| 1. |
- Areskoug Josefsson, Kristina, et al.
(författare)
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Detecting decreased sexual health with MDHAQ-S
- 2013
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Ingår i: Health (Irvine). - 1949-4998 .- 1949-5005. ; :5, s. 38-47
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Tidskriftsartikel (refereegranskat)abstract
- There are instruments that measure sexual function or sexual health for persons with RA, but since sexual health is a sensitive issue, the hypothesis is that it would be easier to have a standard questionnaire that could indicate the need for communication about sexual health issues instead of an extra questionnaire with more detailed questions on sexual health. The aim of the study is to find out whether sexual health difficulties can be screened by factors included in the MDHAQ-S for persons with RA. This study explores the relation between factors included in the MDHAQ-S and the Sexual Health Questionnaire (QSH) using a mixed methods design combining quantitative and qualitative data. The MDHAQ-S covers sexual health issues, not only by using the question on sexual health, but also on other factors included in the questionnaire such as increased pain, fatigue, depression, anxiety, physical capacity, level of physical activity and body weight. To explore decreased sexual arousal, decreased sexual satisfaction and decreased sexual well-being, in-depth interviews must be held with persons with RA, either using a sexual health questionnaire or in a clinical interview.
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| 2. |
- Areskoug Josefsson, Kristina, et al.
(författare)
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Swedish version of the multi dimensional health assessment questionnaire – translation and psychometric evaluation
- 2013
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundHealth assessment measurements for patients with Rheumatoid arthritis (RA) have to be meaningful, valid and relevant. A commonly used questionnaire for patients with RA is the Stanford Health Assessment Questionnaire Disability Index (HAQ), which has been available in Swedish since 1988. The HAQ has been revised and improved several times and the latest version is the Multi Dimensional Health Assessment Questionnaire (MDHAQ). The aim of this study was to translate the MDHAQ to Swedish conditions and to test the validity and reliability of this version for persons with RA. MethodsTranslation and adaption of the MDHAQ were performed according to guidelines by Guillemin et al. The translated version was tested for face validity and test-retest in a group of 30 patients with RA. Content validity, criterion validity and internal consistency were tested in a larger study group of 83 patients with RA. Reliability was tested with test-retest and Cronbach´s alpha for internal consistency. Two aspects of validity were explored: content and criterion validity. Content validity was tested with a content validity index. Criterion validity was tested with concurrent validity by exploring the correlation between the MDHAQ-S and the AIMS2-SF. Floor and ceiling effects were explored. ResultsTest-retest with intra-class correlation coefficient (ICC) gave a coefficient of 0.85 for physical function and 0.79 for psychological properties. Reliability test with Cronbach´s alpha gave an alpha of 0.65 for the psychological dimension and an alpha of 0.88 for the physical dimension of the MDHAQ-S. The average sum of the content validity index for each item was of the MDHAQ-S was 0.94. The MDHAQ-S had mainly a moderate correlation with the AIMS2-SF, except for the social dimension of the AIMS2-SF, which had a very low correlation with the MDHAQ-S. ConclusionsThe MDHAQ-S was considered to be reliable and valid, but further research is needed concerning sensitivity to change.
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| 3. |
- Gard, Gunvor, et al.
(författare)
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Physical Therapists´ emotional expressions in interviews about factors important for interaction with patients
- 2000
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Ingår i: Physiotherapy. - 1873-1465 .- 0031-9406. ; 86:5, s. 229-240
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Tidskriftsartikel (refereegranskat)abstract
- Interactions between patients and physiotherapists have been studied by various researchers. Some results indicate that physiotherapists have an awareness of underlying emotions, but often respond only on an intellectual level. It seems that verbally expressed emotions may be important for interaction between physiotherapists and patients during treatment. Aim The aim of this study was to investigate how many and what verbally expressed emotions physiotherapists state during interviews between physiotherapists and patients. Method The study was a qualitative case study with cross-case analysis according to Shepard et al (1993) and Merriam (1988). Ten informants participated, all of them 'experts in interaction with patients', women, Swedish-speaking, and with at least five years' experience in primary health care. The physiotherapists' emotions were categorised according to Tomkins (1984) and Izard (1977) in the categories of interest/excitement, surprise/startle, enjoyment/joy, sadness, anger/rage, fear/terror, shame/humiliation, contempt and disgust. Results Positive emotions such as interest and joy were expressed most often in the interviews, in situations where physiotherapy had been successful, as joyful contacts with colleagues, or in situations where humour was used as a therapeutic instrument. Surprise, sadness and anger were expressed more seldom and contempt or disgust were not expressed at all in the interviews. Conclusion Verbal expressions of emotions in treatment situations in physiotherapy practice should be promoted more emphatically. This may start a reflective process in both patients and physiotherapists and deepen the understanding of the interaction.
