| 1. |
- Fristedt, Sofi, et al.
(författare)
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Concurrent validity of the Swedish version of the life-space assessment questionnaire
- 2016
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Ingår i: BMC Geriatrics. - : BioMed Central. - 1471-2318 .- 1471-2318. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Life-Space Assessment (LSA), developed in the USA, is an instrument focusing on mobility with respect to reaching different areas defined as life-spaces, extending from the room where the person sleeps to mobility outside one's hometown. A newly translated Swedish version of the LSA (LSA-S) has been tested for test-retest reliability, but the validity remains to be tested. The purpose of the present study was to examine the concurrent validity of the LSA-S, by comparing and correlating the LSA scores to other measures of mobility.METHOD: The LSA was included in a population-based study of health, functioning and mobility among older persons in Sweden, and the present analysis comprised 312 community-dwelling participants. To test the concurrent validity, the LSA scores were compared to a number of other mobility-related variables, including the Short Physical Performance Battery (SPPB) as well as "stair climbing", "transfers", "transportation", "food shopping", "travel for pleasure" and "community activities". The LSA total mean scores for different levels of the other mobility-related variables, and measures of correlation were calculated.RESULTS: Higher LSA total mean scores were observed with higher levels of all the other mobility related variables. Most of the correlations between the LSA and the other mobility variables were large (r = 0.5-1.0) and significant at the 0.01 level. The LSA total score, as well as independent life-space and assistive life-space correlated with transportation (0.63, 0.66, 0.64) and food shopping (0.55, 0.58, 0.55). Assistive life-space also correlated with SPPB (0.47). With respect to maximal life-space, the correlations with the mobility-related variables were generally lower (below 0.5), probably since this aspect of life-space mobility is highly influenced by social support and is not so dependent on the individual's own physical function.CONCLUSION: LSA was shown to be a valid measure of mobility when using the LSA total, independent LS or assistive LSA.
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| 2. |
- Fristedt, Sofi, et al.
(författare)
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Factors Influencing the Use of Evidence-Based Practice among Physiotherapists and Occupational Therapists in Their Clinical Work
- 2016
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Ingår i: The Internet Journal of Allied Health Sciences & Practice. - : NSUWorks. - 1540-580X. ; 14:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Evidence-based practice (EBP) is a process through which research is applied in daily clinical practice. Occupational therapists (OTs) and physiotherapists (PTs) are expected to work in line with EBP in order to optimise health care resources. This expectation is too seldom fulfilled. Consequently, research findings may not be implemented in clinical practice in a timely manner, or at all. To remedy this situation, additional knowledge is needed regarding what factors influence the process of EBP among practitioners. The purpose of the present study was to identify factors that influence the use of EBP and the experienced effects of the use of EBP among PTs and OTs in their clinical work. Method: This was a qualitative interview study that consisted of six group interviews involving either OTs or PTs employed by the Jönköping County Council in the South of Sweden. Resulting data were analysed using content analysis. Results: The analysis resulted in the following categories: “definition of evidence and EBP”, “sources of evidence”, “barriers to acquiring evidence and to using evidence in clinical work”, “factors that facilitate the acquisition of evidence and the use of evidence in clinical work”, and “personal experiences of using EBP”. Basing clinical practice on scientific evidence evoked positive experiences, although an ambivalent view towards acting on clinical experience was evident. Participants reported that time for and increased knowledge about searching for, evaluating, and implementing EBP were needed. Conclusion: Because OTs are more oriented towards professional theories and models, and PTs are more focused on randomised controlled trials of interventions, different strategies appear to be needed to increase EBP in these two professions. Management support was considered vital to the implementation of EBP. However, the personal obligation to work in line with EBP must also be emphasised; the participants apparently underestimate its importance.
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| 3. |
- Fristedt, Sofi, et al.
