| 1. |
- Gustafsson, Susanne, 1963, et al.
(författare)
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A Cross-Cultural Adaptation of the ICECAP-O: Reliability and Validity in Swedish 70-Year-Old Persons
- 2017
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Ingår i: 21st International Association of Gerontology and Geriatrics (IAGG) World Congress, July 23-27, 2017 San Francisco, California. Innovation in Aging, 1 (S1), s. 752. - : Oxford University Press (OUP). - 2399-5300.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Few Quality of Life (QoL) measures tap into the concept of capability, i.e. genuine opportunities to 'do' and 'be' the things that a person deems important in life. The ICECAP-O is one such instrument. This presentation includes test-retest reliability, item relevance, face- and content validity, and accessibility of the ICECAP-O in a Swedish context. Thirty-nine 70-year-olds who took part in a population-based study completed the Swedish version of the ICECAP-O on two occasions, and another 18 partook in cognitive interviews. Test-retest reliability was analyzed for the index and separate items, and participants rated item relevance on a Visual Analogue Scale. A standardized classification scheme was used to quantify any identified response problems, and a thematic analysis was applied to capture participants’ experiences of completing the measure and perceptions of included attributes. Test-retest showed that the index score had good stability, ICC of 0.80 (95 % CI 0.62-0.90). However, Kappa was low for each separate item, and ranged from 0.18 (Control) to 0.41 (Role). Participants gave their highest relevance rating to Attachment and the lowest to Enjoyment. In the cognitive interviews, three participants (18%) had problems completing ICECAP-O, and out of 80 question segments, judged problems occurred for five (6%). Most participants perceived the attributes as understandable even though the meaning of Control brought some uncertainty. ICECAP-O has potential for becoming a valuable addition to the supply of QoL measures in research and health and social care in Sweden. However, we recommend further research on more diverse groups of older person.
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| 2. |
- Ottenvall Hammar, Isabelle, 1984, et al.
(författare)
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Erfarenheter av självbestämmande hos personer som nyligen utvecklat ett beroende i dagliga aktiviteter
- 2013
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Ingår i: AT-Forum (Arbetsterapeuternas nationella konferens). Stockholm, 24-25 april 2013 (Muntlig presentation).
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Övergången från att vara oberoende till att utveckla sårbarhet och beroende av annan person i dagliga aktiviteter kan vara fylld med utmaningar. I takt med att en person utvecklar ett beroende, kan möjligheten till självbestämmande i dagliga aktiviteter försämras vilket kan upplevas stressande för den äldre personen. Äldre som är beroende uttrycker ett behov att kunna fortsätta vara delaktiga i beslutsfattande som rör dagliga aktiviteter. För att äldre ska kunna bibehålla god hälsa och välbefinnande är det viktigt att de involveras och tillåts att ta beslut som rör deras dagliga aktiviteter. Hälso- och sjukvårdspersonal är medvetna om vikten av äldres rätt till självbestämmande, dock påvisar studier att professionella efterfrågar mera kunskap om äldres erfarenheter för att kunna stödja de äldre till ökat självbestämmande. Syfte: Att undersöka erfarenheter av självbestämmande vid övergången från oberoende till beroende av annan person i daglig aktivitet hos personer 80 år och äldre. Tillvägagångssätt och analys: En explorativ design baserad på Grounded Theory beskriven av Charmaz används i studien. Semistrukturerade intevjuer kommer att genomföras på ca 15 personer i åldern 80 år och äldre som börjat uppleva svårigheter i dagliga aktiviteter eller som utvecklat ett beroende i minst en Instrumentell Daglig Aktivitet (I-ADL) och/eller minst en Personlig Daglig Aktivitet (P-ADL) enligt ADL-trappan. Insamlad data kommer att analyseras med Grounded Theory. Både intervjuer och analys av data har påbörjats. Resultat/förväntat resultat: Studien förväntas ge en förståelse för hur personer vilka är 80 år och äldre erfar sitt självbestämmande vid övergången från oberoende till beroende av annan person i daglig aktivitet. Slutsatser: Förväntat resultat kommer att leda till ökad kunskap om hur personal inom hälso- och sjukvården kan stödja äldre personer som är i övergången till att utveckla ett beroende i dagliga aktiviteter till ökat självbestämmande.
