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- Brämberg, Elisabeth, et al.
(författare)
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Effects of work-directed interventions on return-to-work in people on sick-leave for to common mental disorders—a systematic review
- 2024
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Ingår i: International Archives of Occupational and Environmental Health. - 0340-0131 .- 1432-1246.
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Forskningsöversikt (refereegranskat)abstract
- Purpose To evaluate the body of evidence of the effects of work-directed interventions on return-to-work for people on sick leave due to common mental disorders (i.e., mild to moderate depression, anxiety, adjustment disorders and reactions to severe stress).Methods The systematic review was conducted in accordance with an a priori developed and registered protocol (Prospero CRD42021235586). The certainty of evidence was assessed by two independent reviewers using the Grading of Recommendations, Assessment, Development and Evaluations.Results We reviewed 14,794 records published between 2015 and 2021. Of these, eight RCTs published in eleven articles were included in the analysis. Population: Working age adults (18 to 64 years), on sick leave due to mild to moderate depression, anxiety, adjustment disorders or reactions to severe stress. Intervention: Work-directed interventions. Comparator: No comparator, Standard care, or other measures. Outcome: return to work, number of days on sick leave, income. Overall, the effects of work-focused CBT and work-focused team-based support on RTW resulted in increased or faster return-to-work compared with standard care or no intervention (low certainty of evidence). The effects of Individual Placement and Support showed no difference in RTW compared with standard care (very low certainty of evidence).Conclusion Interventions involving the workplace could increase the probability of RTW. Areas in need of improvement in the included studies, for example methodological issues, are discussed. Further, suggestions are made for improving methodological rigor when conducting large scale trials.
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| 3. |
- Gebru, Kerstin, et al.
(författare)
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Nursing and medical documentation on patients´cultural background
- 2007
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Ingår i: Journal of Clinical Nursing. - : Blackwell Publishing Ltd. - 0962-1067 .- 1365-2702. ; 16:11, s. 2056-2065
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. To investigate if, and to what extent, nursing and medical documentation in patients records include entries on cultural background. Background. Health care professionals in Sweden may have difficulties in providing satisfactory care, due to lack of knowledge about immigrants´background. According to Swedish law the information needed to garantee safe care must be specified in the patients´records. It is therefore, important to investigate what information nurses and physicians document on patients´cultural background. Design and methods. In this descriptive study, archival data concerning older and terminally ill patients were analysed retrospectively. The sample consisted of records from 121 patients 65 years or more at the time of the death, who were born abroad and died during the year 1999. Content analysis was used to interrogate data collected from patients records, which related to the patient´s cultural background. Entries (sentences or proportion of sentences) were identified, coded and categorized using Leininger´s Sunrise Model. Results. From the patient records, entries could be related to all factors in the upper part of the Sunrise Model. Some factors were found in all records, and all factors, except technological factors, could be traced across the patients´records. Information concerning folk/lay care could not be found. Conclusion. The results from this study indicate that nurses´and physicians´documentation in patient records included all factors in the Sunrise Model except technological. The overall impression is that the documentation is partly atomistic and insufficient as cultural assessment. Relevance to clinical practice. Even if the health care personnel want to reduce the amount of documentation produced, this study highlighted the importance of documentation on cultural factors. To save time the nursing documentation coukd be based on the Sunrise Model and structured according to the VIPS model.
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| 5. |
- Sundell, Knut, et al.
(författare)
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Trends in Methodological Quality in Controlled Trials of Psychological and Social Interventions
- 2018
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Ingår i: Research on social work practice. - : SAGE Publications. - 1049-7315 .- 1552-7581. ; 28:5, s. 568-576
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Tidskriftsartikel (refereegranskat)abstract
- Objective: There is substantial evidence that poorly designed and reported research can mislead decision making in clinical care. This review investigates the methodological quality of Swedish trials of a wide array of psychological and social interventions.Method: The review includes 302 articles published in peer-reviewed journals during 1990–2014, which evaluated a psychological or social intervention; included a randomized or nonrandomized control group with a pre–post- or pre-follow-up design; and targeted individuals in order to prevent or rehabilitate from physical, psychological, or social problems. The results are based on the information reported in the articles.Results: Overall, methodological quality increased with time. However, more recent studies contained methodological deficits. For example, few had used blinded data collectors, reported power analyses, or searched for adverse events.Conclusion: The results indicate a potential risk of biased results in both older and newer trials. Possible implications for practice and research are discussed.
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| 6. |
- Åhsberg, Elizabeth, et al.
