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- Bachrach-Lindström, Margareta, 1957-
(författare)
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Näringstillstånd och höftfraktur
- 2005
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Ingår i: Incitament. - 1103-503X. ; 1, s. 59-62
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Tidskriftsartikel (refereegranskat)
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| 4. |
- Gutefeldt, Kerstin, 1972-, et al.
(författare)
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Clinical Examination and Self-Reported Upper Extremity Impairments in Patients with Long-Standing Type 1 Diabetes Mellitus
- 2020
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Ingår i: Journal of Diabetes Research. - : Hindawi Publishing Corporation. - 2314-6745 .- 2314-6753. ; 2020
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Tidskriftsartikel (refereegranskat)abstract
- Aim. The aims of the current study were (1) to determine the prevalence of upper extremity impairments (UEIs) in patients with type 1 diabetes by clinical investigation; (2) to investigate if self-reported impairments were concordant with clinical findings and if key questions could be identified; and (3) to investigate if answers to our self-reported questionnaire regarding UEIs are reliable. Methods. Patients with type 1 diabetes were invited to participate in a cross-sectional study of clinical and self-reported (12 items) UEIs in adjunction to ordinary scheduled clinical visit. Before the visit, a questionnaire on UEIs was filled in twice (test-retest) followed by clinical testing at the planned visit. Results. In total, 69 patients aged and with diabetes duration were included in the study. In the clinical examination, two-thirds (65%) of the patients showed one or more UEI, with failure to perform hand against back as the most common clinical finding (40%) followed by positive Phalen’s test (27%), Tinel’s test (26%), and Prayer’s sign (24%). UEIs observed by clinical examination were often bilateral, and multiple impairments often coexisted. Self-reported shoulder stiffness was associated with impaired shoulder mobility and with Prayer’s sign. Self-reported reduced hand strength was associated to lower grip force, Prayer’s sign, trigger finger, fibrosis string structures, and reduced thenar strength as well as reduced shoulder mobility. In addition, self-reporting previous surgery of carpal tunnel and trigger finger was associated with several clinical UEIs including shoulder, hand, and finger. The test-retest of the questionnaire showed a high agreement of 80-98% for reported shoulder, hand, and finger impairments. Conclusion. UEIs are common in type 1 diabetes. Self-reported shoulder stiffness and reduced hand strength might be used to capture patients with UEIs in need of clinical investigation and enhanced preventive and therapeutic strategies, as well as rehabilitative interventions.
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- Gutefeldt, Kerstin, et al.
(författare)
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Upper extremity impairments in type 1 diabetes with long duration : common problems with great impact on daily life
- 2019
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Ingår i: Disability and Rehabilitation. - : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 41:6, s. 633-640
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate the prevalence, activity limitations and potential risk factors of upper extremity impairments in type 1 diabetes in comparison to controls.METHODS: In a cross-sectional population-based study in the southeast of Sweden, patients with type 1 diabetes <35 years at onset, duration ≥20 years, <67 years old and matched controls were invited to answer a questionnaire on upper extremity impairments and activity limitations and to take blood samples.RESULTS: Seven hundred and seventy-three patients (ages 50 ± 10 years, diabetes duration 35 ± 10 years) and 708 controls (ages 54 ± 9 years) were included. Shoulder pain and stiffness, hand paraesthesia and finger impairments were common in patients with a prevalence of 28-48%, which was 2-4-folds higher than in controls. Compared to controls, the patients had more bilateral impairments, often had coexistence of several upper extremity impairments, and in the presence of impairments, reported more pronounced activity limitations. Female gender (1.72 (1.066-2.272), p = 0.014), longer duration (1.046 (1.015-1.077), p = 0.003), higher body mass index (1.08 (1.017-1.147), p = 0.013) and HbA1c (1.029 (1.008-1.05), p = 0.007) were associated with upper extremity impairments.CONCLUSIONS: Compared to controls, patients with type 1 diabetes have a high prevalence of upper extremity impairments, often bilateral, which are strongly associated with activity limitations. Recognising these in clinical practise is crucial, and improved preventative, therapeutic and rehabilitative interventions are needed. Implications for rehabilitation Upper extremity impairments affecting the shoulder, hand and fingers are common in patients with type 1 diabetes, the prevalence being 2-4-fold higher compared to non-diabetic persons. Patients with diabetes type 1 with upper extremity impairments have more pronounced limitations in daily activities compared to controls with similar impairments. Recognising upper extremity impairments and activity limitations are important and improved preventive, therapeutic and rehabilitation methods are needed.
