hosp, Funct Area Occupat Therapy & Physiotherapy, Huddinge, Sweden.
    Factors affecting outcome in participation one year after stroke: a secondary analysis of a randomized controlled trial2019Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 51, nr 3, s. 160-166Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective:

    To explore the importance of client characteristics (age, sex, stroke severity and participation before stroke), rehabilitation context (in-patient or client's home) and approach (enhanced client-centeredness or not) on participation in everyday life after stroke.

    Methods:

    A secondary analysis of data on 237 participants from a previous randomized controlled trial evaluating an enhanced client-centred intervention after stroke. Plausible associations between client characteristics, context and rehabilitation approach, and a positive outcome regarding participation were explored. Three different outcome measures for participation were used: Stroke Impact Scale 3.0, domain participation; Frenchay Activities Index; and Occupational Gaps Questionnaire.

    Results:

    For all participants there was a significant association between mild stroke and a positive outcome using the Frenchay Activities Index. Among participants who had not received the enhanced client-centred approach, there was a significant association between mild stroke and a positive outcome using the Stroke Impact Scale. The context of rehabilitation, i.e. receiving home rehabilitation, was also associated with a positive outcome in the Frenchay Activities Index for the control group.

    Conclusion:

    In order to increase participation in everyday life for people after stroke it appears to be important to use an enhanced client-centred approach, particularly when working within in-patient rehabilitation and with people with moderate or severe stroke.

  • 37.
    Hedman, Annicka
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Box 23 200, SE-14183 Huddinge, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Box 23 200, SE-14183 Huddinge, Sweden.
    von Koch, Lena
    Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Box 23 200, SE-14183 Huddinge, Sweden;Karolinska Univ Hosp, Neuro, Stockholm, Sweden.
    Guidetti, Susanne
    Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Box 23 200, SE-14183 Huddinge, Sweden.
    Five-year follow-up of a cluster-randomized controlled trial of a client-centred activities of daily living intervention for people with stroke2019Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 33, nr 2, s. 262-276Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To compare five-year outcomes and changes over time of a client-centred activities of daily living (ADL) intervention versus usual ADL interventions for people with stroke and their significant others.

    Design: Five-year follow-up of a cluster-randomized controlled trial where a client-centred ADL intervention (n = 129) or usual ADL interventions (n = 151) were delivered to people with stroke.

    Setting: Multicentre study including 16 inpatient or home-based rehabilitation units.

    Participants: People with stroke and significant others.

    Intervention: The client-centred ADL intervention aimed at enabling agency in daily activities and participation in everyday life and at reducing caregiver burden.

    Main measures: For people with stroke, perceived participation (Stroke Impact Scale), independence in ADL, life satisfaction, and use of formal/informal care were measured. For significant others, caregiver burden, life satisfaction, and mood (Hospital Anxiety and Depression Scale) were assessed.

    Results: Five years post-intervention, data were collected from 145 people with stroke (intervention group: n = 71/control group: n = 74) and 75 significant others (intervention group: n = 36/control group: n = 39). For those with stroke, the Participation domain of the Stroke Impact Scale showed no group differences at year five (68.9 vs 75.4, P = 0.062) or in changes over time. At year five, the control group had better outcomes regarding Other help/supervision. Significant others in the control group were more likely to show signs of depression at year five (odds ratio = 22.3; P < 0.001).

    Conclusion: The client-centred ADL intervention appears to render similar long-term effects as usual ADL interventions for people with stroke, but for significant others signs of depression might be reduced.