(författare)
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Development of an Instrument for Assessing Elder Care Needs
- 2017
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Ingår i: Research on social work practice. - : SAGE Publications. - 1049-7315 .- 1552-7581. ; 27:3, s. 291-306
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To construct a needs assessment instrument for older people using a standardized terminology (International classification of functioning, disability, and health [ICF]) and assess its psychometrical properties. Method: An instrument was developed comprising questions to older people regarding their perceived care needs. The instrument's reliability, validity, and utility were tested. Forty-one social workers and 251 older people participated. Results: The questions were sufficiently unambiguous (inter-rater reliability, intraclass correlation = .60-.80); measured a person's care and service needs to a satisfactory extent (criteria validity, agreement between social workers' and older people's assessments = 72-94%); both social workers and older people considered the questions useful; and the needs of older people were documented in social records to a greater extent when the instrument was used. Conclusion: The psychometric properties of the instrument support its use by social workers to gain relevant information on elder care needs.
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| 7. |
- Åhsberg, Elizabeth
(författare)
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Discharge from hospital : a national survey of transition to out-patient care
- 2019
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 33:2, s. 329-335
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Despite a generally decreased length of stay in Swedish hospitals, an increasing delay of discharge has been observed among patients with long-term care need. Aim Identify challenges and opportunities in the transition of patients between hospitals and out-patient care. Method Data were obtained from national registers on patients discharged from hospitals in 2014, interviews with public care authorities, and a systematic literature review. Results A total of 1 121 823 persons were discharged from Swedish hospitals in 2014. Of all discharged patients, 334 420 (30%) was in need of further out-patient medical care while 221 221 (20%) needed social services. Among these discharged patients, 53 763 (5%) needed both medical care and social services. In this group of frail persons (primarily females 80 years or older), 25 760 (48%) were readmitted to hospital within 30 days from the discharge. Main reported challenges in the transition were as follows: a decreasing number of beds in hospitals and nursing homes, lack of staff with proper education, and problems in transfer of information between caregivers. To solve these problems, respondents reported some new approaches: extensive initial home services after discharge, out-patient care organised by both municipalities and county councils, local follow-up of patient data as well as an emphasis on collaboration between caregivers. The literature reported ambiguous results about effects of single interventions at discharge. However, evidence suggests that the number of readmissions to hospital may be reduced by combining several interventions before discharge (individual planning, geriatric assessment, and patient education) with follow-up after discharge. Conclusion Since many frail patients are readmitted to hospital within 30 days after discharge, Swedish out-patient care may need new working methods in order to promote a coherent care. Further, multi-component interventions at discharge, including follow-up after discharge, may prevent unintended readmissions.
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| 8. |
- Åhsberg, Elizabeth, 1958-
(författare)
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Perceived fatique related to work
- 1998
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Perceived fatigue at work is important because it may be unpleasant for the individual, it may interfere with productivity, and prolonged fatigue without recovery may lead to work-related disorders. This thesis presents a comprehensive approach towards assessment of work-related perceived fatigue. The thesis is based on the notion that perceived fatigue is a multi-dimensional construct, and the principal aim is to identify these dimensions. The aim is further to develop an instrument for measuring work-related perceived fatigue based on self-reports, and to validate the importance of these fatigue dimensions during different types of work. An instrument, the Swedish Occupational Fatigue Inventory (SOFI), was developed for measuring fatigue based on self-reports. In a questionnaire survey 705 employees from different occupations described their perceived fatigue by rating 95 verbal expressions. Factor analyses resulted in five dimensions of work-related perceived fatigue. These dimensions were called Lack of energy, Physical exertion, Physical discomfort, Lack of motivation, and Sleepiness. The SOFI consisted of 25 items, and each of the five dimensions were assessed by five items.The proposed five-dimensional model of perceived fatigue was evaluated in two laboratory experiments and one field study. The first experiment focused on fatigue after physical work, whereas the second experiment focused on fatigue after mental work. The field study was conducted among industrial three-shift workers, who answered a questionnaire after each shift. The results indicated a reasonably good validity of the instrument, in the sense that it showed an ability to reflect different fatigue dimensions in different types of work. That is, perceived fatigue due to physical work was primarily described by Lack of energy, Physical exertion and Physical discomfort, fatigue due to mental work primarily by Lack of energy, Lack of motivation and Sleepiness, and fatigue due to night work primarily by Sleepiness. The results also add to previous knowledge by showing that night work is not only associated with perceived Sleepiness, but also with Lack of energy and Lack of motivation.The proposed five-dimensional model of perceived fatigue was cross-validated in a new occupational population, using the SOFI to assess fatigue in different work situations. Linear structural equation analyses (LISREL) of the results suggested a slightly revised model for perceived fatigue, still comprising five dimensions, but with a reduced number of variables - 20 instead of 25. Lack of energy was defined as a latent factor directly related to all observed variables, indicating its general character.The results in this thesis also showed common gender differences of perceived fatigue in field settings: women reported more fatigue than men. However, gender did not differ in fatigue during simulated work in the laboratory, irrespective of whether the work consisted of similar mental workload or individually adjusted physical workload. This indicates that work-related perceived fatigue is influenced by factors other than the work task.In conclusion, work-related perceived fatigue can be described as being composed of five dimensions. An instrument, the SOFI, has been developed. The results indicated a reasonably good validity for the SOFI.
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