| 1. |
- Lindstedt, Helena, et al.
(författare)
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Background factors related to and/or influencing occupation in mentally disordered offenders
- 2006
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 20:3, s. 331-338
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Knowledge of background and occupational related factors of mentally disordered offenders are missing. It is essential to understand these issues when planning discharge from forensic psychiatric hospital care to enable community dwelling. Aims: One aim was to investigate mentally disordered offenders' background factors, confidence in and how they value occupations. Another aim was to investigate MDOs background factors' in relation to and the influences on Occupational Performance and Social Participation. Method: Data was collected with an explorative, correlative design after informed consent, from 74 mentally disordered offenders (mean age 34,2) cared for in forensic psychiatric hospitals. Assessments were Allen Cognitive Level Screen, Capability to Perform Daily Occupations, Interview Schedule of Social Interaction, Manchester Short Assessment of Quality of Life, Self-efficacy Scale and Importance scale. Eight background factors were assembled from the individual forensic psychiatric investigation. Findings: Most of the investigated background factors relate to and half of them influence occupational performance, particular the cognitive aspect of occupational performance. The influences on occupation originate from adulthood, such as suffering from schizophrenia, psycho/social problems, and having performed violent crimes. These findings indicate that staff in forensic hospital care should initiate rehabilitation with knowledge about MDOs' complex daily occupations. For avoiding information bias, information gathering preceding treatment planning should be performed in collaboration between caring staff and mentally disordered offenders.
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| 2. |
- Lindstedt, Helena, 1944-
(författare)
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Daily Occupations in Mentally Disordered Offenders in Sweden : Exploring Occupational Performance and Social Participating
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The major aim was to explore perceived daily occupations in mentally disordered offenders (MDO) through occupational performance (OP) and social participation (SP) with descriptive, comparative and longitudinal designs. The 74 consecutively included MDOs were visited onsite for data collection. The following assessments were used: Capability to Perform Daily Occupation, Self-efficacy Scale, Importance scale, Allen Cognitive Level Screen, Interview Schedule for Social Interaction, Manchester Short Assessment of Quality of Life, Psycho/social and Environmental Problems, Global Assessment of Functioning Scale, assessment of Support and Service for Persons with Certain Functional Impairments and Karolinska Scales of Personality. Background factors were assembled from the individual forensic psychiatric investigation. The results indicate that MDOs had contradictive problems in OP, SP and lack of disability awareness. The MDOs and professionals had different appraisals of the MDOs’ OP and SP. Schizophrenic MDOs need substantial support for community dwelling. MDOs with psychopathic personality traits had more problems during upbringing, however, no perceived problems in OP and SP compared to the remaining group. Low Socialization, high Anxiety and psychopathy personality traits partially influenced perceived OP and SP. After one year of forensic psychiatric care, 60 % were still hospitalized and 32 % were community dwelling. Changes after one year of care consisted of higher satisfaction of OP and SP, 1/36 subject valued daily occupations higher and 5/36 subjects reported better social interaction. Although, there are some methodological weaknesses in this thesis (e.g. high attrition rate), the unique results should be taken into consideration. It is concluded that MDOs’ appraisal of their own capability has to be taken seriously in treatment and care. Also long treatment periods, targeting daily occupations from start and providing substantial individual support are necessary for successful transition into community dwelling for MDOs. This thesis contributes to extended knowledge of the MDOs’ daily occupations.
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| 3. |
- Lindstedt, Helena, et al.
(författare)
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Personality traits as predictors of occupational performance and life satisfaction among mentally disordered offenders
- 2005
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 59:5, s. 357-364
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Tidskriftsartikel (refereegranskat)abstract
- The study investigated to what extent personality traits, e.g. socialization, proneness for anxiety, aggression and hostility were associated with and predictive of self-reported and observed occupational performance and perceived life satisfaction among male mentally disordered offenders (MDOs). Also, subjects with psychopathic-related personality traits were compared with subjects without such traits regarding demographic data and dependent variables. The MDOs were included from the Swedish National Board of Forensic Medicine. A total of 55 subjects were visited at their hospital ward for data collection with the Karolinska Scales of Personality (KSP), Capability to Perform Daily Occupation (CPDO), Allen Cognitive Level Screen (ACLS) and the Manchester Quality of Life Scale (MANSA). Seven KSP scales and two KSP factors correlated significantly with the dependent variables. Regression analyses revealed that the KSP Socialization scale, the KSP Anxiety-proneness and Psychopathy factors were the most important predictors. Subjects with psychopathy differed from remaining groups by having more conduct disorders before 15 years, being more often brought up in outcasted families and less subjected to measures of pupil welfare activities. The life history was concluded to be important influencing occupational performance and life satisfaction. Subjects with high anxiety proneness should be given attention in treatment planning.