  • 38.
    Hellman, Therese
    et al.
    Karolinska Inst, Inst Environm Med, Unit Intervent & Implementat Res Worker Hlth, Box 210, S-17177 Solna, Sweden..
    Bergström, Aileen
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden..
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden..
    Falkdal, Annie Hansen
    Umea Univ, Dept Community Med & Rehabil, Occupat Therapy, Umea, Sweden..
    Johansson, Ulla
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden.;Reg Gavleborg, Dept Res & Dev, Gavle, Sweden..
    Return to work after stroke: Important aspects shared and contrasted by five stakeholder groups2016Ingår i: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 55, nr 4, s. 901-911Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Poor co-operation between the various stakeholders underscores the need for reviewing important factors that facilitate return to work (RTW) after stroke. OBJECTIVE: To explore and describe important aspects expressed by Swedish stakeholders in the RTW process for persons post stroke and to contrast the stakeholders' aspects exploring different perspectives that may influence optimal RTW. METHODS: Data from seven focus group interviews with the stakeholders were analyzed using qualitative content analysis. RESULTS: Three main categories made up the findings; the prolonged RTW process, the need for extended knowledge, and the assessment of work ability in the RTW process. Despite the stakeholders' agreement on these important aspects, they presented divergent views of the categories, representing their diverse agendas. CONCLUSIONS: A stroke coordinator may remediate the stakeholders' divergent perspectives. The coordinator should be versed in stroke specific knowledge and in a person centered approach to inform the decision process regarding RTW, while finding optimal solutions within regulatory boundary conditions. A coordinator could increase collaboration of the various stakeholders, provide support and coordinate services for the client with stroke and the employer throughout the whole process facilitating RTW after stroke. Future studies are needed to confirm this proposal.

  • 39.
    Hellman, Therese
    et al.
    Karolinska Inst, Inst Environm Med, Unit Intervent & Implementat Res Worker Hlth, Box 210, S-17177 Solna, Sweden..
    Bergström, Aileen
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden..
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden..
    Falkdal, Annie Hansen
    Umea Univ, Dept Community Med & Rehabil, Occupat Therapy, Umea, Sweden..
    Johansson, Ulla
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden.;Reg Gavleborg, Dept Res & Dev, Gavle, Sweden..
    Return to work after stroke: Important aspects shared and contrasted by five stakeholder groups2016Ingår i: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 55, nr 4, s. 901-911Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Poor co-operation between the various stakeholders underscores the need for reviewing important factors that facilitate return to work (RTW) after stroke. OBJECTIVE: To explore and describe important aspects expressed by Swedish stakeholders in the RTW process for persons post stroke and to contrast the stakeholders' aspects exploring different perspectives that may influence optimal RTW. METHODS: Data from seven focus group interviews with the stakeholders were analyzed using qualitative content analysis. RESULTS: Three main categories made up the findings; the prolonged RTW process, the need for extended knowledge, and the assessment of work ability in the RTW process. Despite the stakeholders' agreement on these important aspects, they presented divergent views of the categories, representing their diverse agendas. CONCLUSIONS: A stroke coordinator may remediate the stakeholders' divergent perspectives. The coordinator should be versed in stroke specific knowledge and in a person centered approach to inform the decision process regarding RTW, while finding optimal solutions within regulatory boundary conditions. A coordinator could increase collaboration of the various stakeholders, provide support and coordinate services for the client with stroke and the employer throughout the whole process facilitating RTW after stroke. Future studies are needed to confirm this proposal.

  • 40.
    Holmlund, Lisa
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden;Rehab Stn Stockholm, Spinalis SCI Unit, Stockholm, Sweden.
    Guidetti, Susanne
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden.
    Asaba, Eric
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden;Stockholms Sjukhem Fdn, Res Educ & Dev Unit, Stockholm, Sweden;Tokyo Metropolitan Univ, Grad Sch Human Hlth Sci, Dept Occupat Therapy, Tokyo, Japan.
    Return to work in the context of everyday life 7-11 years after spinal cord injury - a follow-up study2018Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, nr 24, s. 2875-2883Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The aim of this follow-up study was to explore experiences of return to work in the context of everyday life among adults 7-11 years after spinal cord injury (SCI). Methods: This study used in-depth interviews and observations in a qualitative design with eight persons who had previously been interviewed in 2008. A narrative approach was used during data gathering and analysis. Results: Return to work was experienced as something constantly needing to be negotiated in the context of everyday life. Several years after SCI expectations for work and perceptions of possibilities for meaningful work had changed. Five main themes were identified through the analysis, (1) negotiating the possibilities of working, (2) hope for future work tempered with concern, (3) education as a possible path to employment, (4) paths toward return to work in light of unmet support, and (5) unpaid occupations grounded in interest and competence. Conclusions: Persons who have no higher education or lack viable employment to return to after SCI seem to be vulnerable in return to work. Early and timely interventions tailored to the person's interests and competencies, in which the rehabilitation team has a distinct coordinating role, are thus critical in return to work.

