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  • Månsson Lexell, Eva, et al. (författare)
  • Occupational adaptation in people with Multiple Sclerosis.
  • 2011
  • Ingår i: OTJR: Occupation, Participation and Health. - American Occupational Therapy Foundation. - 1539-4492. ; 31:3, s. 127-134
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to gain an enhanced understanding of how people with multiple sclerosis experience their occupational adaptation. Ten people with multiple sclerosis were interviewed and the constant comparative method was used to analyze the data. Their occupational adaptation was experienced as a constant struggle and non-linear, and served as the means of achieving either a desired self or a desired family life. Adaptations of occupations differed according to the evolving goals of the participants. The findings showed that the participants often selected occupational adaptations to meet their family needs over their own. These findings can help professionals to establish where their clients with multiple sclerosis are in the adaptation process and offer appropriate client-centered interventions.
  • Nilsson, Maria H, et al. (författare)
  • Walking ability is a major contributor to fear of falling in people with Parkinson's disease: implications for rehabilitation.
  • 2012
  • Ingår i: Parkinson's Disease. - Hindawi Publishing Corporation. - 2090-8083 .- 2042-0080. ; 2012:Sep 19, s. 713236
  • Tidskriftsartikel (refereegranskat)abstract
    • Although fear of falling (FOF) is common in people with Parkinson's disease (PD), there is a lack of research investigating potential predictors of FOF. This study explored the impact of motor, nonmotor, and demographic factors as well as complications of drug therapy on FOF among people with PD. Postal survey data (including the Falls Efficacy Scale, FES) from 154 nondemented people with PD were analyzed using multiple regression analyses. Five significant independent variables were identified explaining 74% of the variance in FES scores. The strongest contributing factor to FOF was walking difficulties (explaining 68%), followed by fatigue, turning hesitations, need for help in daily activities, and motor fluctuations. Exploring specific aspects of walking identified three significant variables explaining 59% of FOF: balance problems, limited ability to climb stairs, and turning hesitations. These results have implications for rehabilitation clinicians and suggest that walking ability is the primary target in order to reduce FOF. Specifically, balance, climbing stairs, and turning seem to be of particular importance.
  • Dahlin Ivanoff, S, et al. (författare)
  • Occupational therapy research on assistive technology and physical environmental issues: a literature review.
  • 2006
  • Ingår i: Canadian journal of occupational therapy. Revue canadienne d'ergothérapie. - 0008-4174. ; 73:2, s. 109-19
  • Forskningsöversikt (refereegranskat)abstract
    • Background. To determine future directions for research in the area of assistive technology and physical environmental issues, it is important to have an understanding of prior research. Purpose. This literature review examined how assistive technology and physical environmental issues have been studied in the research published in international peer-reviewed occupational therapy journals. Method. Five recent volumes of nine journals were manually searched utilizing specific criteria. The publications were classified according to their perspective, application of the Person-Environment-Occupation (PEO) model, and the research design. Results. Both research fields demonstrated use of different research methods and they displayed equal needs with regard to improved research methodologies. Practice Implications. There are a lack of studies involving all three PEO components indicating a lack of research in occupational performance issues. Further research
  • Iwarsson, Susanne, et al. (författare)
  • Assessment of dependence in daily activities combined with a self-rating of difficulty.
  • 2009
  • Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - 1651-2081. ; 41:3, s. 150-6
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To study the information gained by extending a well-established instrument of dependence/independence in activities of daily living with a self-rating of difficulty, and to illustrate the relevance and usefulness of this combined approach with cross-national data. DESIGN AND SUBJECTS: Cross-sectional survey study data collected with 1918 very old persons in 5 European countries. METHODS: The "ADL staircase assessment" of dependence/independence, extended with a self-rating of difficulty, was administered at home visits. Data distribution in the 5 national samples and analyses with or without use of the self-rating data were carried out. RESULTS: High proportions of the subjects were independent in most of the activities assessed, while substantial proportions reported difficulties. Considerable differences were identified among the national samples. In personal activities of daily living, those assessed as independent varied from 87% to 100%, while the proportion of those who rated themselves as "independent without difficulty" ranged from 53% to 98%. In instrumental activities, 33-91% were assessed as independent, while the proportions of "independent without difficulty" ranged from 24% to 77%. Analysis results differed as to whether or not self-ratings of difficulty were used. CONCLUSION: The combined approach to data collection gave a diversified, information-rich picture. The assessment used is easy to administer and can be used in practice contexts in different countries.
  • Haak, Maria, et al. (författare)
  • Home as a signification of independence and autonomy: Experiences among very old Swedish people.
  • 2007
  • Ingår i: Scandinavian Journal of Occupational Therapy. - Scandinavian University Press. - 1103-8128. ; 14:1, s. 16-24
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to explore independence in the home as experienced by very old single-living people in Sweden. A grounded theory approach was used and interviews were conducted with 40 men and women aged 80-89. Data analysis revealed the core category "Home as a signification of independence" with two main categories: "Struggle for independence" and "Governing daily life". The findings showed that home is strongly linked to independence, and being independent is extremely valued. Explicit descriptions of the ageing process as an individual process of changing living conditions within the home emerged from the findings. Hence, the ageing process influences the participants' perception of themselves as independent persons. Along the ageing process the participants' view of independence changed from being independent in activity performance without help from others to experiencing independence in being able to make autonomous decisions concerning daily life at home. Consequently, there is a need to develop strategies to support very old people in staying as active and independent as possible in their own homes. In addition, since the findings highlight that independence is a complex construct, there is a need for conceptual differentiation between independence and a construct often used synonymously, namely autonomy.
