| 1. |
- Blomgren, Johannes, et al.
(författare)
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Effects of deep cervical flexor training on impaired physiological functions associated with chronic neck pain: a systematic review
- 2018
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Ingår i: BMC Musculoskeletal Disorders. - London : BMC. - 1471-2474. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background:Neck pain is a major health issue with high rates of recurrence. It presents with a variety ofaltered sensorimotor functions. Exercise is a cornerstone of rehabilitation and many training methods areused. Exercise is evaluated in most randomized controlled trials on its pain relieving effects. No review hasassessed the effect of exercise on the altered physiological functions or determined if there are differentialeffects of particular training methods. This review investigated the effects of deep cervical flexor (DCF)training, a training method commonly used for patients with neck pain, and compared it to other trainingmethodsornotrainingonoutcomesofcervicalneuromuscular function, muscle size, kinematics and kinetics.Methods:Web of Science, Scopus, CINAHL, PubMed were searched from inception until January 2018. Twelverandomized controlled trials were included that compared DCF training as sole intervention to other trainingor no interventions in persons with neck pain. The Cochrane Risk of Bias tool was used to assess the methodquality. All outcome measures were analysed descriptively and meta-analyses were performed for measuresevaluated in three or more studies.Results:DCF training was compared to cervical endurance, strength, proprioception and mobility training,muscle stretching, and no intervention control groups. Physiological outcome measures includedneuromuscular co-ordination (craniocervical flexion test), functional tasks, muscle fatigability, muscle size,kinematics (joint position sense, posture and range of motion) and kinetics (strength, endurance andcontraction accuracy). Strong evidence was found for effectiveness of DCF training on neuromuscularcoordination, but it had no or small effects on strength and endurance at higher loads. DCF trainingimproved head and cervical posture, while evidence was limited or contradictory for other measures.Conclusions:DCF training can successfully address impaired neuromuscular coordination, but not cervicalflexor strength and endurance at higher contraction intensities. A multimodal training regime is proposedwhen the aim is to specifically address various impaired physiological functions associated with neck pain
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| 2. |
- Falk, Jimmy, et al.
(författare)
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Increased co-contraction reaction during a surface perturbation is associated with unsuccessful postural control among older adults
- 2022
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Ingår i: BMC Geriatrics. - : Springer Nature. - 1471-2318. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: As a strategy to maintain postural control, the stiffening strategy (agonist-antagonist co-contractions) is often considered dysfunctional and associated with poor physical capacity. The aim was to investigate whether increased stiffening is associated with unsuccessful postural control during an unpredictable surface perturbation, and which sensory and motor variables that explain postural stiffening.Methods: A sample of 34 older adults, 75.8 ± 3.8 years, was subjected to an unpredicted surface perturbation with the postural task to keep a feet-in-place strategy. The participants also completed a thorough sensory- and motor test protocol. During the surface perturbation, electromyography was measured from tibialis anterior and gastrocnemius to further calculate a co-contraction index during the feed-forward and feedback period. A binary logistic regression was done with the nominal variable, if the participant succeeded in the postural task or not, set as dependent variable and the co-contraction indexes set as independent variables. Further, the variables from the sensory and motor testing were set as independent variables in two separate Orthogonal Projections of Latent Structures (OPLS)-models, one with the feed-forward- and the other with the feedback co-contraction index as dependent variable.Results: Higher levels of ankle joint stiffening during the feedback, but not the feed-forward period was associated with postural task failure. Feedback stiffening was explained by having slow non-postural reaction times, poor leg muscle strength and being female whereas feed-forward stiffening was not explained by sensory and motor variables.Conclusions: When subjected to an unpredicted surface perturbation, individuals with higher feedback stiffening had poorer postural control outcome, which was explained by poorer physical capacity. The level of feed-forward stiffening prior the perturbation was not associated with postural control outcome nor the investigated sensory and motor variables. The intricate causal relationships between physical capacity, stiffening and postural task success remains subject for future research.
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| 3. |
- Falk, Jimmy, et al.
(författare)
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What Explains Successful or Unsuccessful Postural Adaptations to Repeated Surface Perturbations among Older Adults?
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:22
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Tidskriftsartikel (refereegranskat)abstract
- As we age there are natural physiological deteriorations that decrease the accuracy and flexibility of the postural control system, which increases the risk of falling. Studies have found that there are individual differences in the ability to learn to manage repeated postural threats. The aim of this study was to investigate which factors explain why some individuals are less proficient at adapting to recurrent postural perturbations. Thirty-five community dwelling older adults performed substantial sensory and motor testing and answered surveys regarding fall-related concerns and cognitive function. They were also subjected to three identical surface perturbations where both kinematics and electromyography was captured. Those that were able to adapt to the third perturbation were assigned to the group “Non-fallers” whereas those that fell during all perturbations were assigned to the group “Fallers”. The group designation dichotomized the sample in a hierarchical orthogonal projection of latent structures— the discriminant analysis model. We found that those who fell were older, had poorer physical performance, poorer strength and longer reaction times. The Fallers’ postural control strategies were more reliant on the stiffening strategy along with a more extended posture and they were less skillful at making appropriate feedforward adaptations prior to the third perturbation.
