| 1. |
- Kirvalidze, Mariam, et al.
(författare)
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Effectiveness of integrated person-centered interventions for older people's care: Review of Swedish experiences and experts’ perspective
- 2024
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Ingår i: Journal of Internal Medicine. - : John Wiley & Sons. - 1365-2796 .- 0954-6820. ; 295:6, s. 804-824
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Tidskriftsartikel (refereegranskat)abstract
- Older adults have multiple medical and social care needs, requiring a shift toward an integrated person-centered model of care. Our objective was to describe and summarize Swedish experiences of integrated person-centered care by reviewing studies published between 2000 and 2023, and to identify the main challenges and scientific gaps through expert discussions. Seventy-three publications were identified by searching MEDLINE and contacting experts. Interventions were categorized using two World Health Organization frameworks: (1) Integrated Care for Older People (ICOPE), and (2) Integrated People-Centered Health Services (IPCHS). The included 73 publications were derived from 31 unique and heterogeneous interventions pertaining mainly to the micro- and meso-levels. Among publications measuring mortality, 15% were effective. Subjective health outcomes showed improvement in 24% of publications, morbidity outcomes in 42%, disability outcomes in 48%, and service utilization outcomes in 58%. Workshop discussions in Stockholm (Sweden), March 2023, were recorded, transcribed, and summarized. Experts emphasized: (1) lack of rigorous evaluation methods, (2) need for participatory designs, (3) scarcity of macro-level interventions, and (4) importance of transitioning from person- to people-centered integrated care. These challenges could explain the unexpected weak beneficial effects of the interventions on health outcomes, whereas service utilization outcomes were more positively impacted. Finally, we derived a list of recommendations, including the need to engage care organizations in interventions from their inception and to leverage researchers’ scientific expertise. Although this review provides a comprehensive snapshot of interventions in the context of Sweden, the findings offer transferable perspectives on the real-world challenges encountered in this field.
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| 2. |
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| 3. |
- Wickford, Jenny, 1979, et al.
(författare)
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Physiotherapy in Afghanistan - Needs and challenges for development.
- 2008
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Ingår i: Disabil Rehabil.. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 30:4, s. 305-313
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. The aim of this paper is to describe and analyse the current situation of the physiotherapy component of the Rehabilitation of Afghans with Disability (RAD) programme, in order to identify the needs and challenges for further development. Method. The study was conducted as a field study with an anthropological approach by means of participant observation, unstructured and semi-structured interviews and photography. Results. The therapists in RAD work in isolation with little opportunity for further education or professional development. Their approach is mainly medical, where the work is dictated by the patients' expectations and doctors' recommendations. They use primarily passive methods of treatment, and their work is affected by cultural, religious and situational factors. They demonstrate a low capacity of clinical reasoning in their practical work. Conclusions. There is a need for further development of physiotherapy in Afghanistan. Active and individually adapted treatment methods, clinical reasoning processes and evidence-based practice should be encouraged. There are several challenges in this, based on Afghan culture and traditions, gender issues, religious factors, an authoritative society, a medical approach in treatment, and isolation and limitations in access to information. By means of an Action Research project the physiotherapists could be included in further development and research to promote a sustainable and culturally relevant development.
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| 4. |
- Folke, Mia, 1967-, et al.
(författare)
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Evaluation of the content of a web tool aimed to identify early markers related to fall risk among middle-aged people
- 2020
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Ingår i: Health and Technology. - : Springer Science and Business Media Deutschland. - 2190-7188 .- 2190-7196. ; 10:6, s. 1571-1578
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Tidskriftsartikel (refereegranskat)abstract
- Today, the health care sector has no test for early age-related deterioration in physical ability. The aim of this study was to evaluate questionnaires, videos and physical tests whose task will be to identify early markers related to an increased fall risk in middle-aged people. If the person is aware of deficits in physical ability related to fall risk, the person can then use that knowledge to perform relevant training that can strengthen the physical ability related to fall risk. Self-efficacy for balance and strength, physical ability related to fall risk and body composition were measured for 36 middle-aged test participants. This study shows that the tested physical exercises were useful for self-assessment of physical ability. Impairment in physical ability could not be identified solely with measurement of body composition, walking speed, questions, videos that show adjustments that are common in people with impaired balance, or an extended version of the Short version of Activities-specific Balance Confidence scale. This study indicates that a combination of questionnaires, videos and physical exercises can evaluate physical ability and act as a method to identify early markers related to increased fall risk. The questionnaire, videos and physical exercises can be implemented in a web tool that could make persons aware that they have decreased physical ability regarding fall risk or that they needlessly make physical compensations when performing daily activities and thus are missing opportunities to strengthen their physical ability every day.
