| 1. |
- Sandlund, Marlene, et al.
(författare)
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Gender perspectives on views and preferences of older people on exercise to prevent falls : mixed studies review
- 2017
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Ingår i: BMC Geriatrics. - : BioMed Central. - 1471-2318 .- 1471-2318. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDTo offer fall prevention exercise programs that attract older people of both sexes there is a need to understand both women's and men's views and preferences regarding these programs. This paper aims to systematically review the literature to explore any underlying gender perspectives or gender interpretations on older people's views or preferences regarding uptake and adherence to exercise to prevent falls.METHODSA review of the literature was carried out using a convergent qualitative design based on systematic searches of seven electronic databases (PubMed, CINAHL, Amed, PsycINFO, Scopus, PEDro, and OTseeker). Two investigators identified eligible studies. Each included article was read by at least two authors independently to extract data into tables. Views and preferences reported were coded and summarized in themes of facilitators and barriers using a thematic analysis approach.RESULTSNine hundred and nine unique studies were identified. Twenty five studies met the criteria for inclusion. Only five of these contained a gender analysis of men's and women's views on fall prevention exercises. The results suggests that both women and men see women as more receptive to and in more need of fall prevention messages. The synthesis from all 25 studies identified six themes illustrating facilitators and six themes describing barriers for older people either starting or adhering to fall prevention exercise. The facilitators were: support from professionals or family; social interaction; perceived benefits; a supportive exercise context; feelings of commitment; and having fun. Barriers were: practical issues; concerns about exercise; unawareness; reduced health status; lack of support; and lack of interest. Considerably more women than men were included in the studies.CONCLUSIONAlthough there is plenty of information on the facilitators and barriers to falls prevention exercise in older people, there is a distinct lack of studies investigating differences or similarities in older women's and men's views regarding fall prevention exercise. In order to ensure that fall prevention exercise is appealing to both sexes and that the inclusion of both men and women are encouraged, more research is needed to find out whether gender differences exists and whether practitioners need to offer a range of opportunities and support strategies to attract both women and men to falls prevention exercise.
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| 2. |
- Ahlgren, Christina, et al.
(författare)
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Engagement in New Dietary Habits : Obese Women's Experiences from Participating in a 2-Year Diet Intervention
- 2016
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Ingår i: International Journal of Behavioral Medicine. - : Springer. - 1070-5503 .- 1532-7558. ; 23:1, s. 84-93
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Dietary weight loss interventions most often result in weight loss, but weight maintenance on a long-term basis is the main problem in obesity treatment. There is a need for an increased understanding of the behaviour patterns involved in adopting a new dietary behavior and to maintain the behaviour over time.PURPOSE: The purpose of this paper is to explore overweight and obese middle-aged women's experiences of the dietary change processes when participating in a 2-year-long diet intervention.METHODS: Qualitative semi-structured interviews with 12 overweight and obese women (54-71 years) were made after their participation in a diet intervention programme. The programme was designed as a RCT study comparing a diet according to the Nordic nutrition recommendations (NNR diet) and a Palaeolithic diet (PD). Interviews were analysed according to Grounded Theory principles.RESULTS: A core category "Engagement phases in the process of a diet intervention" concluded the analysis. Four categories included the informants' experiences during different stages of the process of dietary change: "Honeymoon phase", "Everyday life phase", "It's up to you phase" and "Crossroads phase". The early part of the intervention period was called "Honeymoon phase" and was characterised by positive experiences, including perceived weight loss and extensive support. The next phases, the "Everyday life phase" and "It's up to you phase", contained the largest obstacles to change. The home environment appeared as a crucial factor, which could be decisive for maintenance of the new dietary habits or relapse into old habits in the last phase called "Crossroads phase".CONCLUSION: We identified various phases of engagement in the process of a long-term dietary intervention among middle-aged women. A clear personal goal and support from family and friends seem to be of major importance for long-term maintenance of new dietary habits. Gender relations within the household must be considered as a possible obstacle for women engaging in diet intervention.
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| 3. |
- Ahlgren, Christina, et al.
(författare)
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The meanings given to gender in studies on multimodal rehabilitation for patients with chronic musculoskeletal pain : a literature review
- 2016
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 38:23, s. 2255-2270
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Forskningsöversikt (refereegranskat)abstract
- Purpose: The purpose of this study is to assess and describe the meanings given to "gender" in scientific publications that evaluate multidisciplinary, interdisciplinary or multimodal rehabilitation for patients with chronic musculoskeletal pain.Method: A systematic literature search for papers evaluating multimodal rehabilitation was conducted. The PubMed and EBSCO databases were searched from 1995 to 2015. Two or three researchers independently read each paper, performed a quality assessment and coded meanings of gender using qualitative content analysis.Results: Twenty-seven papers were included in the review. Gender was used very differently in the MMR studies investigated but primarily it referred to factual differences between men and women. Only one paper provided a definition of the concept of gender and how it had been used in that study. In the content analysis, the meaning of gender formed three categories: "Gender as a factual difference", "The man is the ideal" and "Gender as a result of social role expectations".Conclusions: The meaning of the concept of gender in multimodal rehabilitation is undefined and needs to be developed further. The way the concept is used should be defined in the design and evaluation of multimodal rehabilitation in future studies.Implications for rehabilitationHealthcare professionals should reflect on gender relations in encounters with patients, selection of patients into rehabilitation programs and design of programs. In rehabilitation for chronic pain the patients' social circumstances and cultural context should be given the same consideration as biological sex and pain symptoms.