(författare)
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Life-space mobility and participation in daily activities and social life among older men and women
- 2015
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Konferensbidrag (refereegranskat)abstract
- BackgroundLife-space mobility, i.e., the frequency and independence of transferring to different life-spaces (extending from a person’s bedroom to places beyond hometown), is evident to decrease in later life with potential risk of restricted participation in daily activities and social life. Modes of transport support participation through life-space mobility differently, and older men and women tend to choose different modes. The aim was to identify differences in participation in daily activities and social life related to life-space mobility and gender.MethodsData included the Life-Space Assessment (LSA), transportation, activities of daily living, and community activities. Participants living in their own housing in Sweden (n=312; 147 men, 165 women), aged 75+ (mean age 80), were randomly selected from a population register.ResultLSA total score differed significantly (p<0.001) between men (mean=72) and women (mean=58), and between different modes of transport (p<0.001) with bike users (mean=79) and car drivers (mean=77) reaching the highest LSA total scores. Gender differences were evident related to mode of transport (p<0.001), with men predominantly (74%) driving their own car, while women were driving (32%), going by car as a passenger (32%) or used public transportation (21%). Participation in community activities did not differ significantly between genders, but between LSA total scores (p<0.001). For example, LSA total score was lower for persons taking part in no (mean=55) compared to five (mean=84) community activities at least once a month.ConclusionLife-space mobility is vital to consider when aiming to support continuing participation in daily activities and social life.
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| 4. |
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| 5. |
- Fristedt, Sofi, 1969-, et al.
(författare)
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Physical functioning associated with life-space mobility in later life among men and women
- 2022
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Ingår i: BMC Geriatrics. - London, United Kingdom : BioMed Central. - 1471-2318 .- 1471-2318. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundLife-space mobility is defined as the ability to access different areas extending from the room where the person sleeps to places outside one’s hometown. Life-space mobility is vital to support performance of daily life activities and autonomous participation in social life. However, there is a dearth of research that investigates a wider range of physical functions and functioning in relation to life-space mobility rather than just single aspects. Thus, the purpose of the present study was to identify and describe several measures of physical functioning associated with life-space mobility among older men and women.MethodsData used in this study was derived from the OCTO 2 study, a population-based study of health, functioning and mobility among older persons (n = 312) in Sweden. Associations between Life-Space Assessment (LSA) total score and age, sex, Short Physical Performance Battery (SPPB), dizziness, lung function i.e. Peak Expiratory Flow (PEF), grip strength, self-rated vision and hearing were analysed through bivariate and multivariate regression models.ResultsThe bivariate models showed that life-space mobility was significantly associated with sex, but also age, SPPB, PEF and grip strength in the total group as well as among men and women. In addition, hearing was significantly associated with life-space mobility among women. Those factors that were statistically significant in the bivariate models were further analysed in multivariable models for the total group, and for men and women separately. In these models, sex, grip strength and SPPB remained significantly associated with life-space mobility in the total group, as well as SPPB among both men and women.ConclusionSex, physical function in terms of physical performance measured by SPPB (balance, gait speed and chair stand), and grip strength are associated with life-space mobility. Consequently, these factors need to be considered in assessments and interventions aiming to maintain mobility in old age.
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| 6. |
- Fristedt, Sofi, 1969-, et al.