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| 5. |
- Tegler, Helena
(författare)
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Social Interaction Involving Non-speaking Children with Severe Cerebral Palsy and Intellectual Disability : The role of communication partners and speech-generating devices
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to investigate the use of speech-generating device (SGD)-mediated interaction with children with anarthria, severe physical impairments and intellectual disabilities due to cerebral palsy with a focus on partner strategies and social practices.Studies I and II were cross-sectional studies that used questionnaires, which were analyzed using descriptive statistics and directed content analysis. In Study I, speech and language pathologists’ (SLPs) practices and perceptions of communication partner training in SGD-mediated interaction were examined. In Study II, communication partners’ (i.e., caregivers’, teachers’, and assistants’) practices and perceptions of communication partner training in SGD-mediated interaction were examined.Studies III and IV were qualitative observational studies that used video recordings, which were analyzed with ethnomethodological conversation analysis. Study III investigated how multiparty classroom interaction was organized when one of the students used an eye-gaze accessed SGD. Study IV explored the social actions that mobilized SGD-mediated responses when the child was a beginner user of the eye-gaze accessed SGD.The findings suggest the following: all participants (i.e., SLPs, caregivers, teachers, and assistants) considered that SGD-mediated interaction was beneficial for the children. SLPs were important providers but they provided few training sessions and used mostly verbal instructions. Communication partners could benefit from more support from SLPs and SLPs should consider using additional instructional approaches such as feedback and role-play when coaching communication partners in SGD-mediated interaction. Children could interact with their eye-gaze accessed SGDs in multiparty classroom interactions provided that the turn-taking in Initiation-Response-Evaluation (IRE) sequences was applied and that the teacher or the assistant provided contingent on-screen gaze and deictic scaffolding actions. Communication partners to children who were beginner users of an eye-gaze accessed SGD may need to produce repeated turn transition relevance places and use contingent on-screen gaze and deictic practices to scaffold an SGD-mediated response.This thesis brings new knowledge to the field of SGD-mediated interaction. Partner strategies that can enhance children’s linguistic skills were seldom used in multiparty classroom interaction, but other social practices were used, which facilitated social inclusion and participation.
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| 6. |
- Gustavsson, Catharina, et al.
(författare)
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What is required to facilitate implementation of Swedish physical activity on prescription? - interview study with primary healthcare staff and management
- 2018
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The method, Swedish Physical Activity on Prescription (SPAP), has been launched in Swedish healthcare to promote physical activity for prevention and treatment of lifestyle related health disorders. Despite scientific support for the method, and education campaigns, it is used to a limited extent by health professionals. The aim of the study was to describe the views of health professionals on perceived facilitators, barriers and requirements for successful implementation of SPAP in primary healthcare.METHODS: Eighteen semi-structured interviews with stakeholders in SPAP, i.e. ten people working in local or central management and eight primary healthcare professionals in two regional healthcare organisations, were analysed using qualitative content analysis.RESULTS: We identified an overarching theme regarding requirements for successful implementation of SPAP: Need for knowledge and organisational support, comprising four main categories: Need for increased knowledge and affirmative attitude among health professionals; Need for clear and supportive management; Need for central supporting structures; Need for local supporting structures. Knowledge of the SPAP method content and core components was limited. Confidence in the method varied among health professionals. There was a discrepancy between the central organisation policy documents declaring that disease preventive methods were prioritised and a mandatory assignment, while the health professionals asked for increased interest, support and resources from management, primarily time and supporting structures. There were somewhat conflicting views between primary healthcare professionals and managers concerning perceived barriers and requirements. In contrast to some of the management's beliefs, all primary healthcare professionals undisputedly acknowledged the importance of promoting physical activity, but they lacked time, written routines and in some cases competence for SPAP counselling.CONCLUSION: The study provides knowledge regarding requirements to facilitate the implementation of SPAP in healthcare. There was limited knowledge among health professionals regarding core components of SPAP and how to practise the method, which speaks for in-depth training in the SPAP method. The findings highlight the importance of forming policies and guidelines and establishing organisational supporting structures, and ensuring that these are well known and approved in all parts of the healthcare organisation.