  • 41.
    Kamwesiga, Julius T.
    et al.
    Uganda Allied Hlth Examinat Board, Kampala, Uganda;Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat therapy, Stockholm, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat therapy, Stockholm, Sweden.
    Tham, Kerstin
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat therapy, Stockholm, Sweden;Malmo Univ, Malmo, Sweden.
    Fors, Uno
    Stockholm Univ, Dept Comp & Syst Sci DSV, Stockholm, Sweden.
    Ndiwalana, Ali
    Knowledge Consulting Ltd, Kampala, Uganda.
    von Koch, Lena
    Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden;Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat therapy, Stockholm, Sweden.
    Guidetti, Susanne
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat therapy, Stockholm, Sweden.
    A feasibility study of a mobile phone supported family-centred ADL intervention, F@ce (TM), after stroke in Uganda2018Ingår i: Globalization and Health, ISSN 1744-8603, E-ISSN 1744-8603, Vol. 14, artikel-id 82Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: There is a lack of evidence-based health services to reduce the impact of stroke in low-income countries at a personal, family or community level. The aim was to evaluate the feasibility of: i) a mobile phone supported family-centred intervention (F@ce (TM)), and ii) the study design for evaluating the effects of the intervention on the perceived impact of stroke; perceived participation in everyday life; and self-efficacy in everyday activities amongst persons with stroke and their families in Uganda. Methods: The study comprised a pre-post design with an intervention group (IG) receiving the F@ce (TM) and a control group (CG). The inclusion criteria's were: a) confirmed stroke diagnosis, b) access to and ability to use a mobile phone, c) ability to communicate in English and/or Luganda, d) > 18 years, e) residents in Kampala, and f) a Modified Rankin Scale level 2 to 4. The aimof the F@ce (TM) was to increase functioning in daily activities for persons living with the consequences of stroke, and participation in everyday life for persons with stroke and their families. The F@ce (TM) was an eight-week family-centred intervention, which entailed goal setting and problem-solving strategies, daily reminders and self-rated follow-ups of performance by short message service (SMS). Data were collected in the participants' home environment at baseline and after eight weeks. Data on acceptability of the F@ce (TM) and study procedures were collected by log-books and the responses of the SMS follow ups on the server. The primary outcomes were performance and satisfaction of valued daily activities in everyday life using the Canadian Occupational Performance Measure (COPM), self-efficacy in performance of activities in daily life. Results: The IG comprised n = 13 and the CG n = 15. There were differences between the IG and CG in changes between baseline and follow-up in the primary outcomes COPM (performance component) and self-efficacy in favour of F@ce (TM). Overall with minor modifications the intervention and the study design were feasible for all participants involved. Conclusion: The results support the need for further research to rigorously evaluate the effects of F@ceT (TM) since the intervention appears to be feasible for persons with stroke and their family members.

  • 42.
    Kamwesiga, Julius T.
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden;Inst Allied Hlth & Management Sci Mulago, Occupat Therapy Sch, Mulago, Uganda.
    von Kock, Lena K.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden;Karolinska Univ Hosp, Dept Neurol, Solna, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Guidetti, Susanne G. E.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    The impact of stroke on people living in central Uganda: A descriptive study2018Ingår i: African Journal of Disability, ISSN 2226-7220, Vol. 7, artikel-id UNSP a438Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Knowledge about perceived impact of stroke on everyday life as well as rehabilitation needs after stroke in Uganda is necessary to identify and develop rehabilitation interventions. Objectives: To explore and describe clinical characteristics and functioning during the acute or subacute phase and chronic phase, as well as the impact of stroke on everyday life during the chronic phase in stroke survivors in central Uganda. Method: A cross-sectional observational study was conducted on a consecutively included acute or subacute (n = 58) sample and a chronic (n = 62) sample. Face-to-face interviews were conducted to collect demographic information and clinical characteristics. The Scandinavian Stroke Scale (SSS) was used to collect clinical characteristics, assess neurological impairment and define stroke severity. The Barthel Index was used to assess the level of dependence in activities of daily living. In addition, the Stroke Impact Scale (SIS) 3.0 Uganda version was used to assess the impact of stroke in everyday life as perceived by the individuals in the chronic sample receiving rehabilitation. Results: The mean age of the acute/subacute sample was 49 years and 81% had moderate or severe stroke. The mean age of the chronic rehabilitation group was 53 years and 58% had mild stroke. Time since onset in the acute sample was between 2 days and 3 weeks, and time since onset for the chronic sample varied between 3 months and 3 years. Strength, hand function and participation were the most impacted SIS domains in the chronic sample. Conclusion: People with severe and moderate stroke were more likely to be admitted to Mulago Hospital. The mean age in the study sample was lower than that in high-income countries. Further knowledge is needed regarding the impact of stroke to develop guidelines for stroke rehabilitation interventions feasible in the Ugandan healthcare context in both rural and urban areas.

