| 1. |
- Ehn, Maria, et al.
(author)
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SALUTOGEN : User-center development and prototype testing of a system supporting seniors’ physical activity for fall prevention
- 2019
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Conference paper (peer-reviewed)abstract
- Background:Physical activity (PA) can contribute to fall prevention among seniors. Many seniors need to increase their PA and regularly perform balance-enhancing activities. Changing behavior is often challenging, especially long-term. Therefore, support for change and long-term maintenance of PA behavior contributing to fall prevention is essential. Technology-based applications are widely exploited to support PA but do not match seniors’ needs. Therefore, new solutions are needed that support seniors’ PA for fall prevention leveraging theory for behavioral change and the specific target user’ needs.Aim, Method:SALUTOGEN is a research and innovation project aiming to develop and test a system prototype of technology-based motivation support for seniors’ PA including balance training. The developed technology includes apps for tablet and mobile phone that together provide seniors with motivation support for PA, activity measurement and video-coaching. The project is based on iterative user-centered methodology including: development of needed app components; evaluation of single apps and their integration; pilot feasibility evaluation with seniors and coaches in real world settings. Results:Valuable feedback from seniors was collected and used in the iterative development, especially from the motivation support perspective. The evaluation showed that the apps must be very intuitive and easy to understand. Preliminary results from the on-going pilot evaluation indicate that the coaching is highly appreciated by seniors and coaches. Moreover, the seniors’ and coaches’ experience in using the technology highly depends on the technology’s usability and reliability. Conclusions:Technology-based interventions can play an important role in supporting seniors’ PA for fall prevention. Results from the project indicate that solution’s key elements are perceived important and appreciated by seniors and coaches. However, it is crucial for the users that the technical applications are light, intuitive and robust.
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| 2. |
- Ehn, Maria, et al.
(author)
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Technology-Based Motivation Support for Seniors' Physical Activity-A Qualitative Study on Seniors' and Health Care Professionals' Views
- 2019
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In: International Journal of Environmental Research and Public Health. - : NLM (Medline). - 1661-7827 .- 1660-4601. ; 16:13
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Journal article (peer-reviewed)abstract
- This paper investigates seniors' and health care professionals' (HCPs) perceptions on needed contributions and qualities of digital technology-based motivation support for seniors' physical activity (PA). Seniors and HCPs expressed their views in focus groups, which were analyzed separately by inductive content analysis. Similarities and differences in seniors' and HCPs' views were identified through thematic analysis of qualitative results from both focus groups. This article's main findings are that both seniors and HCPs believed digital technology should support and make PA more enjoyable in ways to strengthen seniors' control and well-being. However, seniors emphasized support for social interaction, while HCPs also requested support for increasing seniors' insight into PA and for facilitating their dialogue with seniors. Conclusions to be drawn are that seniors and HPCs shared overall views on digital technology's main contributions but had different perspectives on how those contributions could be obtained. This highlights the importance of the early identification of user groups and exploration of their different needs when developing new solutions. Moreover, seniors' and HCPs' perceptions included aspects relevant for personal motivation, technology acceptance, and PA behavioral change according to self-determination theory, unified theory of acceptance and use of technology, and behavioral change techniques for increasing PA.
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| 3. |
- Hedelin, Maria, et al.