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- Holstein, Jane, 1970-
(författare)
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Cultural Competence for Health Professionals : Instrument Development
- 2019
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In recent decades, both global migration in general and specifically migration to Sweden have increased. This development compels the need for delivering healthcare to the increasingly diverse populations in Sweden. To support health professionals, for instance occupational therapists, in developing their professional knowledge in encounters with foreign-born clients a self-rating instrument measuring cultural competence is developed. This may contribute to the development of suitable services for foreignborn clients and improve person-centered interventions for these clients.The general aim of this thesis was to develop an instrument for health professionals by examining psychometric properties and utility of the Swedish version of the Cultural Competence Assessment Instrument (CCAI-S) among occupational therapists. The specific aim of study I was to evaluate the content validity and utility of the Swedish version of the Cultural Competence Assessment Instrument (CCAI-S) among occupational therapists. The study had a descriptive and explorative design. Nineteen occupational therapists participated, divided into four focus groups. Qualitative content analysis was used to examine the content validity and utility of the CCAI-S. The specific aim of study II was to examine the clinical relevance, construct validity and reliability of the Swedish version of the Cultural Competence Assessment Instrument (CCAI-S) among Swedish occupational therapists. The study had a cross-sectional design. A web-based questionnaire was e-mailed to a randomised sample of 428 occupational therapists to investigate the construct validity, reliability and utility of the CCAI-S. Factor analysis was performed as well as descriptive statistics.The findings from study I revealed high content validity for all 24 items. However, six items needed reformulations and exemplifications. Regarding utility, the results showed strong support for CCAI-S. The category ‘Interactions with clients’ showed that the CCAI-S could be utilised individually for the health professional and create a higher awareness of cultural questions in practice. The category ‘Workplace and its organisational support’ displayed potential for use in different workplaces regarding CCAI-S and indicated the importance of organisational support for health professionals in the development of cultural competence. The findings from study II regarding construct validity generated a three-factor model with the labels ‘Openness and awareness’, ‘Workplace support’ and ‘Interaction skills’. All three factors showed high factor loadings and contained 12 of the 24 original items. The Cronbach’s Alpha showed high support for the three-factor model. Concerning utility, the participants reported that all 24 items had high clinical relevance.In conclusion, the findings from the two studies indicated good measurement properties and high clinical relevance for the CCAI-S. This may sup-port the utilisation of CCAI-S in the Swedish context for health professionals, for instance occupational therapists. The results of the instrument development show that the upcoming published version of the CCAI-S can be a valuable self-assessment tool for health professionals who strive to improve in person-centred communication in encounters with foreign-born clients. CCAI-S can also be of support for the organisation to serve as a guide for what to focus on to develop cultural competence within the staff. Altogether this presumably influence the effectiveness of the healthcare and enhance the evidence of interventions for foreign-born clients. To develop an instrument is an iterative process requiring several evaluations and tests in various settings and populations. Therefore further psychometric testing and utility studies on the CCAI-S is crucial.
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- Jamali, Reza, 1967-, et al.
(författare)
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Continuous glucose monitoring system signals the occurrence of marked postprandial hyperglycemia in the elderly
- 2005
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Ingår i: Diabetes Technology & Therapeutics. - : Mary Ann Liebert Inc. - 1520-9156 .- 1557-8593. ; 7:3, s. 509-515
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to ascertain whether dysglycemic episodes occur in institutionalized elderly persons and, if that is the case, to determine whether such episodes are related to meal patterns. Another objective was to investigate the feasibility of subcutaneous (s.c.) glucose measurements in the elderly using a Medtronic MiniMed (Sylmar, CA) continuous glucose monitoring system (CGMS®). Methods: Nine nursing home residents (74-95 years old) without known diabetes or other metabolic disorders were included. The s.c. glucose level was measured for 3 days with the Medtronic MiniMed CGMS. Capillary blood glucose was measured four times daily with a Glucometer Elite® device (Bayer, Leverkusen, Germany). Body mass index and basal metabolic rate were calculated, and food intake was recorded. Results: The s.c. glucose level fluctuated noticeably over time, 22.5% of the values recorded during the 3-day period were ≥8 mmol/L, and values <3.5 mmol/L were rarely seen. A marked (>5 mmol/L) and short-term (2-4 h) increase in s.c. glucose was seen after a meal. The mean capillary blood glucose concentration was 7.5 ± 1.8 mmol/L. Capillary blood glucose ≥8 mmol/L was recorded on 32.5% of the measurement occasions, and no values were <3.5 mmol/L. The s.c. glucose values agreed with corresponding capillary blood glucose levels (mean r = 0.75, range 0.43-0.86). Five participants consumed less energy than recommended according to their age, weight, and physical activity level. Conclusions: Postprandial hyperglycemia frequently occurs in elderly people living in nursing homes. The CGMS is convenient to use to detect hyperglycemia in this age group.
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| 8. |
- Johansson, Yvonne, 1956-, et al.
(författare)
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Self-perceived health among older women living in their own residence
- 2007
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Ingår i: International Journal of Older People Nursing. - : Wiley. - 1748-3735 .- 1748-3743. ; 2:2, s. 111-118
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Tidskriftsartikel (refereegranskat)abstract
- Aim. The aim was to characterize women who perceived themselves as healthy and to compare them with women who perceived themselves as less healthy with regard to demographical, social, medical and functional factors. Another aim was to describe changes within the healthy group after one year. Background. Self-perceived health is influenced by several factors, of which diseases and illness are only a part. Method and participants. Two hundred and seventy-eight women, 75 and 80 years old, of which 50% (n ¼ 139) perceived themselves as healthy and less healthy, respectively. Data were collected by using the Nottingham Health Profile, Geriatric Depression Scale, Mini Nutritional Assessment, Mini Mental State Examination and Philadelphia Geriatric Center Multilevel Assessment Instrument, in two examinations at intervals of one year. Results. The women in the healthy group were characterized as having no or low depression symptoms (P ¼ 0.016), better physical mobility (P ¼ 0.029) and better physical health (P < 0.001). Furthermore no or less pain, fewer doctor visits, more energy and fewer negative emotional reactions were predictors for self-perceived health in the healthy group at the one-year follow-up. Conclusion. The most important predictors associated with perceiving oneself as healthy were no or few depression symptoms, physical mobility and good physical health. Relevance to clinical practice. Attention has to be paid to women’s mood, physical health, mobility, pain and energy to help them stay healthy.
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