  • 43.
    Matuseviciene, Giedre
    et al.
    Karolininska Institutet.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolininska Institutet.
    Nygen DeBoussard, Catharina
    Karolininska Institutet.
    No effect of an early intervention after mild traumatic brain injury on activity and participation: A randomized controlled trial.2016Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, nr 1, s. 19-26Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To evaluate measures of activity, participation and quality of life 3 months after mild traumatic brain injury and the effect of an early intervention for patients with an estimated high risk for problems after mild traumatic brain injury.

    PATIENTS: Consecutive patients attending the emergency room with mild traumatic brain injury.

    DESIGN: Randomized controlled trial.

    METHODS: Patients reporting < 3 symptoms after 10 days were considered to have a low risk for prolonged problems. Patients with ≥ 3 symptoms (high-risk patients) were randomized to a visit to a physician or treatment-as-usual. Data on self-reported limitations in activity, restrictions in participation, and quality of life were collected for all patients at 3 months.

    RESULTS: At 3 months post-injury, low-risk patients reported good quality of life and significantly fewer problems in everyday life compared with high-risk patients. The intervention had no effect on activity, participation or quality of life.

    CONCLUSION: Patients who report few symptoms early after mild traumatic brain injury are likely to have a good outcome regarding activity and participation. The intervention offered in this study, focusing on reassurance of a good outcome and treatment of comorbidities, had no effect.

  • 44.
    Matuseviciene, Giedre
    et al.
    Karolininska Institutet.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolininska Institutet.
    Nygen DeBoussard, Catharina
    Karolininska Institutet.
    No effect of an early intervention after mild traumatic brain injury on activity and participation: A randomized controlled trial.2016Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, nr 1, s. 19-26Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To evaluate measures of activity, participation and quality of life 3 months after mild traumatic brain injury and the effect of an early intervention for patients with an estimated high risk for problems after mild traumatic brain injury.

    PATIENTS: Consecutive patients attending the emergency room with mild traumatic brain injury.

    DESIGN: Randomized controlled trial.

    METHODS: Patients reporting < 3 symptoms after 10 days were considered to have a low risk for prolonged problems. Patients with ≥ 3 symptoms (high-risk patients) were randomized to a visit to a physician or treatment-as-usual. Data on self-reported limitations in activity, restrictions in participation, and quality of life were collected for all patients at 3 months.

    RESULTS: At 3 months post-injury, low-risk patients reported good quality of life and significantly fewer problems in everyday life compared with high-risk patients. The intervention had no effect on activity, participation or quality of life.

    CONCLUSION: Patients who report few symptoms early after mild traumatic brain injury are likely to have a good outcome regarding activity and participation. The intervention offered in this study, focusing on reassurance of a good outcome and treatment of comorbidities, had no effect.

  • 45.
    Nilsson, Annika Öst
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, S-14183 Huddinge, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, S-14183 Huddinge, Sweden.
    Johansson, Ulla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, S-14183 Huddinge, Sweden.
    Hellman, Therese
    Karolinska Inst, Unit Intervent & Implementat Res Worker Hlth, Solna, Sweden..
    Experiences of the return to work process after stroke while participating in a person-centred rehabilitation programme2017Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 24, nr 5, s. 349-356Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: In Sweden, less than 50% of those getting stroke in working age return to work (RTW). Effective rehabilitation programmes need to be developed and therapeutic aspects understood.Aim: To explore and describe how persons with stroke experience their RTW process while participating in a person-centred rehabilitation programme focusing on RTW.Materials and methods: Seven persons with mild or moderate stroke were interviewed twice during the intervention in the vocational training phase using semi-structured interviews. Data were analysed using grounded theory.Results: Having a coordinator by their side gave support and guidance during the RTW process. Knowledge of stroke, strategies and a straightforward communication created a structure for the RTW process. Expressing one's own wishes increased opportunities to influence and decide which path to follow in order to reach the goal.Conclusion: Straightforward, open and recurring communication facilitated the possibility to adapt to the situation. These aspects increased insight and awareness which facilitated the RTW process.Significance: The findings indicate that a precondition for a fruitful RTW process was that suitable platforms at work were created in which the actors involved could cooperate. This knowledge might also be valuable in the RTW process for people with other diagnosis.