(author)
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Dietary intake of phytoestrogens, estrogen receptor-beta polymorphisms and the risk of prostate cancer
- 2006
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In: The Prostate. - Karolinska Inst, Dept Med Epidemiol & Biostat, SE-17177 Stockholm, Sweden. Orebro Univ Hosp, Dept Urol, Orebro, Sweden. Ctr Assessment Med Technol, Orebro, Sweden. Umea Univ, Dept Radiat Sci Oncol, Umea, Sweden. Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA. : Wiley-Liss. - 0270-4137 .- 1097-0045. ; 66:14, s. 1512-1520
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Journal article (peer-reviewed)abstract
- BACKGROUND: The causes of prostate cancer are poorly understood, but genetic factors may be more important than for many other malignancies, and dietary phytoestrogens may be protective. Because phytoestrogens bind tightly to the estrogen receptor-beta, we conducted an epidemiologic investigation of synergistic effects between phytoestrogen intake and estrogen receptor-beta gene polymorphisms. METHODS: We performed a population-based case-control study in Sweden. All participants reported their phytoestrogen intake and donated a blood sample. We identified four haplotype-tagging single nucleotide polymorphisms (htSNPs) and genotyped these htSNPs in 1314 prostate cancer patients and 782 controls. Odds ratios were estimated by multivariate logistic regression. Interactions between phytoestrogen intake and estrogen receptor-beta SNPs on prostate cancer risk were evaluated considering both multiplicative and additive effect scales. RESULTS: We found a significant multiplicative interaction (P = 0.04) between dietary intake of phytoestrogens and a promoter SNP in the estrogen receptor-beta gene (rs 2987983-13950), but not with any of the three other htSNPs (P = 0.11, 0.69, 0.85). Among carriers of the variant promoter alleles, we found strong inverse associations with increasing intake of total phytoestrogens (odds ratio for highest vs. lowest quartile = 0.43; P for trend <0.001), isoflavonoids (odds ratio = 0.63; P for trend = 0.05), and coumestrol (odds ratio = 0.57; P for trend = 0.003). We found no association between phytoestrogens and prostate cancer among carriers homozygous for the wild-type allele (TT). CONCLUSIONS: Our study provides strong evidence that high intake of phytoestrogens substantially reduce prostate cancer risk among men with specific polymorphic variation in the promoter region of the estrogen receptor-beta gene.
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| 4. |
- Hedelin, Maria, et al.
(author)
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Dietary phytoestrogen, serum enterolactone and risk of prostate cancer : the cancer prostate Sweden study (Sweden)
- 2006
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In: Cancer Causes and Control. - Karolinska Inst, Dept Med Epidemiol & Biostat, SE-17177 Stockholm, Sweden. Orebro Univ Hosp, Dept Urol, Orebro, Sweden. Ctr Assessment Med Technol, Orebro, Sweden. Univ Helsinki, Dept Clin Chem, SF-00100 Helsinki, Finland. Univ Helsinki, Inst Prevent Med Nutr & Canc, Folkhalsan Res Ctr, Helsinki, Finland. Umea Univ, Dept Radiat Sci Oncol, Umea, Sweden. : Springer. - 0957-5243 .- 1573-7225. ; 17:2, s. 169-180
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Based on evidence that phytoestrogens may protect against prostate cancer, we evaluated the associations between serum enterolactone concentration or dietary phytoestrogen intake and risk of prostate cancer. METHODS: In our Swedish population-based case-control study, questionnaire-data were available for 1,499 prostate cancer cases and 1,130 controls, with serum enterolactone levels in a sub-group of 209 cases and 214 controls. Unconditional logistic regression was performed to estimate multivariate odds ratios (ORs) and 95% confidence intervals (CIs) for associations with risk of prostate cancer. RESULTS: High intake of food items rich in phytoestrogens was associated with a decreased risk of prostate cancer. The OR comparing the highest to the lowest quartile of intake was 0.74 (95% CI: 0.57-0.95; p-value for trend: 0.01). In contrast, we found no association between dietary intake of total or individual lignans or isoflavonoids and risk of prostate cancer. Intermediate serum levels of enterolactone were associated with a decreased risk of prostate cancer. The ORs comparing increasing quartiles of serum enterolactone concentration to the lowest quartile were, respectively, 0.28 (95% CI: 0.15-0.55), 0.63 (95% CI: 0.35-1.14) and 0.74 (95% CI: 0.41-1.32). CONCLUSIONS: Our results support the hypothesis that certain foods high in phytoestrogens are associated with a lower risk of prostate cancer.
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| 5. |
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| 6. |
- Revenäs, Åsa, et al.
