| 1. |
- Antonsson, Helena, 1962-
(författare)
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Interaktion i särskilt boende för personer med utvecklingsstörning och utmanande beteende
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Många personer med utvecklingsstörning har kommunikativa svårigheter och har därför behov av att utveckla olika sätt att kommunicera för att kunna förstå andra och göra sig förstådda. Svårigheter i kommunikationen påverkar interaktionen mellan personer med utvecklingsstörning och deras vårdare. Detta ställer höga krav på vårdare att kunna tolka och förstå den enskilda individens sätt att uttrycka önskningar och behov. På samma sätt riskerar vårdares budskap att missförstås. Om vårdaren misslyckas att förstå den boendes kommunikation och vice versa, kan det leda till situationer med utmanande beteende exempelvis i form av vägran, verbal eller fysisk aggressivitet.Syfte: Det övergripande syftet med avhandlingen är att studera interaktion mellan vuxna personer med utvecklingsstörning och vårdare i gruppbostäder, samt att studera effekter av en utbildningsintervention för vårdare som arbetar i gruppbostäder.Metod: Avhandlingens samtliga delstudier har genomförts i gruppbostäder för personer med utvecklingsstörning bland boende och vårdare i ett län i norra Sverige. I studie I insamlades data kring 556 personer med utvecklingsstörning. I studie II och III deltog 16 vårdare och 11 personer med utvecklingsstörning. I studie IV deltog 7 vårdare. Studie I bygger på personalens skattningar av funktionsnivåer och förekomst av begränsningsåtgärder. I Studie II och III utgörs data av videoobservationer och narrativa intervjuer. I studie IV användes flera datainsamlingsmetoder i en mixed method design med både vårdarnas skattningar, med hjälp av instrument och semi-strukturerade intervjuer. Analys av materialet i studie II, III och IV har gjorts med kvalitativ innehållsanalys och i studie I och IV har data analyserats statistiskt.Resultat: I studie I framkom att av 556 boende hade 99 (18%) varit föremål för fysiska begränsningsåtgärder under den senaste veckan. Av dessa 99 hade nästan alla varit föremål för mer än en typ av begränsningsåtgärd. Den vanligaste begränsningsåtgärden var bälte i stol (74%). Användningen av begränsningsåtgärder var relaterade både till fysiska funktionsnedsättningar och till beteende.I studie II reflekterade vårdare över videoinspelad interaktion där vårdarna medverkat, både framgångsrik och misslyckad interaktion. Exempel på framgångsrik interaktion var att förstå tecken, kunna möta behov och hantera situationer med utmanande beteenden. Vårdarna reflekterade över att framgångsrik interaktion ledde till säkerhet, trygghet och självförtroende hos de boende. Vårdarna reflekterade även över de konsekvenser misslyckad interaktion fick i form av irritation, aggression och våld från de boende.I studie III studerades videoinspelad interaktion mellan 11 personer med utvecklingsstörning och 16 av deras vårdare. Verbal och icke-verbal interaktion identifierades. Fyra inspelade situationer valdes ut för att belysa framgångsrikt samspel. Resultatet visade att framgångsrikt samspel mellan personer med utvecklingsstörning och deras vårdare bland annat bygger på möjligheten att bekräfta varandra, dela vardagshändelser, ge tid och utrymme och på att använda ett kongruent och tydligt språk.I studie IV utvärderades effekterna av en web-baserad utbildningsintervention, vars syfte var att förbättra interaktionen mellan personer med utvecklingsstörning och vårdare samt att därmed reducera förekomsten av situationer med utmanande beteende. Resultatet visade att vårdarna hade förbättrat sin förmåga att hantera situationer med utmanande beteende och att förekomsten av utmanande beteende minskat. Vårdarna beskrev att den web-baserade utbildningen upplevts givande och möjlig att ta del av parallellt med arbetet.Slutsats: Fysiska begränsningsåtgärder förekommer i gruppbostäder för personer med utvecklingsstörning. Användningen av begränsningsåtgärder kan vara relaterade både till fysiska funktionsnedsättningar och till beteenden i samspelet mellan brukare och vårdare. Vårdare upplever användningen av fysiska begränsningsåtgärder svår och tröttande. Brott i kommunikationen mellan personer med utvecklingsstörning och deras vårdare kan leda till försvårad interaktion med risk för situationer med utmanande beteenden. När vårdare är framgångsrika i interaktionen med personer med utvecklingsstörning ger det tillfredsställelse både för de boende och vårdarna. Vårdarna upplever dock ofta hjälplöshet och osäkerhet i relation till hantering av situationer med utmanande beteende och efterfrågar utbildning. Web-baserad utbildning om interaktion med personer med utvecklingsstörning och utmanande beteende har i vår studie visat sig ge lovande effekter och bör vara möjlig att utveckla för både introduktion av nyanställda vårdare och för kompetensutveckling bland mer erfaren personal.