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| 3. |
- Ottenvall Hammar, Isabelle, 1984, et al.
(författare)
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Governing or being governed: Older persons' experiences of self-determination
- 2014
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Ingår i: Age Well - 22nd Nordic Congress of Gerontology, 25-28 maj, Göteborg, Sverige.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: In Sweden it is a legal right for older persons to exercise self-determination. Exercising self-determination is also important for older persons’ health and well-being. Health professionals are in general aware of the importance, but research shows that older persons’ self-determination is not fully respected within the health care sector. Research on self-determination from the perspective of older persons who are in the beginning to develop dependence in daily activities is limited. In order to deepen the knowledge of older persons own experiences in this process, further studies are needed. Aim: The aim of this study was to explore experiences of self-determination when developing dependence in daily activities among community-dwelling persons 80 years and older. Method: Qualitative interviews with 11 persons aged 84-95 years who were in the beginning to experience difficulties in daily activities were performed in accordance with the constructivist grounded theory method. Results: The core category, shifting between governing oneself or being governed by others, illustrates the complexity and the shifting of the experiences during the development of dependence. The categories struggling against the aging body, guarding one’s own independence and transferring the performance highlights different ways of governing in one’s life, whereas exercising self-determination is in the hands of others is a result of the increasing dependence. Conclusions: For community-dwelling older persons, the social context and the ageing body may influence the possibilities to exercise self-determination in daily life. Professionals and health care providers should enable and encourage older persons to exercise self-determination related their own healthcare.
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| 4. |
- Ottenvall Hammar, Isabelle, 1984
(författare)
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Navigating towards a self-determined daily life in old age. Experiences, instrument evaluation and explanatory factors.
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim of this thesis was to explore self-determination in the context of community-dwelling older persons with different degrees of dependence in daily activities. Methods: Using a qualitative, grounded design, study I explored how people 80 years and older experienced their self-determination when developing dependence in daily activities. Study II employed a qualitative and quantitative design where the validity of the questionnaire Impact on Participation and Autonomy (IPA-S) was tested using focus group discussions and individual interviews. The participants were aged 70 years and older. The focus groups were followed by a reliability test-retest of the adjusted version (IPA-O) on persons in the same age. Study III and IV applied an exploratory, cross-sectional design where two sets of data were combined, resulting in a sample of persons aged 80 years and older. Perceived self-determination in daily life was explored in relation to degree of dependence in daily activities (study III) and in relation to a set of explanatory factors (study IV). Results: The results showed that self-determination was experienced as constantly shifting between self-governing and being governed by the ageing body or by other persons. This shift gave rise to a struggle against the ageing body and a need to constantly guard one’s own independence. The relationship had an impact on the person’s possibilities to make decisions; that is, decision-making was relational (study I). The validity test showed that the items within the IPA-S were important and relevant, but the questionnaire was too extensive and focused on the executional part of the activities. The IPA-S was adjusted to a version entitled IPA-O (-Older persons) consisting of fewer items with emphasises on the decisional part. The reliability test-retest step showed that 15 of the 22 items within the IPA-O had high agreement and six items had moderate agreement. One item showed low agreement between the test and retest (study II). People dependent in activities of daily living (ADL) showed a general pattern of perceiving reduced self-determination in daily life. Perceptions of reduced self-determination were most pronounced among people dependent in personal activities of daily living (P-ADL) (study III). However, the association between dependence in ADL and reduced self-determination was not statistically significant. The final regression model showed that the explanatory factors of high education, frailty, poor self-rated health, unsatisfaction with physical health, and receiving help from public home care service were significantly associated with perceiving reduced self-determination (study IV). Conclusions: Being dependent in daily activities occasionally meant being governed by the ageing body or by others. Reduced perceptions of self-determination in daily life were associated with both internal and external factors. Exercising self-determination in old age was directly related to the relationship between the persons receiving help and the persons providing help. Therefore, healthcare professionals should enable trough navigate towards a more self-determined daily life in old age. A first step in this direction could be to conduct a conversation about self-determination based on the IPA-O, a psychometrically tested and adjusted instrument designed specifically for older people. Acknowledging human capabilities and creating relationships based on partnership could enhance the older person’s self-determination.