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| 7. |
- Jedel, Elizabeth, et al.
(författare)
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Differences in personality, perceived stress and physical activity in women with burning mouth syndrome compared to controls.
- 2021
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Ingår i: Scandinavian Journal of Pain. - : Walter de Gruyter GmbH. - 1877-8860 .- 1877-8879. ; 21:1, s. 183-190
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Burning mouth syndrome (BMS) is a long-lasting pain condition which is commonly associated with anxiety symptoms and experience of adverse, stressful life events have been reported by those diagnosed with the syndrome. Stress-related biomarkers have been related to personality traits in BMS and a personality with high stress susceptibility and perceived stress may be of importance. Although biopsychosocial approaches are suggested to manage long-lasting orofacial pain, to date little is known about physical activity in women with BMS. The aim of this study was to investigate if personality, perceived stress and physical activity distinguish women with BMS from controls. Methods Fifty-six women with BMS and 56 controls matched on age and gender completed Swedish universities Scales of Personality (SSP), Perceived Stress Questionnaire (PSQ) and a general questionnaire with an item on weekly physical activity frequency. In addition, health-related quality of life was explored by additional questionnaires and reported in a companion article (Jedel et al. Scand J Pain. 2020. PubMed PMID: 32853174). Results SSP subscales Somatic Trait Anxiety, Psychic Trait Anxiety, Stress Susceptibility and Verbal Trait Aggression differed between women with BMS and controls and the personality factor scores for Neuroticism and Aggressiveness were higher. Perceived stress measured by PSQ index was higher for women with BMS compared to controls. Women with BMS reported lower physical activity frequency compared to controls and those reporting physical activity <4 days/week scored higher on PSQ compared to those with weekly physical activity ≥4 days/week. Conclusions Personality distinguished women with BMS from controls in this study. Perceived stress was higher and weekly physical activity was lower in women with BMS compared to controls. Our findings suggest physical activity should be more comprehensively measured in future BMS studies and, by extension, physical activity may be a treatment option for women with BMS. Pain management aiming to restore function and mobility with stress reduction should be considered in clinical decision making for women with BMS who have a personality with stress susceptibility, especially if reporting high perceived stress and insufficient physical activity.
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| 8. |
- Velandia, Marianne, et al.
(författare)
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Onset of Vocal Interaction Between Parents and Newborns in Skin-to-Skin Contact Immediately After Elective Cesarean Section
- 2010
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Ingår i: Birth. - : Wiley Periodicals Inc.. - 0730-7659 .- 1523-536X. ; 7:3, s. 192-201
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cesarean section is associated with delayed mother-infant interaction because neither the mother nor the father routinely maintains skin-to-skin contact with the infant after birth. The aim of the study was to explore and compare parent-newborn vocal interaction when the infant is placed in skin-to-skin contact either with the mother or the father immediately after a planned cesarean section. Methods: A total of 37 healthy infants born to primiparas were randomized to 30 minutes of skin-to-skin contact either with fathers or mothers after an initial 5 minutes of skin-to-skin contact with the mothers after birth. The newborns’ and parents’ vocal interaction were recorded on a vid-eotape and audiotape. The following variables were explored: newborns’ and parents’ soliciting, newborns’ crying and whining, and parental speech directed to the other parent and to the newborn. Results: Newborns’ soliciting increased over time (p = 0.032). Both fathers and mothers in skin-to-skin contact communicated more vocally with the newborn than did fathers (p = 0.003) and mothers (p = 0.009) without skin-to-skin contact. Fathers in skin-to-skin contact also communicated more with the mother (p = 0.046) and performed more soliciting responses than the control fathers (p = 0.010). Infants in skin-to-skin con-tact with their fathers cried significantly less than those in skin-to-skin contact with their mothers (p = 0.002) and shifted to a relaxed state earlier than in skin-to-skin contact with mothers (p = 0.029). Conclusions: Skin-to-skin contact between infants and parents immediately after planned cesarean section promotes vocal interaction. When placed in skin-to-skin contact and exposed to the parents’ speech, the infants initiated communication with soliciting calls with the parents within approximately 15 minutes after birth. These findings give reason to encourage parents to keep the newborn in skin-to-skin contact after cesarean section, to support the early onset of the first vocal communication.