  • 46.
    Terio, Minna
    et al.
    Danderyds Univ Hosp, Dept Rehabil Med, Danderyd, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Lexell: Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Box 23 200, S-14183 Huddinge, Sweden.
    Kamwesiga, Julius T.
    Uganda Allied Hlth Examinat Board, Kampala, Uganda.
    Guidetti, Susanne
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Box 23 200, S-14183 Huddinge, Sweden.
    What's in it for me?: A process evaluation of the implementation of a mobile phone-supported intervention after stroke in Uganda2019Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, artikel-id 562Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    The prevalence of stroke in Uganda is increasing. In stroke rehabilitation, information and communication technology has been shown to have potential in improving service delivery in high-income countries but there is limited knowledge of its use and impact in low-income countries.The aim of the study was to evaluate the implementation process of a mobile phone-supported family-centred rehabilitation intervention and to gain knowledge on the mechanisms of impact as well as the contextual factors that might have affected the implementation process and its outcome.

    Method

    This was a single-case study design using the integrated Promoting Action on Research Implementation in Health Services framework and the Medical Research Council guidance as frameworks. Quantitative process data was derived from 14 log books used by occupational therapists during the implementation. Qualitative semi-structured interviews were conducted with 12 implementers in different professions, 12months into the implementation, in order to obtain the primary data. Secondary data was derived from six semi-structured interviews conducted directly after pre-intervention workshops and 6 months later. The framework method was used in the data analysis.

    Results

    In 11 out of 14 cases, the clients were compliant with the intervention. Yet, challenges such as technical problems were reported. The target of conducting 16 phone calls for each client was achieved to 74%. Eight categories emerged from the qualitative analysis of the interviews including: 1) perceptions on facilitation, 2) using scientific and experience-based knowledge, 3) tailoring the intervention, 4) supportive working culture, 5) barriers to the service delivery, 6) implementers' interaction with the intervention, 7) perceptions on motivations and values, and 8) improving the model and enabling sustainability. Mechanisms contributing to the implementation of the intervention included engaged facilitators and motivated participants. Challenges in the client recruitment and poor information dissemination were some of the mechanisms impeding the implementation.

    Conclusions

    The intervention was partially delivered in accordance with the logic model for the project, where the implementation process was influenced by several barriers in the context such as technical setbacks. However, there were also several mediators in the process driving the project forward, including strong facilitation and motivated participants.

  • 47.
    Tistad, Malin
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden;Dalarna Univ, Sch Educ Hlth & Social Studies, Falun, Sweden;Umea Univ, Dept Rehabil & Social Med, Physiotherapy, Umea, Sweden.
    Flink, Maria
    Karolinska Univ Hosp, Funct Area Social Work Hlth, Stockholm, Sweden;Karolinska Inst, Dept Learning Informat Management & Eth, Stockholm, Sweden.
    Ytterberg, Charlotte
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Physiotherapy, Huddinge, Sweden;Karolinska Univ Hosp, Funct Area Occupat Therapy & Physiotherapy, Stockholm, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden.
    Guidetti, Susanne
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden.
    Tham, Kerstin
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden;Malmo Univ, Fac Hlth & Soc, Malmo, Sweden.
    von Koch, Lena
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden;Karolinska Univ Hosp, Theme Neuro, Stockholm, Sweden.
    Resource use of healthcare services 1 year after stroke: a secondary analysis of a cluster-randomised controlled trial of a client-centred activities of daily living intervention2018Ingår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, nr 8, artikel-id e022222Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The objective of the study was to compare the total use of healthcare services in the course of the first year after a stroke between participants who, after the acute care, had received occupational therapy as a client-centred activities of daily living (ADL) intervention (CADL) and participants who had received usual ADL intervention (UADL).