(författare)
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Validitet och reliabilitet för Life-Space Assessment (LSA) - ett instrument för bedömning av äldre personers mobilitet
- 2015
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Konferensbidrag (refereegranskat)abstract
- Bakgrund: Förmågan och möjligheter att förflytta (mobilitet) begränsas ofta i senare delen av livet, med negativa konsekvenser fördelaktighet i dagliga och sociala aktiviteter. Såväl i praktisk verksamhet som för forskning behövs instrument som kanbedöma mobilitet. The Life Space Assessment (LSA), utvecklat i USA, är bedömer en individs mobilitet genom attfokusera på förmågan att ta sig till olika “life-spaces”, från rummet där personen sover till platser bortom hemorten undersenaste månaden. LSA beaktar dessutom hur ofta detta sker, och om det sker med hjälpmedel eller hjälp av annanperson.Syfte: Syftet var att undersöka samtidig validitet och testa reliabilitet av LSAs svenska version.Metod: LSA översattes till svenska och inkluderades tillsammans med andra hälsorelaterade mått i en populationsbaserad studiemed slumpmässigt utvalda personer mellan 75 och 90 år (medelålder 81 år) i enskilt boende. LSA summerades till fyrapoängsummor, dvs total, oberoende, assisterad och maximal life-space poäng. 298 individer ingick i reliabilitetstudienoch besvarade LSA vid två tillfällen med 14 dagars mellanrum. 312 individer ingick i validitetsstudien där LSA jämfördesmed andra mobilitetsrelaterade mått.Resultat/preliminärt resultat: Det fanns inga signifikanta skillnader mellan skattningarna över tid för LSA fyra poängsummor. Medelvärdet för total life-space poäng var t ex 65 (22) och 65 (23) (max 120). Korrelationsvärden (ICC) mellan 0.84-0.94 visar på god till utmärktreliabilitet för total, oberoende och assisterad LSA. Vad gäller validitet påvisas signifikanta (p<0.01) och måttligt till godakorrelationer (0.50- 0.75) mellan LSAs fyra poängsummor och förmåga till förflyttning (överflyttning, balans, uppresningoch gångförmåga), transport (vardagliga resor och nöjesresor), och aktivitet i samhället (inköp och fritid)Slutsats: Den svenska versionen av LSA har god validitet samt god till utmärkt reliabilitet och kan med förtroende användas för attbedöma mobilitet hos äldre i enskilt boende.
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| 7. |
- Kammerlind, Ann-Sofi, et al.
(författare)
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Test–retest reliability of the Swedish version of the life-space assessment questionnaire among community-dwelling older adults
- 2014
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 28:8, s. 817-823
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the test–retest reliability of the Swedish version of the Life-Space Assessment Questionnaire.Design: Test–retest reliability study.Subjects: A total of 298 community-dwelling subjects between 75 and 90 years of age.Methods: The Life-Space Assessment Questionnaire was translated into Swedish. By personal interviews during home visits and two weeks later by telephone interviews the subjects were asked about their life-space mobility during the past four weeks, and how often and whether they were independent or needed assistance from another person or equipment to reach different life-space levels.Results: None of the four scoring methods showed significant difference between test sessions. The mean (SD) total scores were 65 (22) and 65 (23) out of the maximum possible score of 120 at the two sessions. High levels were found for independent, assisted, and maximal life-space at both sessions. Intraclass correlation coefficients and weighted Kappa-values between 0.84–0.94 were found for the total score, the independent, and the assisted life-space levels, indicating good to excellent reliability. A lower Kappa-value was observed for the maximal life-space level, mainly owing to skewed distributions. The method error values showed that a change of 10 in the total score and a change of one level in any of the three life-space levels can be considered to indicate a real change in clinical practice.Conclusion: The Swedish version of the Life-Space Assessment Questionnaire can be reliably used among community-dwelling older adults.
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| 8. |
- Areskoug Josefsson, Kristina, et al.
(författare)
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Evidence-based practice in a multiprofessional context
- 2012
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Ingår i: International Journal of Evidence-Based Healthcare. - : Ovid Technologies (Wolters Kluwer Health). - 1744-1595 .- 1744-1609. ; 10:2, s. 117-125
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Tidskriftsartikel (refereegranskat)abstract
- Background Healthcare today is a complex system with increasing needs of specific knowledge of evaluation of research and implementation into clinical practice. A critical issue is that we all apply evidence-based practice (EBP) with standardised methods and continuing and systematic improvements. EBP includes both scientific and critical assessed experience-based knowledge. For the individual, this means applying evidence-based knowledge to a specific situation, and for the organisation, it means catering for a systematic critical review and evaluation and compiling research into guidelines and programmes. In 2009, the County Council of Jönköping had approximately 335 000 inhabitants and the healthcare organisation had more than 10 000 employees. As the County Council actively promotes clinical improvement, it is interesting to explore how healthcare employees think about and act upon EBP. The aim of this survey was therefore to describe factors that facilitate or hinder the application of EBP in the clinical context.Method A quantitative study was performed