(author)
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A randomized study of two physiotherapeutic approaches after kneeligament reconstruction
- 2009
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In: Advances in Physiotherapy. - : Informa UK Limited. - 1403-8196 .- 1651-1948. ; 11, s. 30-41
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Journal article (peer-reviewed)abstract
- Little is known about whether physiotherapeutic knee classes provide additional benefits in the rehabilitation after anterior cruciate ligament reconstruction (ACLR). In the present randomized study, we compare the results of a hospital-based programme, Knee-class Therapy (KT), with an individual programme with limited physiotherapy appointments, Guided Therapy (GT), 6 and 12 months after knee surgery, in terms of function, activity level, muscle strength, knee-joint stability and knee-joint mobility. After ACLR, 24 patients were randomized to the KT group and 27 to the GT group. Fourteen patients in the KT group and 24 in the GT group completed the physiotherapy appointments as prescribed. At 6 months after surgery, the median Lysholm knee score was significantly higher in the KT group. At the 12-month follow-up, the GT group’s improvement in the Lysholm knee score was significantly greater than the KT group’s. Non-compliance was high in the KT group. The subgroup analysis of the non-compliers in the KT group showed that their improvement in the Lysholm knee score between 0 and 12 months was significantly greater than that of the KT group’s compliers. These results could indicate that an individual exercise programme with limited physiotherapy appointments might be as effective asphysiotherapeutic knee classes.
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| 7. |
- Revenäs, Åsa, et al.
(author)
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Integrating key user characteristics in user-centered design of digital support systems for seniors’ physical activity interventions to prevent falls : Protocol for a usability study
- 2020
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In: JMIR Research Protocols. - : JMIR Publications Inc.. - 1929-0748. ; 9:12
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Journal article (peer-reviewed)abstract
- Background: The goal of user-centered design (UCD) is to understand the users’ perspective and to use that knowledge to shape more effective solutions. The UCD approach provides insight into users’ needs and requirements and thereby improves the design of the developed services. However, involving users in the development process does not guarantee that feedback from different subgroups of users will shape the development in ways that will make the solutions more useful for the entire target user population. Objective: The aim of this study was to describe a protocol for systematic analysis and prioritization of feedback from user subgroups in the usability testing of a digital motivation support for fall-preventive physical activity (PA) interventions in seniors (aged 65 years and older). This protocol can help researchers and developers to systematically exploit feedback from relevant user subgroups in UCD. Methods: Gender, PA level, and level of technology experience have been identified in the literature to influence users’ experience and use of digital support systems for fall-preventive PA interventions in seniors. These 3 key user characteristics were dichotomized and used to define 8 (ie, 23) possible user subgroups. The presented method enables systematic tracking of the user subgroups’ contributions in iterative development. The method comprises (1) compilation of difficulties and deficiencies in the digital applications identified in usability testing, (2) clustering of the identified difficulties and deficiencies, and (3) prioritization of deficiencies to be rectified. Tracking user subgroup representation in the user feedback ensures that the development process is prioritized according to the needs of different subgroups. Mainly qualitative data collection methods are used. Results: A protocol was developed to ensure that feedback from users representing all possible variants of 3 selected key user characteristics (gender, PA level, and level of technology experience) is considered in the iterative usability testing of a digital support for seniors’ PA. The method was applied in iterative usability testing of two digital applications during spring/summer 2018. Results from the study on the users’ experiences and the iterative modification of the digital applications are expected to be published during 2021. Conclusions: Methods for systematic collection, analysis, and prioritization of feedback from user subgroups might be particularly important in heterogenous user groups (eg, seniors). This study can contribute to identifying and improving the understanding of potential differences between user subgroups of seniors in their use and experiences of digital support for fall-preventive PA interventions. This knowledge may be relevant for developing digital support systems that are appropriate, useful, and attractive to users and for enabling the design of digital support systems that target specific user subgroups (ie, tailoring of the support). The protocol needs to be further used and investigated in order to validate its potential value.
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| 8. |
- Sandborgh, Maria, 1955-, et al.
