| 1. |
- Cederfeldt, Marie, 1957, et al.
(författare)
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Concurrent validity of the Executive Function Performance Test in people with mild stroke
- 2011
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Ingår i: The British Journal of Occupational Therapy. - 0308-0226 .- 1477-6006. ; 74:9, s. 443-449
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Studies have shown that executive dysfunction is common in adults after stroke. Occupational therapists working in acute care assess the performance of activities of daily living; most instruments focus on personal care. However, the assessment of instrumental activities of daily living has been shown to discriminate executive dysfunction more effectively. An instrument for assessing executive dysfunction in more complex activities that is easy to handle in acute care is consequently required for clinical use. The Executive Function Performance Test (EFPT) was recently introduced into Sweden. The purpose of this study was to evaluate the concurrent validity of the EFPT in acute care for patients with mild stroke. Method: Twenty-three patients from an acute stroke unit were assessed with both the EFPT and the Assessment of Motor and Process Skills (AMPS). Results: The correlation between the EFPT and the AMPS assessments was highly significant (p = 0.003) and the concurrent validity was rho = 0.61. Conclusion: Since there is a risk that adult patients with mild stroke are discharged without rehabilitation, and there is a lack of a relevant instrument for occupational therapists that discriminates executive dysfunction in acute stroke care, the EFPT may be a suitable instrument to use with these patients.
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| 2. |
- Cederfeldt, Marie, 1957, et al.
(författare)
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Influence of cognition on personal activities of daily living (P-ADL) in the acute phase: the Gothenburg Cognitive Stroke Study in Elderly.
- 2009
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Ingår i: Archives of gerontology and geriatrics. - : Elsevier BV. - 1872-6976 .- 0167-4943. ; 49:1, s. 118-22
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Tidskriftsartikel (refereegranskat)abstract
- This study examines how prestroke dementia and cognitive dysfunction after stroke influence the personal activities of daily living (P-ADL) in elderly patients in the acute phase after stroke. Elderly stroke patients (n=60) referred to geriatric rehabilitation were included. Assessments were carried out at admission and evaluated at discharge from the geriatric ward. The median age of the group was 77 years. Astrand's questionnaire was used to interview a close relative about the patient's prestroke cognitive status. P-ADL was assessed with the Barthel Index (BI). The Mini Mental State Examination (MMSE) and a neuropsychological test battery were used to measure cognitive functions. Analyses were made using non-parametrical methods. In the acute phase after stroke, neither the presence of prestroke dementia nor the cognitive status after stroke onset among these elderly patients influenced P-ADL at admission or at discharge. Prestroke dementia and cognitive dysfunction's were found to be common after stroke onset, however this did not have any impact on dependence in P-ADL in these elderly patients at admission or at discharge.
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| 3. |
- Cederfeldt, Marie, 1957, et al.
(författare)
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Recovery in personal care related to cognitive impairment before and after stroke - a one-year follow-up
- 2010
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 122:6, s. 430-437
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective: To examine whether there were any differences in the recovery in performance of personal activities of daily living (P-ADL) in elderly persons in relation to cognitive impairments pre- and poststroke from discharge to 6 and 12 months in elderly persons. Methods: Forty-five elderly persons after stroke were assessed at discharge from hospital and at 6 and at 12 months after stroke onset. A questionnaire posed to the next of kin was used to evaluate the person´s pre- and poststroke cognitive status. P-ADL was assessed with the Barthel Index. The Mini Mental State Examination and neuropsychological tests were used to measure cognitive functions after stroke. The National Institute of Health Stroke Scale was used to measure neurological deficits. Results: Persons with cognitive impairments before and after stroke did not improve in P-ADL from the acute phase until 6 and 12 months, while persons with intact cognition pre- and post stroke did. Conclusion: Since cognitive problems pre- and poststroke hinder recovery in P-ADL, it is important to understand the connection between cognitive impairment and activity limitations when planning the optimal rehabilitation, which could include special compensation strategies, learnt by the patients, cognitive assistive devices and/or appropriate personal support trained in meaningful activities in daily life in their natural environment.
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| 4. |
- Wilhelmson, Katarina, 1958, et al.
(författare)
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Design of a randomized controlled study of a multi-professional and multidimensional intervention targeting frail elderly people.
- 2011
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Ingår i: BMC geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: Frail elderly people need an integrated and coordinated care. The two-armed study "Continuum of care for frail elderly people" is a multi-professional and multidimensional intervention for frail community-dwelling elderly people. It was designed to evaluate whether the intervention programme for frail elderly people can reduce the number of visits to hospital, increase satisfaction with health and social care and maintain functional abilities. The implementation process is explored and analysed along with the intervention. In this paper we present the study design, the intervention and the outcome measures as well as the baseline characteristics of the study participants. Methods/design: The study is a randomised two-armed controlled trial with follow ups at 3, 6 and 12 months. The study group includes elderly people who sought care at the emergency ward and discharged to their own homes in the community. Inclusion criteria were 80 years and older or 65 to 79 years with at least one chronic disease and dependent in at least one activity of daily living. Exclusion criteria were acute severely illness with an immediate need of the assessment and treatment by a physician, severe cognitive impairment and palliative care. The intention was that the study group should comprise a representative sample of frail elderly people at a high risk of future health care consumption. The intervention includes an early geriatric assessment, early family support, a case manager in the community with a multi-professional team and the involvement of the elderly people and their relatives in the planning process. DISCUSSION: The design of the study, the randomisation procedure and the protocol meetings were intended to ensure the quality of the study. The implementation of the intervention programme is followed and analysed throughout the whole study, which enables us to generate knowledge on the process of implementing complex interventions. The intervention contributes to early recognition of both the elderly peoples' needs of information, care and rehabilitation and of informal caregivers' need of support and information. This study is expected to show positive effects on frail elderly peoples' health care consumption, functional abilities and satisfaction with health and social care. Trial registration: ClinicalTrials.gov, NCT01260493.
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