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| 2. |
- Gabrielsson, Hanna, 1977-
(författare)
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Adults with Spina bifida : voices from everyday life and exploration of living conditions
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to generate knowledge about living with Spina bifida, by mapping the condition and together with the adults with Spina bifida explore their living conditions and experiences in everyday life. Methods Study I was a quantitative study with a cross-sectional design. In Study II, individual experiences of daily life were explored by deep interviews using a reflective lifeworld approach. Study III had a participatory approach including five members of a photovoice group who met for eight sessions. Photographs taken by the members served as a starting point for the dialogue about what was of interest in their daily life. A narrative analysis was conducted by the researchers, incorporating the analysis the group did together. Study IV focused on alignment with the methodology in which photovoice is grounded. By returning to the ideological cornerstones of photovoice, the empirical experiences from Study III and examples from the literature were elaborated through processes within photovoice. The findings show that those adults with Spina bifida who were >46 years old had less complex medical conditions and better physical and cognitive functions, and had attained a higher level of education. The main theme in Study II was presented as “The contradictory path towards wellbeing in daily life.” In Study III, the members’ experiences in everyday life showed that many solutions offered by society were “An adaptation for us, but it works for no one.” The findings are further presented under three themes: “Accessibility – a never-ending project,” “Tensions of a normative view” and “Power to influence.” By focusing on action and narrative in Study IV, it is shown that dialogue, action, and interaction are important aspects of using photovoice. In conclusion, not all adult persons receive the support they need in everyday life, something future generations of adult persons with Spina bifida may have a higher need for. The stories and experiences of adults with Spina bifida in this thesis paint a history of not being asked, concerning their own situation. This shows that there is insufficient integration of the persons’ experiences in society’s efforts to plan for, and support, these individuals. The photovoice method was feasible for this group, providing opportunity for being part of dialogue, action, and interaction.
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| 3. |
- Granlund, Anna, 1984-
(författare)
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Facilitating Automation Development in Internal Logistics Systems
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The internal logistics system includes all activities connected with managing the flow of materials within the physical limits of a facility. This system is an important part of operations in need of increased focus and continuous improvements. Automation is one possible tool with a previously confirmed great potential to improve internal logistics. Despite this great potential and a growing trend of using automation in the area, internal logistics activities are still not automated to the same extent as other parts of operations. The overall aim of this research is therefore to develop knowledge that supports the successful use of automation in internal logistics systems.The automation development process has been identified as critical for the success of the use of automation. With the overall aim of the research in mind, the objective of this thesis is to develop a framework facilitating the automation development process in internal logistics systems. To help fulfil the objective, empirical data have been collected through five case studies and a survey study. During the empirical studies, the process of improving the internal logistics system and the automation development process have been analysed and the focus has been on identifying challenges and facilitators for the successful use and development of automation in internal logistics systems.The findings indicate a poor awareness of both current and desired performance of the internal logistics system at the companies studied. In addition, automation development is often conducted in an unstructured and poorly supported manner and there is often insecurity regarding what steps and actions to take. Foremost, the findings indicate a poor base for proper evaluation and decisions during automation development in internal logistics systems. This is analysed and concluded as a cause of unclear goals and requirements and the lack of a strategic view with regard to both internal logistics operations and the use and development of automation.A framework, including proposed guidelines to overcome the observed challenges by including identified factors facilitating successful automation development in internal logistics systems has been developed. The core of the framework is a proposed process model for automation development in an internal logistics context. Due to the identified importance and the lack of a strategy linked to and supporting the automation development process, the framework also includes a proposed model for an internal logistics strategy as well as a proposed model for an automation strategy.
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| 4. |
- Janeslätt Granlund, Gunnel, et al.
(författare)
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Assessment of time processing ability and daily time management in children with and without developmental disabilities
- 2011
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Ingår i: Learning and Memory Developments and Intellectual Disabilities. - : Nova Science Publishers, Inc. - 9781608763979 ; , s. 269-280
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- In the time-dependent society of today, those with limited ability to manage time will show a heightened dependence on others and more need for support, exacerbating their vulnerability. Children with developmental disorders e.g. intellectual disabilities or Autism Spectrum Disorders are reported to have problems in time perception, time orientation or time management, in this chapter all related to the suggested overarching concept: time processing ability (TPA). The aim of this short communication is to present a currently developed innovative assessment of TPA and its relation to daily time management (TM) in children with and without developmental disabilities, including intellectual disabilities. The new assessment of TPA; Kit for assessing Time processing ability (KaTid) for children was based on current knowledge of information processing in children with cognitive disabilities e.g. using iconic symbols and concrete concepts. Using modern test statistics (Rasch analysis), the evaluation of the KaTid and a related Parent scale for estimating the daily TM presented acceptable psychometric properties. The results indicate that the items in KaTid, initially defined as time perception, time orientation and time management, all empirically support a potential uni-dimensional construct, TPA. In this TPA construct, time perception, time orientation and time management can be seen as different levels of complexity rather than as separate constructs. The Parent scale of daily TM also demonstrated acceptable psychometric properties. There is a relation between the parents' ratings of a child's daily TM and TPA in children with developmental disabilities. Thus TPA seems to be a factor related to children's daily TM that needs to be taken into consideration when planning and evaluating interventions designed to facilitate everyday functioning for children with ID. This is a step towards providing evidence-based instruments that, together with other information, can help the professional in structuring the intervention planning process for children with difficulties in daily TM.