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| 4. |
- Linnman, Clas, et al.
(författare)
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Chronic whiplash symptoms are related to altered regional cerebral blood flow in the resting state
- 2009
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Ingår i: European Journal of Pain. - : Wiley. - 1090-3801 .- 1532-2149. ; 13:1, s. 65-70
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Tidskriftsartikel (refereegranskat)abstract
- The neural pathogenic mechanisms involved in mediating chronic pain and whiplash associated disorders (WAD) after rear impact car collisions are largely unknown. This study's first objective was to compare resting state regional cerebral blood flow (rCBF) by means of positron emission tomography with (15)O labelled water in 21 WAD patients with 18 healthy, pain-free controls. A second objective was to investigate the relations between brain areas with altered rCBF to pain experience, somatic symptoms, posttraumatic stress symptoms and personality traits in the patient group. Patients had heightened resting rCBF bilaterally in the posterior parahippocampal and the posterior cingulate gyri, in the right thalamus and the right medial prefrontal gyrus as well as lowered tempero-occipital blood flow compared with healthy controls. The altered rCBF in the patient group was correlated to neck disability ratings. We thus suggest an involvement of the posterior cingulate, parahippocampal and medial prefrontal gyri in WAD and speculate that alterations in the resting state are linked to an increased self-relevant evaluation of pain and stress.
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| 5. |
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| 6. |
- Nilsson, B-M, et al.
(författare)
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Head posture in patients with whiplash-associated disorders and the measurement method's reliability - A comparison to healthy subjects
- 2005
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Ingår i: Advances in Physiotherapy. - : Informa UK Limited. - 1403-8196 .- 1651-1948. ; 7:1, s. 13-19
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Tidskriftsartikel (refereegranskat)abstract
- Whiplash-associated disorders (WAD) are a major problem for healthcare providers and sufferers. Neck pain is one of the most common WAD, and forward head posture may contribute to neck pain. Objective methods for assessing head posture are necessary in the evaluation of postural correction. The purpose of this study was to investigate the inter-rater reliability of the goniometer and to examine differences in head posture inpatients with WAD compared with healthy individuals. Twenty-seven consecutive patients and 40 healthy subjects matched for age and gender were included in the study. Head position relative to shoulders in standing was assessed by three examiners. The inter-rater reliability for the goniometer showed an intraclass correlation coefficient of 0.95. The absolute reliability for the three testers was 1.8°. An independent t-test showed that the difference in head posture between the patients and controls was significant. The patient group showed more forward head posture.Patients with WAD had more forward head posture than persons without neck problems. The goniometer proved to be reliable with high inter-rater reliability in assessing the head position relative to shoulders.
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| 7. |
- Söderlund, Anne, et al.
(författare)
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A three-group study, internet-based, face-to-face based and standard- management after acute whiplash associated disorders (WAD) - choosing the most efficient and cost-effective treatment : Study protocol of a randomized controlled trial
- 2009
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 10:90
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Tidskriftsartikel (refereegranskat)abstract
- Background The management of Whiplash Associated Disorders is one of the most complicated challenges with high expenses for the health care system and society. There are still no general guidelines or scientific documentation to unequivocally support any single treatment for acute care following whiplash injury. The main purpose of this study is to try a new behavioural medicine intervention strategy at acute phase aimed to reduce the number of patients who have persistent problems after the whiplash injury. The goal is also to identify which of three different interventions that is most cost-effective for patients with Whiplash Associated Disorders. In this study we are controlling for two factors. First, the effect of behavioural medicine approach is compared with standard care. Second, the manner in which the behavioural medicine treatment is administered, Internet or face-to-face, is evaluated in it's effectiveness and cost-effectiveness. Methods/Design The study is a randomized, prospective, experimental three-group study with analyses of cost-effectiveness up to two-years follow-up. Internet-based programme and face-to-face group treatment programme are compared to standard-treatment only. Patient follow-ups take place three, six, twelve and 24 months, that is, short-term as well as long-term effects are evaluated. Patients will be enrolled via the emergency ward during the first week after the accident. Discussion This new self-help management will concentrate to those psychosocial factors that are shown to be predictive in long-term problems in Whiplash Associated Disorders, i.e. the importance of self-efficacy, fear of movement, and the significance of catastrophizing as a coping strategy for restoring and sustaining activities of daily life. Within the framework of this project, we will develop, broaden and evaluate current physical therapy treatment methods for acute Whiplash Associated Disorders. The project will contribute to the creation of a cost-effective behavioural medicine approach to management of acute Whiplash Associated Disorders. The results of this study will answer an important question; on what extent and how should these patients be treated at acute stage and how much does the best management cost.