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| 4. |
- Forsberg, Angelica, et al.
(författare)
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Patient's perceptions of perioperative quality of care in relation to self-rated health
- 2018
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Ingår i: Journal of Perianesthesia Nursing. - : Elsevier. - 1089-9472 .- 1532-8473. ; 33:6, s. 834-843
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To explore (1) associations between patient and perioperativefactors and dimensions of quality of care and (2) perioperative patients’self-rated physical health in relation to information, encouragement, andparticipation.Design: A nonexperimental descriptive exploratory design (n 5 170participants).Methods: Analyses were performed using quantitative techniques;collected data were quantitative in nature. Multiple logistic regressionand Mann-Whitney U tests were used to analyze the data.Findings: The factor associatedwith patients’ satisfaction within the dimensionof ‘‘identity-oriented approach of the caregivers,’’ including the qualityof information, encouragement, and participation, was self-estimated physicalhealth. Those who estimated their physical health as being good weregenerally more satisfied. Patients who rated their physical health as beingless thangoodwere significantly less satisfiedwith the informationprovidedbefore surgery about their stay in the postanesthesia care unit (PACU).Conclusions: Nurses should chart patients’ estimations of their physicalhealth initially in care to provide reinforced support for patients who estimatetheir physical health is less than good. Before surgery, patients whohave estimated their physical health as being less than good should begiven realistic information about their stay in the PACU—that they willbe in a PACU after surgery, what that stay means, and why it is necessary.
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| 5. |
- Forsberg, Angelica, et al.
(författare)
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Patients' perceptions of quality of care during the perioperative procedure
- 2015
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Ingår i: Journal of Perianesthesia Nursing. - : Elsevier BV. - 1089-9472 .- 1532-8473. ; 30:4, s. 280-289
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Tidskriftsartikel (refereegranskat)abstract
- To describe patients' perceptions of quality of care during the perioperative period and to identify areas for quality improvement. Design: A cross-sectional descriptive survey design was used. Methods: The data were collected (N = 170) using a questionnaire for perioperative care. The methods were descriptive statistics, reported as percentages, and a manifest content analysis of the free text. Finding: The areas identified for improvement were information and participation. The participants lacked knowledge, preferred to hand over decision making to the hospital staff, and indicated that having personalized information about the surgery and perioperative period was important. However, too detailed information before surgery could cause increased anxiety. Conclusions: This study indicates that participation and information needs in perioperative settings seem to be situation specific. In addition, these needs seem to be personal and surgery specific. Further studies are required to clarify the differences in the satisfaction and quality of care between groups of patients in the perioperative context
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| 6. |
- Forsberg, Angelica, et al.
(författare)
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Patients' perceptions of quality of care during the perioperative procedure
- 2017
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Ingår i: ACORN: The Journal of Perioperative Nursing in Australia. - : Australian College of Perioperative Nurses. - 1448-7535. ; 30:3, s. 13-22
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To describe patients' perceptions of quality of care during the perioperative period and to identify areas for quality improvement. Design: A cross-sectional descriptive survey design was used. Method: The data was collected (N=170) using a questionnaire for perioperative care. The methods were descriptive statistics, reported as percentages, and a manifest content analysis of the free text. Finding: The areas identified for improvement were information and participation. The participants lacked knowledge, preferred to hand over decision making to the hospital staff, and indicated that having personalised information about the surgery and perioperative period was important. However, too detailed information before surgery could cause increased anxiety. Conclusions: This study indicates that participation and information needs in perioperative settings seem to be situation specific. In addition, these needs seem to be personal and surgery specific. Further studies are required to clarify the differences in the satisfaction and quality of care between groups of patients in the perioperative context.
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| 7. |
- Forsberg, Angelica, et al.
(författare)
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Patients' perceptions of their postoperative recovery for one month
- 2015
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 24:13-14, s. 1825-1836
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectivesTo explore orthopaedic and general surgery patients' perceptions of their postoperative recovery for one month.BackgroundIn general, nursing research in the postoperative context has been directed towards a single symptom or area, which is valuable. However, there is a lack of studies of orthopaedic and general surgery patients' perceptions of postoperative recovery from a short-term perspective.DesignA quantitative approach with a longitudinal design was used.MethodsA total of 180 patients participated in the study. Data were collected using a standardised questionnaire, the Postoperative Recovery Profile, for self-assessment of recovery. Descriptive statistics reported as proportions were used for the categorical variables. Analytic statistics were used to identify statistically significant differences. Mean values and t-tests were used for quantity variables, and Mann–Whitney U-tests and Chi-squared tests were used for nonparametric variables.ResultsOverall, the orthopaedic patients were substantially less recovered than the general surgery patients. Two-thirds of the orthopaedic patients and half of the general surgery patients perceived severe or moderate pain in the acute recovery phase. Within the general surgery group, there were significant differences in the recovery between the Gastric Bypass patients and colon/ileum surgery patients. The gastric bypass patients were overall more recovered than the other groups of patients. The Gastric Bypass patients reported that they had improved after one month compared to their own status prior to surgery.Conclusions and relevance to clinical practiceNursing support for orthopaedic patients must be improved, especially after they are discharged from the hospital. To structure and monitor individual recovery, a top-five priority profile of the most important problems should be used during follow-up calls after the patient is discharged from the hospital. Postoperative pain continues to represent a clinical problem that requires attention. Heterogeneity in the perceptions of recovery within the general surgery group was indicated, which may depend on the surgical procedure as well as the patients' expectations and comparisons with their lives before surgery. Rather than return to their preoperative levels, certain patients tend to continue towards a new or different life postoperatively.