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| 5. |
- Karlsson, Maria, 1973-, et al.
(författare)
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Changing services to children with disabilities and their families through in-service training - is the organisation affected?
- 2008
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Ingår i: European Journal of Special Needs Education. - London : Routledge. - 0885-6257 .- 1469-591X. ; 23:3, s. 207-222
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Tidskriftsartikel (refereegranskat)abstract
- Professional development in family centred services was given to professionals supporting children with disabilities and their families with the purpose to influence ways to perform working tasks. Is it possible to change ways of working through in-service training? In order to find answers to that question perceptions of in-service training at different organisational levels was collected by interviews. Ways to perform working tasks was investigated by self reported ratings on questionnaires. What kind of change the teams experienced was analysed through written assignments in the end of professional development. The study builds on a longitudinal design. Watzlawick, Weakland and Fisch (1974) identified orders of change is used to analyse perceptions of and changes after professional development. The findings reveal that participants at different levels of the organisation have rather similar perceptions of the in-service training. They are described more in depth by participants within the organisation than the ones outside (parents and managers), who rather describe the consequences of the professional development than the actual professional development process. After professional development the family approach has been adopted among most professionals, for example are assessment tools and model for habilitation plans which were presented in professional development used in everyday work after professional development. This implies a second order change. However do some professionals claim that the family ways of working is nothing new to them, which correspond to a first order change. Professional development in conjunction with resources after professional development are therefore seen as factors that facilitate second order change.
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| 6. |
- Lundström, Mats, 1956-
(författare)
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Våld - utmaning och utmattning : vårdares utsatthet och upplevelser i samband med våld i gruppbostäder för personer med utvecklingsstörning
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- ABSTRACT This thesis aims to explore the prevalence of violence towards caregivers working in group home for people with learning disabilities, as well as the influence of work climate and personality on the caregivers’ experiences of strain and exposure to violence. The thesis comprises four studies conducted among caregivers working in group homes for people with learning disabilities in one urban district in Sweden. Study I includes data regarding caregivers’ exposure to violence and their demographics. In study II and III data were collected by instruments for measuring caregivers’ personalities and experiences of the work climate as well as emotional reactions, strain, and experiences of burnout. Data were also collected by 50 narrative interviews with 44 caregivers reporting exposure to violence. In order to illuminate caregivers’ experiences of being exposed to violence, the interviews were transcribed and interpreted using qualitative content analysis. The results showed that 31% of the caregivers (n=120) had been exposed to violence during the preceding year, with physical violence being the most common type. Weak relationships were found between reported exposure to violence and caregivers’ age and education (I). Among those in studies II and III who completed all instruments (n=112), 45 caregivers (40%) reported exposure to violence. A significant difference in age was found between exposed and not exposed caregivers. In the total sample of studies II and III, 30% (n=41) of the caregivers were at risk of developing burnout. The relationship between exposure to violence and the caregivers’ experiences of the work climate (CCQ) showed that “debates” was the only factor that on average was significantly higher among caregivers reporting violence from the residents. The caregivers’ emotional reactions, strain, and work climate factors explained 35% of the variance in burnout scores (II). No significant relationships were found between the caregivers’ personalities (TCI and RSES) and their exposure to violence. Personality dimensions explained 32% of the variance of the caregivers’ experiences of burnout. The results did not show a significant relationship between a caregiver’s personality and exposure to violence. However, those exposed to violence reported more emotional exhaustion than those not exposed (III). Caregivers exposed to violence reported feelings of powerlessness, insufficiency, anger and violence was very seldom followed by support from the managers at the group homes (I). Interviews show that caregivers’ experiences are about “falling apart” and “keeping it together”. Falling apart involves fear, powerlessness, sadness, anger, and timelessness, while keeping it together involves joy, respect, self-reflection, and habituation. Destructive experiences are balanced by a more constructive view of the situation by keeping the situation, and the caregivers themselves, together. The findings show that exposure to violence occurs frequently and a large proportion of the exposed caregivers are at risk for burnout. It was not possible to confirm the relationships between the caregivers’ personality, experiences of the work climate, and exposure to violence but partly to emotional reactions, strain and burnout. The findings of the four studies are discussed in relation to how it is to live and work in an environment where violence is of frequent occurrence.