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| 9. |
- Eliasson, Ann-Christin, 1950-, et al.
(författare)
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Mini-MACS : development of the Manual Ability Classification System for children younger than 4 years of age with signs of cerebral palsy
- 2017
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Ingår i: Developmental Medicine & Child Neurology. - : Mac Keith Press. - 0012-1622 .- 1469-8749. ; 59:1, s. 72-78
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To develop the Mini-Manual Ability Classification System (Mini-MACS) and to evaluate the extent to which its ratings are valid and reliable when children younger than 4 years are rated by their parents and therapists.METHOD: The Mini-MACS was created by making adjustments to the MACS. The development involved a pilot project, consensus discussions within an expert group, and the creation of a test version of the Mini-MACS that was evaluated for content validity and interrater reliability. A convenience sample of 61 children with signs of cerebral palsy aged 12 to 51 months (mean age 30.2mo [SD 10.1]) were classified by one parent and two occupational therapists across a total of 64 assessments. Agreement between the parents' and therapists' ratings was evaluated using the intraclass correlation coefficient (ICC) and the percentage of agreement.RESULTS: The first sentence of the five levels in the MACS was kept, but other descriptions within the Mini-MACS were adjusted to be more relevant for the younger age group. The ICC between parents and therapists was 0.90 (95% confidence interval [CI] 0.79-0.92), and for the two therapists it was 0.97 (95% CI 0.78-0.92). Most parents and therapists found the descriptions in the Mini-MACS suitable and easy to understand.INTERPRETATION: The Mini-MACS seems applicable for children from 1 to 4 years of age.
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| 10. |
- Ahlstedt, Carina, 1969-, et al.
(författare)
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What makes registered nurses remain in work? : An ethnographic study
- 2019
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Ingår i: International Journal of Nursing Studies. - : Elsevier Ltd. - 0020-7489 .- 1873-491X. ; 89, s. 32-38
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Tidskriftsartikel (refereegranskat)abstract
- Background: Registered nurses’ work-related stress, dissatisfaction and burnout are some of the problems in the healthcare and that negatively affect healthcare quality and patient care. A prerequisite for sustained high quality at work is that the registered nurses are motivated. High motivation has been proved to lead to better working results. The theory of inner work life describes the dynamic interplay between a person's perceptions, emotions and motivation and the three key factors for a good working life: nourishment, progress and catalysts. Objectives: The aim of the study was to explore registered nurses’ workday events in relation to inner work life theory, to better understand what influences registered nurses to remain in work. Design: A qualitative explorative study with an ethnographic approach. Methods: Participant observation over four months; in total 56 h with 479 events and 58 informal interviews during observation; all registered nurses employed at the unit (n = 10) were included. In addition, individual interviews were conducted after the observation period (n = 9). The dataset was analysed using thematic analysis and in the final step of the analysis the categories were reflected in relation to the three key factors in theory of inner work life. Results: Nourishment in a registered nurse context describes the work motivation created by the interpersonal support between colleagues. It was important to registered nurses that physicians and colleagues respected and trusted their knowledge in the daily work, and that they felt comfortable asking questions and supporting each other. Progress in the context of registered nurses’ work motivation was the feeling of moving forward with a mix of small wins and the perception of solving more complex challenges in daily work. It was also fundamental to the registered nurses’ development through new knowledge and learning during daily work. Catalysts, actions that directly facilitate the work, were highlighted as the possibility to work independently along with the opportunity to work together with other registered nurses. Conclusion: This study has a number of implications for future work and research on creating an attractive workplace for registered nurses. Working independently, with colleagues from the same profession, integrated with learning, visible progress, and receiving feedback from the work itself, contribute to work motivation.
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