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| 4. |
- Melander-Wikman, Anita, et al.
(författare)
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Project: Early signs of mobility limitations and fall events in old age: long-term consequences and tailored preventive interventions through interactive media
- 2012
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Annan publikation (populärvet., debatt m.m.)abstract
- The aims of this project are 1) to investigate the consequences over five years of early signs of mobility limitations expressed as fallevents, a changed walking pattern with a cognitive load (dual-task costs), and decreased balance confidence on severe fall-relatedinjuries, perceived health, participation, activities of daily living, and gait performance, and 2) to develop, together with older people,and evaluate tailored fall-prevention through interactive media in a randomized controlled trial with two arms.
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| 5. |
- Novak, Masuma, 1969-
(författare)
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Social inequity in health : Explanation from a life course and gender perspective
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: A boy child born in a Gothenburg suburb has a life expectancy that is nine years shorter than that of another child just 23 km away, and among girls the difference is five years. There is no necessary biological reason to this observed difference. In fact, like life length, most diseases follow a social gradient, even in a country like Sweden where many believe there is no class inequity. This social inequity in health tells us that some of us are not achieving our potential in health or in life length compared to our more fortunate fellow citizens. Aim: This thesis attempts to explore the patterns of health inequities and the pathways by which health inequities develop from a life course and gender perspective. In particular focuses on the importance of material, behavioural, health related and psychosocial circumstances from adolescence to adulthood in explaining social inequity in musculoskeletal disorders (MSDs), obesity, smoking, and social mobility. Method: All four papers of this thesis were based on quantitative analyses of data from a 14-year follow-up study. The baseline survey was conducted in 1981 in Luleå, Sweden. The survey included all 16-year-old pupils born in 1965. A total of 1081 pupils (575 boys and 506 girls) were surveyed. They were followed up at ages 18, 21 and 30 years with comprehensive self-administered questionnaires. The response rate was 96.5% throughout the 14-year follow-up. In addition to the questionnaires data, school records, and interviews with nurse and teachers’ were used. Results: There were no class or gender differences in MSDs and in obesity during adolescence, but significantly more girls than boys were smokers. Class and gender differences had emerged when they reached adulthood with more women reporting to have MSDs but more men being overweight and obese. Women continued to be smokers at a higher rate than men through to adulthood. When an intersection between class and gender was considered, a more complex picture emerged. For example, not all women had higher prevalence of MSDs or smoked more than men, rather men with high socioeconomic position (SEP) had lower prevalences of MSDs and smoking than women with high SEP; and these high SEP women had lower prevalences than men with low SEP. The worst-off group was women with low SEP. The obesity pattern was quite the contrary, where women with high SEP had a lower prevalence of obesity than women with low SEP; and these low SEP women had a lower prevalence than men with high SEP. The worst-off group was men with low SEP. Regarding social mobility, health status (other than height in women) and ethnic background were not associated with mobility either for men or women. The results indicated that unequal distribution of material, psychosocial, health and health related behavioural factors during adolescence, young adulthood and adulthood accounted for the observed social gradients and social mobility. However, several factors from adolescence appeared to be more important for women while recent factors were more important for men. Important adolescent factors for social inequity and downward mobility were: unfavourable material circumstances defined as low SEP of parent, unemployed family member, and had no own room during upbringing; unfavourable psychosocial circumstances defined as parental divorce, poor contact with parents, being less liked in school, and low school control; and poor health related behaviour defined as smoking and physical inactivity. Among these factors, being less liked in school showed consistent association with all outcome measures of this thesis. Being less liked by the teachers and students was found to be more common among adolescents whose parents had low SEP. Men and women who were less liked in school during their adolescence were more likely as adults to be smokers, obese (only women), and downwardly mobile. The dominant adult life factor that contributed to class inequity in MSDs for men and women was physical heavy working conditions, which attributed to an estimated 46.9% (women) and 49.5% (men) of the increased risk in MSDs of the lower SEP group. High alcohol consumption among men with low SEP was an additional factor that contributed to class inequities in health and social mobility. Conclusion: Social patterning of health in this cohort was gendered and age specific depending on the outcome measures. Unfavourable school environment in early years had long lasting negative influence on later health, health behavior and SEP. The thesis supports the notion of accumulation of risk that social inequities in health occurs due to accumulation of multiple adverse circumstances among the lower SEP group throughout their life course. Schools should be used as a setting for interventions aimed at reducing socioeconomic inequities in health. The detailed policy implications for reduction of social inequities in health among men and women are discussed.