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| 8. |
- Forsberg, Angelica, et al.
(författare)
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Patterns of changes in patients' postoperative recovery from a short-term perspective
- 2018
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Ingår i: Journal of Perianesthesia Nursing. - : Elsevier. - 1089-9472 .- 1532-8473. ; 33:2, s. 188-199
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To explore patterns of changes in patients' postoperative recovery over 1 month within different surgery groups.Design: A quantitative longitudinal survey design was used.Methods: A standardized questionnaire was used (N = 167 patients); the postoperative recovery profile for self-assessment of recovery. The postoperative recovery profile developed for hospitalized patients contains 17 items distributed over five dimensions: physical symptoms, physical function, psychological function, social function, and activity.Findings: Overall, orthopaedic patients perceived a lower recovery than general surgery patients. All major surgery groups and subgroups except for joint replacement patients indicated significant systematic changes toward lower levels of problems. The orthopaedic patients assessed their psychological functioning as impaired, and the gastric bypass group was the most recovered.Conclusions: The patients' expectations should be charted initially, and patients should be given realistic information to achieve a realistic hope for a good life in the future. A patient's recovery trajectory may not start after the surgery is completed. Rather, it has already commenced before surgery.
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| 9. |
- Govender, Lagunathan, 1989-
(författare)
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Crumbs from the Rich Man's Table? : Municipal Labour Market Policies and Recognition of Welfare Recipients in Sweden
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Labour market policies, also known as activation, are common responses to poverty, unemployment and social exclusion. Activation is characterised by increased individual responsibility, requiring welfare recipients to strive for financial self-sufficiency, be it through job-seeking, training or coaching. In Sweden, activation policies are also implemented in municipal welfare services such as social assistance and activation services. However, knowledge concerning the practical implications of activation for welfare recipients is lacking. The purpose of this thesis is to understand the meaning of recognition in social work with activation. The study explores themes such as poverty, dignity and inclusion in society. Theoretically, the thesis draws on Axel Honneth’s critical theory of recognition, which concerns social justice and a human need of being recognised as a full member of society.The study examines social assistance and activation services in five municipalities in southern Sweden, which participated in a project funded by the European Social Fund, as a case of activation. The project consisted of a skills training programme aimed at enhancing recognition. Social workers underwent training in recognition theory and its implementation in practice over two years. The thesis studies the outcome of the training programme, partly through a survey with social workers and partly through a pre-post-test survey with welfare recipients in the case study municipalities and in five comparison municipalities. However, the study also draws upon welfare recipients’ experiences in activation through focus group and individual interviews, and open-ended survey responses from the pre-post-test.The research findings suggest that the skills training programme did not significantly increase recognition. Also, on the one hand, welfare recipients experience the activation practices as recognising, through supportive individual interactions, increased financial resources and social esteem for work-related contributions. On the other hand, they still experience poverty, low status and limited employment prospects. The main conclusion of the thesis is therefore that welfare recipients are subject to a marginal recognition in activation. On the basis of this conclusion, a discussion is raised about the potential of social work with activation to fully recognise welfare recipients.
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| 10. |
- Gustafsson, Silje, et al.
(författare)
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Influence of self-care advice on patient satisfaction and healthcare utilization
- 2016
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 72:8, s. 1789-1799
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Tidskriftsartikel (refereegranskat)abstract
- AimThe aim of this study is to explore the influence of nurse-led self-care advice on healthcare utilization and patients' satisfaction with telephone nursing.BackgroundMany consultations in high-cost settings are for conditions that are manageable through self-care and callers with greater satisfaction with the nurse interaction are nearly four times more likely to engage in self-care.DesignCross-sectional study.MethodsQuestionnaires were sent out to 500 randomly selected callers to the Swedish Healthcare Direct in Northern Sweden during March 2014. Callers were asked about their satisfaction with the consultation, their intended actions prior to consultation, the recommendation given by the nurse and the action undertaken after the call.ResultsYoung callers and persons recommended watchful waiting or recurrence if no improvements were significantly less satisfied with their care. When calling on their own behalf, both men and women rated the severity of their symptoms equally and were advised to self-care to the same extent. Self-care advice had a constricting influence on self-reported healthcare utilization, with 66·1% of cases resulting in a lower level of care than first intended. Feeling reassured after the call was the aspect of nursing care that influenced satisfaction the most.ConclusionReceiving self-care advice rather than referral to a general practitioner influences patient satisfaction negatively. Feeling reassured after consultation is strongly related to satisfaction, which in turn has been found to increase the likelihood of engaging in self-care behaviour.
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