    Design: A secondary analysis of a multicentre cluster-randomised controlled trial (RCT).

    Setting: Primary and secondary care in Sweden.

    Participants: Participants were included if they: (1) had received CADL or UADL in the RCT, either as inpatients in geriatric rehabilitation units or in their own homes, and (2) data could be retrieved about their use of healthcare services provided by the county council from computerised registers.

    Interventions: CADL or UADL.

    Outcome measures: Inpatient and outpatient healthcare in the course of the first year after stroke.

    Results: Participants from 7 of the 16 units included in the RCT met the criteria. Participants in the CADL group (n=26) who received geriatric inpatient rehabilitation had a shorter length of hospital stay (p=0.03) than participants in the UADL group (n=46), and the CADL group with home rehabilitation (n=13) had fewer outpatient contacts (p=0.01) compared with the UADL group (n=25). Multiple regression analyses showed that in four of the models, a higher age was associated with a lower use of healthcare services. The use of healthcare services was also associated (some of the models) with dependence in ADL, stroke severity and type of rehabilitation received, CADL or UADL.

    Conclusions: The provision of client-centred occupational therapy after stroke did not appear to increase the use of healthcare services during the first year after stroke. Trial registration number NCT01417585.

  • 48.
    Ytterberg, Charlotte
    et al.
    Karolinska Inst, Huddinge, Sweden.
    Dyback, Malin
    Vasternorrland Cty Council, Sundsvall, Sweden.
    Bergstrom, Aileen
    Karolinska Inst, Huddinge, Sweden.
    Guidetti, Susanne
    Karolinska Inst, Huddinge, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Huddinge, Sweden.
    Perceived impact of stroke six years after onset, and changes in impact between one and six years2017Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, nr 8, s. 637-643Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To examine the perceived impact of stroke between 1 and 6 years after stroke using the Stroke Impact Scale 3.0 (SIS). Design: A prospective longitudinal study.

    Methods: A total of 100 individuals were assessed using the SIS 3.0 at 1 and 6 years after onset of stroke and clinically meaningful changes were explored. Changes in domain scores were calculated over time in relation to age, sex and stroke severity.

    Results: The most impacted SIS domains after 6 years were Participation, Strength, Hand function, and Stroke recovery. Participants with moderate/severe stroke experienced a higher impact in all domains except Hand function and Stroke recovery, indicating more problems in everyday life, compared with those with mild stroke. Almost half of the participants had a clinically meaningful change in the domain Participation between 1 and 6 years. Those with moderate/severe stroke and the older age group experienced more negative clinically meaningful changes in several domains in comparison with those with mild stroke and the younger age group.

    Conclusion: The long-term perceived impact of stroke highlights the importance of appropriate rehabilitation interventions within several areas to reduce the long-term negative impact in everyday life.

  • 49.
    Ytterberg, Charlotte
    et al.
    Karolinska Inst, Huddinge, Sweden.
    Dyback, Malin
    Vasternorrland Cty Council, Sundsvall, Sweden.
    Bergstrom, Aileen
    Karolinska Inst, Huddinge, Sweden.
    Guidetti, Susanne
    Karolinska Inst, Huddinge, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Huddinge, Sweden.
    Perceived impact of stroke six years after onset, and changes in impact between one and six years2017Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, nr 8, s. 637-643Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To examine the perceived impact of stroke between 1 and 6 years after stroke using the Stroke Impact Scale 3.0 (SIS). Design: A prospective longitudinal study.

    Methods: A total of 100 individuals were assessed using the SIS 3.0 at 1 and 6 years after onset of stroke and clinically meaningful changes were explored. Changes in domain scores were calculated over time in relation to age, sex and stroke severity.

    Results: The most impacted SIS domains after 6 years were Participation, Strength, Hand function, and Stroke recovery. Participants with moderate/severe stroke experienced a higher impact in all domains except Hand function and Stroke recovery, indicating more problems in everyday life, compared with those with mild stroke. Almost half of the participants had a clinically meaningful change in the domain Participation between 1 and 6 years. Those with moderate/severe stroke and the older age group experienced more negative clinically meaningful changes in several domains in comparison with those with mild stroke and the younger age group.

    Conclusion: The long-term perceived impact of stroke highlights the importance of appropriate rehabilitation interventions within several areas to reduce the long-term negative impact in everyday life.

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