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| 6. |
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| 7. |
- Pohl, Petra, et al.
(författare)
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Fall risk awareness and safety precautions taken by older community-dwelling women and men : a qualitative study using focus group discussions
- 2015
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:3
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Daily life requires frequent estimations of the risk of falling and the ability to avoid a fall. The objective of this study was to explore older women's and men's understanding of fall risk and their experiences with safety precautions taken to prevent falls.Methods A qualitative study with focus group discussions was conducted. Eighteen community-dwelling people [10 women and 8 men] with and without a history of falls were purposively recruited. Participants were divided into two groups, and each group met four times. A participatory and appreciative action and reflection approach was used to guide the discussions. All discussions were audio recorded and transcribed verbatim. Data were analysed by qualitative content analysis, and categories were determined inductively.Findings Three categories describing the process of becoming aware of fall risks in everyday life were identified: 1] Facing various feelings, 2] Recognizing one's fall risk, and 3] Taking precautions. Each category comprised several subcategories. The comprehensive theme derived from the categories was "Safety precautions through fall risk awareness". Three strategies of ignoring [continuing a risky activity], gaining insight [realizing the danger in a certain situation], and anticipating [thinking ahead and acting in advance] were related to all choices of actions and could fluctuate in the same person in different contexts.Conclusions The fall risk awareness process might be initiated for various reasons and can involve different feelings and precautions as well as different strategies. This finding highlights that there are many possible channels to reach older people with information about fall risk and fall prevention, including the media and their peers. The findings offer a deeper understanding of older peoples' conceptualizations about fall risk awareness and make an important contribution to the development and implementation of fall prevention programmes.
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| 8. |
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| 9. |
- Pohl, Petra, et al.
(författare)
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Older women and men as co-creators in design of a mobile application for fall prevention
- 2013
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Konferensbidrag (refereegranskat)abstract
- There is a plethora of fall prevention programs for older community-dwelling people. The evidence for exercise-based programs is strong. There is a problem however with implementation and adherence. Motivational factors and barriers have been identified to some extent. Previous studies have shown that what works best is when exercise programs are tailor made, home based, and when people have access to personal feedback on a regular basis. Mobile applications for Smartphones with exercises have these advantages, and have been available for a long time, but these are most commonly directed to young and middle-aged people. There are no applications for fall prevention developed based on senior’s own wishes. The aim was to investigate how healthy older community-dwelling women and men reason and what exercises they prefer when participating in development and design of a fall prevention program in shape of a mobile application for Smartphones.Method Participatory and appreciative action research design with focus group interviews and workshops. Qualitative data analysis.Results The preliminary results show that when older community-dwelling men and women participate in developing a fall prevention program for Smartphones, they have many ideas, thoughts and experiences that may serve as a motivational factor for following a fall prevention program regularly.ConclusionThe implementation and adherence for evidence based fall preventative exercise programs is insufficient. This study will gain knowledge to design tailor made, home based fall prevention exercise programs among community-dwelling healthy seniors.
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| 10. |
- Pohl, Petra, et al.
(författare)
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Äldre män och kvinnor som med-aktörer i design av tränings-appar för fallprevention
- 2013
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Konferensbidrag (refereegranskat)abstract
- Bakgrund och syfte:Det finns en uppsjö av olika fallpreventiva evidensbaserade träningsprogram för äldre i ordinärt boende. Även om evidensgraden är hög för viss träning finns det svårigheter med att få äldre personer att utföra träningen. Vissa motivationsfaktorer och hindrande faktorer har redan identifierats och forskningen visar att skräddarsydda, hembaserade träningsprogram med möjlighet till regelbunden återkoppling är det som fungerar bäst. Applikationer till mobiltelefoner och surfplattor erbjuder denna möjlighet, och har funnits sedan en längre tid, men dessa vänder sig oftast till yngre och medelålders personer. Det finns ännu ingen applikation som är baserad på de äldres egna önskemål. Syftet med studien är att undersöka hur friska äldre män och kvinnor i ordinärt boende resonerar och vilka övningar de föredrar när de deltar i utveckling och design av ett fallpreventivt träningsprogram i form av en applikation till smarta telefoner och surfplattor. Metoder:18 deltagare > 70 år. Deltagande och uppskattande aktionsforskning samt fokusgruppsintervjuer och workshops. Kvalitativ innehållsanalys. Resultat:De preliminära resultaten visar att när äldre män och kvinnor i ordinärt boende deltar i utvecklingen av ett fallpreventivt träningsprogram för smarta telefoner och surfplattor har de många idéer, tankar och erfarenheter som kan fungera som motiverande faktorer i syfte att utföra regelbunden fallpreventiv träning. Konklusion:Implementeringen och följsamheten för evidensbaserade fallpreventiva träningsprogram är otillräcklig. Denna studie bidrar med kunskaper för att designa skräddarsydda, hembaserade fallpreventiva träningsprogram för friska äldre personer i ordinärt boende.
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