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| 5. |
- Ottenvall Hammar, Isabelle, 1984, et al.
(författare)
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Validitet och reliabilitet av frågeformuläret Inverkan på Delaktighet och Autonomi för äldre personer
- 2013
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Ingår i: Posterpresentation AT-Forum Stockholmsmässan 24-25/4-2013.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Frågeformuläret Inverkan på Delaktighet och Autonomi (IPA) har konstruerats för att mäta en persons upplevda delaktighet och självbestämmande/beslutande autonomi. Eftersom validiteten och reliabiliteten av IPA är testade på personer under 75 års ålder, behövs ytterligare studier riktade mot äldre. Syfte: Att undersöka validiteten och reliabiliteten av frågeformuläret IPA för personer i åldern 70 år och äldre. Metod: Studien utfördes i två steg som figuren visar; först ett validitetstest av den svenska versionen av IPA och därefter ett test-retest reliabilitetstest av det reviderade frågeformuläret. I test-retesten användes Svenssons program, ett statistiskt program som är lämpligt vid analys av ordinaldata. Resultat: Deltagarna ansåg att frågorna var viktiga men omfattande. När de besvarade frågorna framkom att de fokuserade på enbart utförandet av aktiviteterna. Revideringen resulterade i 22 frågor om upplevd delaktighet och självbestämmande. Test-retesten visade att den procentuella överensstämmelsen varierade, 15 frågor hade hög reliabilitet (70 % eller över). Slutsatser: IPA-Ä är valit och reliabelt för den äldre populationen. IPA-Ä kan användas som ett utvärderingsinstrument för att säkerställa äldre personers rätt till självbestämmande och delaktighet. IPA-Ä rekommenderas som ett utvärderingsinstrument vid geriatrisk rehabilitering.
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| 6. |
- Ottenvall Hammar, Isabelle, 1984
(författare)
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Validity and Reliability of the questionnaire Impact on Participation and Autonomy for older people
- 2012
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Ingår i: Poster Nordic Congress of Gerontology 10/6-13/6 2012.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: According to the Swedish Law of Health and Care (1982:763), health care should be built on the respect for self-determination and integrity. Recent studies of older persons indicate that self-determination is not fully respected within the health care sector. Restrictions in older person’s self-determination can influence their mental health. The questionnaire Impact on Participation and Autonomy (IPA) was constructed to measure a person’s perceived impact of every day life on participation and decisional autonomy (self-determination). Since the IPA based its psychometric properties on persons under the age of 75, further studies of higher ages are needed. Purpose: The purpose was to examine the validity and reliability of the IPA for people 70 years and older. Method: The study was performed in two steps: validity was tested with focus groups and individual interviews with persons aged 77-88 years, and reliability with persons aged 70-99 years, all from the Gothenburg region. In the test-retest reliability step data were analyzed in accordance with Svensson's method. Results: Face- and content validity test of IPA-S: The participants emphasized the relevance of the questionnaire. When answering the questions, their way of answering revealed that they focused on the executional part of the activity, and not on the decisional part. The participants valued that their voice could be heard about their possibility of deciding for themselves in daily activities. A removal of items was recommended. Revision phase: All items were revised in order to clarify the decisional part of self-determination in the questionnaire. The IPA-S with its 31 items resulted in 22 items about perceived participation called IPA-O (-for older persons). Test-retest reliability of IPA-O: The range of PA between the test and retest assessments of all 22 items differed from 54 % to 100 %. The test-retest showed that 15 of 22 items had high agreement, one item had low agreement (PA of < 59 %). Discussion and conclusion: The result showed that IPA-O is a valid and reliable questionnaire for the older population. The findings showed that the participants emphasized the importance of receiving questions about making their own decisions in daily activities. IPA-O can be used for older persons both as an evaluation tool and in client work to ensure older persons right to self-determination in the planning of their care and rehabilitation. The questionnaire is appropriate in the scientific research area when the purpose is to examine and investigate older populations’ perceptions of their self-determination. Take home message • IPA-O is a valid and reliable questionnaire when targeting self-determination among older persons in research. • IPA-O is recommended to be used in client work within health care, social care and rehabilitation.
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