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| 8. |
- Söderlund, Anne, et al.
(författare)
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Classification of patients with whiplash associated disorders (WAD) : reliable and valid subgroups based on the Multidimensional Pain Inventory (MPI-S).
- 2006
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Ingår i: European Journal of Pain. - : Wiley. - 1090-3801 .- 1532-2149. ; 10:2, s. 113-119
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Classification of patients with chronic whiplash associated disorders (WAD) into homogenous subgroups is an important objective in order to tailor interventions and to control for subgroup differences when evaluating treatment outcome. AIMS: The aims of this study were to investigate if it was possible to replicate and describe the three cluster solution and profiles found in other pain groups and describe cluster profiles based on self-reported Multidimensional Pain Inventory-scores for patients with WAD three months after the injury, describe characteristics of the clusters in relation to disability, self-efficacy and coping at the same point in time and to validate the cluster solution by comparing clusters in disability, self-efficacy and coping over time. METHODS: Ninety-one WAD-patients three months after the accident took part in the study. The measures used were the Multidimensional Pain Inventory-Swedish version (MPI-S), The Self-Efficacy Scale, The Coping Strategies Questionnaire and The Pain Disability Index. Cluster analysis was conducted for the total sample MPI-S subscale scores. RESULTS: The adaptive copers cluster represented 42% of the sample, dysfunctional 34% of the sample, and interpersonally distressed 24% of the sample. The external validation of cluster solution showed that there were several significant differences between clusters in self-efficacy, disability and coping measures. There was also a significant interaction effect (clusterxtime) in disability (PDI). Patients in dysfunctional cluster reported a decreased disability over time. CONCLUSIONS: These results support the presence of different subgroups among patients with whiplash associated disorders. This classification can be seen as a complement to a classification based on medical condition.
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| 9. |
- Söderlund, Anne, et al.
(författare)
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Cognitive behavioural components in physiotherapy management of chronic whiplash associated disorders (WAD) : a randomised group study
- 2007
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Ingår i: Giornale italiano di medicina del lavoro ed ergonomia. - 1592-7830. ; 29:1 Suppl A, s. A5-A11
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Tidskriftsartikel (refereegranskat)abstract
- Different types of integrated management programmes have lately been introduced in the treatment of Whiplash Associated Disorders (WAD). In this study regular primary care physiotherapy and physiotherapy management with integrated components of cognitive-behavioural origin was compared in an experimental group study. The predictive value of self-efficacy was also addressed. In all thirty-three patients with chronic WAD were included in the trial. Results revealed no significant differences between groups in self-ratings of disability or pain intensity. However, among the self-reported benefits of treatment, patients in the experimental group reported significantly less pain than did the comparison group. At three months follow-up the experimental group also reported better performance of daily activities. Between group differences in the coping repertoire were found at pre-, post-and three-month follow-up. Generally, patients with high self-efficacy reported less use of 'maladaptive' and passive coping style than less self-efficient subjects at all times. In conclusion cognitive behavioural components can be useful in physiotherapy treatment for patients with chronic WAD, but their contributions are not yet fully understood. Self-efficacy is related to patients' use of different coping styles. Positive long-term outcomes in WAD-patients could therefore be improved by boosting self-efficacy and by teaching patients to use active, adaptive coping strategies.
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| 10. |
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