with a questionnaire to healthcare staff employed in the County Council of Jönköping in 2009. The questionnaire consisted of questions concerning which factors are experienced to affect the development of evidence-based healthcare. There were 59 open and closed questions, divided into the following areas:• Sources of knowledge used in practice• Barriers to finding and evaluating research reports and guidelines• Barriers to changing practice on the basis of best evidence• Facilitating factors for changing practice on the basis of best evidence• Experience in finding, evaluating and using different sources of evidenceThe participants were selected using the county council's staff database and included medical, caring and rehabilitative staff within hospitals, primary care, dentistry and laboratory medicine. The inclusion criteria were permanent employment and clinical work. Invitations were sent to 5787 persons to participate in the study and 1445 persons answered the questionnaire.Results Knowledge used in daily clinical practice was mainly based on information about the patient, personal experience and local guidelines. Twenty per cent answered that they worked ‘in the way they always had’, and 11% responded that they used evidence from research as a basis for change. The participants experienced that EBP was not used enough in clinical healthcare and explained this with practical and structural barriers, which they thought should be better monitored by the organisation and directors.Conclusion Overall, the results indicate that the scientific evidence for healthcare is not used sufficiently as a base for decisions in daily practice as well as for changing practice. This is more prominent among assistant staff. As a consequence, this might affect the care of the patients in a negative way. Increased awareness of EBP and a stronger evidence-based approach are keys in the ongoing improvement work in the county. Local guidelines seem to be a way to implement knowledge. But, as the arena of activities is complex and the employees have diverse education levels, different strategies to facilitate and promote EBP are necessary.
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| 9. |
- Davidson, Thomas, et al.
(författare)
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Robot-assisted pelvic and renal surgery compared with laparoscopic or open surgery: Literature review of cost-effectiveness and clinical outcomes
- 2023
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Ingår i: Scandinavian Journal of Surgery. - : SAGE PUBLICATIONS LTD. - 1457-4969 .- 1799-7267.
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Forskningsöversikt (refereegranskat)abstract
- Background and aim: The purpose of this study was to evaluate clinical experiences and cost-effectiveness by comparing robot-assisted surgery with laparoscopic- or open surgery for pelvic and renal operations. Methods: A narrative review was carried out. Results: When using robotic-assisted surgery, oncological and functional results are similar to after laparoscopic or open surgery. One exception may be a shorter survival in cancer of the cervix uteri. In addition, postoperative complications after robotic-assisted surgery are similar, bleeding and transfusion needs are less, and the hospital stay is shorter but the preparation of the operating theater before and after surgery and the operation times are longer. Finally, robot-assisted surgery has, in several studies, been reported to be not cost-effective primarily due to high investment costs. However, more recent studies provide improved cost-effectiveness estimates due to more effective preparation of the operating theater before surgery, improved surgeon experience, and decreased investment costs. Conclusions: Complications and functional and oncological outcomes after robot-assisted surgery are similar to open surgery and laparoscopic surgery. The cost-effectiveness of robot-assisted surgery is likely to equal or surpass the alternatives.
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| 10. |
- Gustafsson, Kristin, 1976-, et al.
(författare)
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Written instructions versus physiotherapist-supervised rehabilitation after acute ankle sprain
- 2017
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Ingår i: European Journal of Physiotherapy. - : Taylor & Francis Group. - 2167-9169 .- 2167-9177. ; 19:2, s. 76-83
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to compare the effects of written instructions (WIs) versus physiotherapist-supervised rehabilitation on patient-rated ankle function, satisfaction and physical activity ability after an acute ankle sprain. Thirty-nine patients with an acute ankle sprain, recruited from an emergency department, received WIs on functional rehabilitation (WI group). The patients were evaluated six weeks and three months after their injury with the disease-specific Foot and Ankle Outcome Score (FAOS). The patients also rated how satisfied they were with their ankle and physical activity ability using visual analogue scales. The results from the WI group were compared with a group of patients (n ¼ 33) who received physiotherapist-supervised rehabilitation in a previous study (PT group). We found that compared with the PT group, the WI group had significantly worse scores in all of the FAOS subscales six weeks after the injury, and in three of five subscales three months after the injury. They also rated significantly lower satisfaction and significantly lower physical activity ability at both follow-ups. In conclusion, physiotherapist-supervised rehabilitation was more effective than WIs on improving patient-rated ankle function, satisfaction and physical activity ability after an acute ankle sprain.
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