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| 4. |
- Lundvik Gyllensten, Amanda, et al.
(författare)
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Interaction between patient and physiotherapist: a qualitative study reflecting the physiotherapist's perspective
- 1999
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Ingår i: Physiotherapy Research International. - : Wiley. - 1358-2267 .- 1471-2865. ; 4:2, s. 89-109
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose The interaction between patient and physiotherapist (PT) is central in physiotherapeutic treatment. The purpose of this study was to investigate expert physiotherapists' perception of important factors influencing the quality of the interaction in physiotherapeutic treatment. Method Ten experienced PTs working in primary healthcare were interviewed twice, triangulating a sort of important events, an exemplar and a key informant interview. The data were transcribed, coded and analysed for main themes and categories according to the qualitative technique described by Shepard et al. (1993) and Merriam (1988). Results Important factors in interaction could be divided into the Prerequisites dimension and the Interaction dimension. In the former, the most dominant theme was Internal prerequisites of the PT. The most-cited category in this theme was Practical professional skills and patient experience. In the latter, the themes Establishing contact, Ways of contact, Frames and the Therapeutic process emerged. Here, the most-cited categories were Establishing contact and confidence, having a Therapeutic role, Being sensitive and intuitive, Encountering, Listening and Identification of patient resources. These factors were seen as essential for promoting a positive patient outcome. Interaction skills were reinforced by reflection on patients' experiences. Conclusions Interaction skills of the expert PT were thought to enhance the resources of the patient and lead to a positive patient outcome. Within professional development more emphasis ought to be put on reinforcing the reflective process of the PT, for instance by the use of supervision by an experienced colleague.
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| 5. |
- Lundvik Gyllensten, Amanda, et al.
(författare)
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Interaction between patient and physiotherapist in psychiatric care-the physiotherapist perspective
- 2000
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Ingår i: Advances in Physiotherapy. - : Informa UK Limited. - 1651-1948 .- 1403-8196. ; 2:4, s. 157-167
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to investigate what factors the physiotherapy experts in psychiatric physiotherapy believed to be important in the interaction between the patient and the physiotherapist (PT). The objective was to obtain a deeper insight into their reasoning concerning interaction and treatment outcomes. Eleven nominated ''expert'' PTs were each interviewed twice. Triangulation of important events, an exemplar (critical incident) and a key informant interview were used in the data collection. A qualitative design with crosscase analysis was used in the data analysis. Important interaction factors were divided into a ''prerequisites dimension'', ''interaction dimension'' and ''outcome dimension''. In the prerequisites dimension there were three themes: ''prerequisites of the PT'', ''prerequisites of the patient'' and ''external factors''. In the interaction dimension there were also three themes: ''ways of contact'', ''therapeutic process'' and ''structure of treatment''. In the outcome dimension the theme ''outcome'' and the two categories ''patient - awareness of own resources and ''PT - improvement of interaction skills with the aid of reflection'' were found. Interaction was considered to be important for the outcome and for the patient's awareness of his:her resources. The body awareness skills of the PT, the therapeutic relationships, help for the patient to identify his:her resources and the contract were also important. The ability to be fully mentally present in the encounter and the use of non-verbal skills were emphasized. Supervision and reflection about the outcome increased the PT's interaction skills in a learning process. The physiotherapy process expressed was resource-oriented.
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| 6. |
- Romé, Åsa, et al.
(författare)
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Costs and outcomes of an exercise referral programme - A 1-year follow-up study.
- 2014
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Ingår i: European Journal of Physiotherapy. - : Informa UK Limited. - 2167-9177 .- 2167-9169. ; 16:2, s. 82-92
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To analyse, at a one year follow up, cost offset and outcomes of changing the physical activity (PA) behaviour due to a primary care intervention. Methodology: Participants were 528 inactive individuals with life-style related health problems, 18-84 years, and randomised into a high-dose intervention group (n=270) or a low-dose intervention group (n=258). The four month lasting intervention “Physical Activity on Prescription” (PAP) contained exercise, education and motivational counselling. At the one year follow up 178 individuals (95 in the high-dose group, 83 in the low-dose group) were assessed with the IPAQ (International Physical Activity Questionnaire) short form, perceived PA and functional ability (Six Minute Walk Test). Motivation and attitudes towards PA were assessed with a questionnaire (Gard et al), and analysed based on factor analysis. Major findings: PA increased significantly, but without differences between high-dose and low-dose groups. The rate of inactive individuals decreased from 75% to 53%. Analysis of motivation showed no differences between the groups. Principal conclusion: The PAP-program significantly improved physical activity behaviour at the one year follow up, and reduced costs for inactivity by 22%. Economic incentives, i.e. expenditures and individuals own valuation of leisure time, seem to influence preferences for participation in the PAP-program. Social-cognitive factors seem important when changing PA behaviour. Prescribed exercise may work pre-motivational for changed physical activity behaviour.