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| 7. |
- Adair, Brooke, et al.
(författare)
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Measures used to quantify participation in childhood disability and their alignment with the family of participation-related constructs : a systematic review
- 2018
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Ingår i: Developmental Medicine & Child Neurology. - : WILEY. - 0012-1622 .- 1469-8749. ; 60:11, s. 1101-1116
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Forskningsöversikt (refereegranskat)abstract
- AimWe aimed to identify measures used to assess the participation of disabled children and to map the measures' content to the family of participation-related constructs (fPRC) to inform future research and practice. MethodSix databases were searched to identify measures used to assess participation in health, psychology, and education research. Included studies involved children aged 0 to 18 years with a permanent impairment or developmental disability and reported use of a quantitative measure of participation. A second search sought relevant literature about each identified measure (including published manuals) to allow a comprehensive understanding of the measure. Measurement constructs of frequently reported measures were then mapped to the fPRC. ResultsFrom an initial yield of 32 767 articles, 578 reported one or more of 118 participation measures. Of these, 51 measures were reported in more than one article (our criterion) and were therefore eligible for mapping to the fPRC. Twenty-one measures quantified aspects of participation attendance, 10 quantified aspects of involvement as discrete scales, and four quantified attendance and involvement in a manner that could not be separated. InterpretationImproved understanding of participation and its related constructs is developing rapidly; thoughtful selection of measures in research is critical to further our knowledge base.
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| 8. |
- Adair, Brooke, et al.
(författare)
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The effect of interventions aimed at improving participation outcomes for children with disabilities : a systematic review
- 2015
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Ingår i: Developmental Medicine & Child Neurology. - : Wiley. - 0012-1622 .- 1469-8749. ; 57:12, s. 1093-1104
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Forskningsöversikt (refereegranskat)abstract
- AimEnhancement of participation has been described as the ultimate outcome for health and educational interventions. The goal of this systematic review was to identify and critically appraise studies that aimed to improve the participation outcomes of children with disabilities.MethodNine databases that index literature from the fields of health, psychology, and education were searched to retrieve information on research conducted with children with disabilities aged between 5 years and 18 years. Articles were included if the author(s) reported that participation was an intended outcome of the intervention. The articles included were limited to those reporting high-level primary research, as defined by Australia's National Health and Medical Research Council evidence hierarchy guidelines. No restrictions were placed on the type of intervention being investigated.ResultsSeven randomized controlled or pseudo-randomized studies were included. Only three of these studies identified participation as a primary outcome. Both individualized and group-based approaches to enhancing participation outcomes appeared to be effective. Studies of interventions with a primary focus on body function or activity level outcomes did not demonstrate an effect on participation outcomes.IntepretationFew intervention studies have focused on participation as a primary outcome measure. Approaches using individually tailored education and mentoring programmes were found to enhance participation outcomes, while exercise programmes, where participation was a secondary outcome, generally demonstrated little effect.
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| 9. |
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| 10. |
- Adolfsson, Margareta, 1950-
(författare)
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Applying the ICF-CY to identify everyday life situations of children and youth with disabilities
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Four studies were included in this doctoral dissertation aiming to investigatehow habilitation professionals perceive the ICF-CY in clinical work and to identify everyday life situations specific for children and youth aged 0-17 years. The ICF-CY was the conceptual framework and since the research was conducted on as well as with the ICF-CY, the use of the classification runs like a thread through all the work. The design was primarily qualitative and included descriptive and comparative content analyses. Study I was longitudinal, aiming to explore how an implementation of the ICF-CY in Swedish habilitation services was perceived. Studies II-IV were interrelated, aiming to explore children’s most common everyday life situations. Content in measures of participation, professionals’ perspectives, and external data on parents’ perspectives were linked to the ICF-CY and compared. Mixed methods design bridged the Studies III-IV. Results in Study I indicated that knowledge on the ICF-CY enhanced professionals’ awareness of families’ views of child functioning and pointed to the need for ICF-CY based assessment and intervention methods focusing on child participation in life situations. A first important issue in this respect was to identify everyday life situations. Two sets of ten everyday life situations related to the ICF-CY component Activities and Participation, chapters d3-d9, were compiled and adopted for younger and older children respectively, establishing a difference in context specificity depending on maturity and growing autonomy. Furthermore, key constructs in the ICFCY model were discussed, additional ICF-CY linking rules were presented and suggestions for revisions of the ICF linking rules and the ICF-CY were listed. As the sample of everyday life situations reflects the perspectives of adults, further research has to add the perspective of children and youth. The identified everyday life situations will be the basis for the development of code sets included in a screening tool intended for self- or proxy- report of participation from early childhood through adolescence.
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