  • Haak, Maria, et al. (författare)
  • Home as the locus and origin for participation: Experiences among very old Swedish people
  • 2007
  • Ingår i: OTJR: Occupation, Participation and Health. - Slack Inc. - 1539-4492. ; 27:3, s. 95-103
  • Tidskriftsartikel (refereegranskat)abstract
    • Using a grounded theory perspective, this article focuses on experiences of participation in relation to home among very old people who are living alone. Eight people selected from the larger ENABLE-AGE Project were interviewed. Data analysis identified the core category as "home as the locus and origin for participation" with two main categories ("performance-oriented participation" and "togetherness-oriented participation"). The findings indicate that the home is the origin for participation both out of the home and within the home. However, as older people's health declines, the home becomes the explicit locus for participation. Participation successively changes from taking part in more physically demanding activities out of the home to participation by means of watching others from within the home (i.e., by being a spectator). In appreciating self-defined goals for a meaningful life, thus enabling the experience of participation in very old age (age 80 to 89 years), this study contributes to the knowledge about relationships between participation and home in very old age.
  • Haak, Maria, et al. (författare)
  • The importance of successful place integration for perceived health in very old age: a qualitative meta-synthesis.
  • 2011
  • Ingår i: International Journal of Public Health. - Springer. - 1661-8556 .- 1661-8564. ; 56:6, s. 589-595
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The aim of this study was to increase our understanding of the multifaceted phenomenon of home and health, by exploring processes underlying these dynamics when living at home in very old age. METHOD: A qualitative meta-synthesis was used on four complementary qualitative studies, based on data from the Swedish ENABLE-AGE In-depth Study, focusing on very old, single-living people's experiences of home in relation to participation, independence and health (N = 40). RESULTS: Over time, very old people manage increased frailty by means of three intertwined processes concerning changes in everyday life: The turning points, The struggle and The negotiations. The findings show that these processes take place through the context of the Homelike functional home and a state of mind labelled, The awareness of frailty. CONCLUSION: The results can be useful in constructing and implementing guidelines for more holistic approaches to housing provision for senior citizens. Further, the study delivers a deeper understanding about how very old people live their lives, useful for practitioners as well as it contributes to theory development within the context of ageing and environments.
  • Månsson Lexell, Eva, et al. (författare)
  • Constantly Changing Lives: Experiences of People With Multiple Sclerosis
  • 2009
  • Ingår i: American Journal of Occupational Therapy. - Amer Occupational Therapy Assoc, Inc. - 1943-7676 .- 0272-9490. ; 63:6, s. 772-781
  • Tidskriftsartikel (refereegranskat)abstract
    • The purpose of this study was to gain an enhanced understanding of how people with multiple sclerosis (MS) experience their engagement in occupations. We interviewed 10 people and then analyzed the data gathered using the constant comparative method of grounded theory, The findings encompassed the core category "essentials of a constantly changing life," showing that along a continuum of change, the participants experienced a decreasing engagement in occupations that forced them to continuously struggle to maintain engagement. This struggle changed them and required them to construct a different life than before. Our findings suggest that professionals working in MS rehabilitation need to broaden their repertoire of interventions relevant to conditions in clients' social environment, with the intention of influencing those occupations that are individually most meaningful. Occupational therapists should focus on the client's engagement in occupations and its consequences for the client's life and self-identity.
  • Månsson Lexell, Eva, et al. (författare)
  • The complexity of daily occupations in multiple sclerosis.
  • 2006
  • Ingår i: Scandinavian Journal of Occupational Therapy. - Scandinavian University Press. - 1103-8128. ; 13:4, s. 241-8
  • Tidskriftsartikel (refereegranskat)abstract
    • The aims of this study were to describe which self-care, productivity, and leisure occupations individuals with multiple sclerosis (MS) perceive as difficult to perform on admission to rehabilitation and the individuals' own perception of the importance of, performance of, and satisfaction with these occupations. Whether the reported self-care, productivity, and leisure occupations were related to sex, age, disease severity, and living arrangements was also investigated. Forty-seven men and women (mean age 49.4 years) were assessed with the Canadian Occupational Performance Measure (COPM) on admission to rehabilitation. The individuals reported 366 occupations (median 8, range 3-15), which were categorized as self-care (51%), productivity (30%), and leisure (19%). Three COPM subcategories—household management (26%), personal care (21%), and functional mobility (20%)—accounted for two-thirds of the reported occupations. All prioritized occupations (n=238; (median 5, range 2-7) had high ratings for importance and the ratings for performance and satisfaction were generally low. Men reported significantly more occupations related to self-care than women, but no significant difference between the sexes could be found for productivity and leisure. No significant differences between the occupational areas were found when age, disease severity, or/and living arrangements were included in the analysis. In conclusion, individuals with MS perceive difficulties with occupations related to all aspects of daily life. This underscores the need to use assessment tools that capture the complexity of daily occupations.
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