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| 7. |
- Romé, Åsa, et al.
(författare)
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Physical activity on prescription (PAP): Costs and consequences of a randomized, controlled trial in primary healthcare.
- 2009
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724 .- 1403-4948 .- 1651-1905. ; 27:4, s. 216-222
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objectives. To analyse costs and consequences of changing physical activity behaviour due to the "Physical Activity on Prescription" (PAP) programme. Design. A randomized controlled trial with a four-month intervention, with comparison between intervention and control group. Intervention. The PAP programme, with exercise twice a week, education, and motivational counselling. Subjects. 525 sedentary individuals, 20-80 years (intervention group n = 268, control group n = 257), with lifestyle-related health problems. A total of 245 returned for the four-month assessment. Main outcome measure. Programme costs based on intention-to-treat estimations, direct and indirect costs of inactivity, and physical activity behaviour analysed with IPAQ (International Physical Activity Questionnaire), self-reported physical activity, and measures of functional capacity. Results. The intention-to-treat programme costs for the four-month programme period was SKr (Swedish Kronor) 6475 (euro [Euro] 684) for the intervention group and SKr 3038 (euro 321) for the control group. Of this, healthcare providers' costs were 24% in the intervention group, and 31% in the control group. The physical activity behaviour was significantly improved in both groups, but no differences were found between the groups. Implications. The largest share of the PAP programme costs was the participants' costs. Significant improvements were shown in physical activity behaviour in both groups, but no differences were found between the intervention and control groups. Due to many non-completers, the potential for improvements of the motivating assignment with sedentary individuals in primary healthcare is obvious. Long-term follow-up can determine the sustainability of the results, and can be used in a future cost-effectiveness analysis.
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| 8. |
- Romé, Åsa, et al.
(författare)
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Willingness to pay for health improvements of physical activity on prescription.
- 2010
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38, s. 151-159
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To estimate the willingness to pay for health improvements among participants in the programme "Physical Activity on Prescription". The objective was also to examine predictors such as income, education level, health status, activity level and BMI, differences for long- and short-term health effects of physical activity and differences between a high- and low-intensity activity group. METHODS: Willingness to pay (WTP) data were collected alongside a randomized, controlled trial in Sweden 2007, and 128 sedentary individuals, 20-80 years old (intervention/high-intensity group n = 71, control/low-intensity group n = 57), with lifestyle-related health problems answered open-ended questions in this contingent valuation study. RESULTS: The highest mean WTP (euro59/SEK 552) was stated for an immediate health improvement, but no significant differences compared with long-term health improvements. The high-intensity group showed higher WTP-values for all health improvements, but without significant differences compared with a low-intensity group. Regression analyses show strong associations between a higher level of education and the WTP for improved well-being and improved health, and also between income and the WTP for improved well-being. There are significant correlations between the WTP and the variables BMI, income and education level, as expected from economic theories. CONCLUSIONS: The willingness to pay for the health improvements of exercise is influenced by a higher education level, income and BMI. The highest WTP for a health outcome of physical activity is for an immediate health improvement. The results of this randomized controlled trial in primary health care may be of interest to decision makers when evaluating different approaches to promoting physical activity among people who are sedentary.
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| 9. |
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| 10. |
- Winkel, Annette, et al.
(författare)
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Early discharge to therapy-based rehabilitation at home in patients with stroke. A systematic review
- 2007
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Ingår i: Physical Therapy Reviews. - 1743-288X .- 1083-3196. ; 13:3, s. 167-187
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Tidskriftsartikel (refereegranskat)abstract
- Early discharge and home rehabilitation (EDHR) for stroke patients seems logical as an alternative to rehabilitation in stroke units, as these patients often show impaired ability to perform activities of daily living. The objective of this review is to present the effects of EDHR for stroke patients on health, quality of life and costs, and to describe the physiotherapy provided. Seventeen randomised controlled trials were included, assessed with the PEDro scale and rated using Sackett's rules of scientific evidence. The results showed that EDHR can reduce the length of time spent in hospital. It might improve basic activities of daily living, but is more likely to improve patients' instrumental activities of daily living and quality of life. The context is a core issue for the physiotherapy intervention. Early discharge and home rehabilitation seems to be cost-effective if rehabilitation at home is provided by a multidisciplinary team from a hospital. It is important to consider patients' coping capacities and possible strain on caregivers as contributing factors to the efficacy of EDHR.
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