(author)
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Integration of Behavioral Medicine Competencies into Physical Therapy Curriculum in an Exemplary Swedish Program : Rationale, Process and Ten-year Review
- 2020
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In: Physiotherapy Theory and Practice. - Philadelphia : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 36:3, s. 365-377
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Research review (peer-reviewed)abstract
- In 2004, Mälardalen University, Sweden, introduced a new undergraduate entry-level physiotherapy program. Program developers constructed the curriculum with behavioral medicine content that reflected the contemporary definition and values of the physiotherapy profession aligning it with current best practices, evidence, and the International Classification of Functioning, Disability, and Health (ICF). The new curriculum conceptualized movement and function as modifiable behaviors in that they reflect behavioral contingencies, perceptions, beliefs, and lifestyle factors as well as pathophysiology and environmental factors. The purpose of this article is to describe how one university accordingly structured its new curriculum and its review. We describe the rationale for the curriculum's behavioral medicinecontent and competencies, its development and implementation, challenges, long-term outcomes, and its related research enterprise. We conclude that physiotherapy practiced by our graduates augments that taught in other programs based on accreditation reviews. With their expanded practice scope, graduates are systematically practicing within the constructs of health and function conceptualized within the ICF. Our intent in sharing our experience is to exemplify one university's initiative to best prepare students with respect to maximizing physiotherapy outcomes as well as establish a dialogue regarding minimum standards of behavioral medicine competencies in physiotherapy education and practice.
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| 9. |
- Svedberg, Petra, 1973-, et al.
(author)
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Psychometric evaluation of “The 25-item Sex after MI Knowledge Test” in a Swedish context
- 2012
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In: Scandinavian Journal of Caring Sciences. - Malden, USA : Wiley. - 0283-9318 .- 1471-6712. ; 26:1, s. 203-208
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Journal article (peer-reviewed)abstract
- The patients’ sexual life after a myocardial infarction is important for his/her quality of life. In spite of this, many patients are in doubt regarding their sex life after a myocardial infarction (MI) and the sexual information received, and counselling from health care providers has been seen to be insufficient. The purpose of this study was to evaluate the psychometric properties of ‘The 25-item Sex after MI Knowledge Test’ in a Swedish context. A convenience sample was recruited. The scale was translated into Swedish and completed by 79 former patients from The Heart and Lung Patients’ National Association on two occasions, with an interval of 2 weeks. The scale was tested for face and content validity, internal consistency and test–retest reliability. The result in this study indicates that the instrument has good face and content validity and displayed a moderate internal consistency (alpha 0.61). The instrument showed some level of instability in test–retest reliability with 60% of the items presenting moderate or strong agreement between the test and retest. Further studies that use this instrument in larger and more diverse samples are thus needed.
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| 10. |
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Vårdvetenskapliga vägskäl
- 2008
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Editorial collection (other academic/artistic)abstract
- Denna vårdvetenskapliga jubileumsskrift tar läsaren med på en resa genom den utveckling som skett av ämnet vid forskarutbildning i vårdvetenskap vid Växjö universitet. Många bäckar små… ett talesätt som kan illustrera det gemensamma arbete och den samlade kunskap som ligger bakom denna skrift. I skriften får vi stifta bekantskap med vårdvetenskapen i varierande kontexter alltifrån rättpsykiatri till akut- och hemsjukvård. Sammanställningen av den vårdvetenskapliga forskning som under denna femårsperiod har gjorts på IVOSA visar att vårdvetenskapen är en autonom vetenskap med en tydlig substans eller kärna. I kärnan finns patienten, och ämnet tar sin utgångspunkt i människors existens. Med fokus på människan som är i behov av vård framträder lidande, hälsa och välbefinnande som väsentliga begrepp. I bokens delar fördjupas och kontextualiseras vårdvetenskapen i skiftande vårdande liksom lärande miljöer. En vårdvetenskap med grund i ett patientperspektiv behövs såväl akademiskt som i vården för att anta både dagens och morgondagens utmaningar.
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