| 1. |
- Caltenco, Héctor A., et al.
(författare)
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Designing interactive systems for balance rehabilitation after stroke
- 2017
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Ingår i: TEI 2017 - Proceedings of the 11th International Conference on Tangible, Embedded, and Embodied Interaction. - New York, NY, USA : ACM. - 9781450346764 ; , s. 511-516
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Konferensbidrag (refereegranskat)abstract
- This paper presents four different tangible interactive prototypes designed to support the continuation of balance rehabilitation at home. The interactive prototypes are designed to provide a more enjoyable and experience when performing balance rehabilitation exercises. Early results from preliminary tests with stroke survivors and rehabilitation professionals are promising. The aim of the designs is to allow people at different levels of rehabilitation to engage into balance training and perform the exercises according to their current skills.
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| 2. |
- Magnusson, Charlotte, et al.
(författare)
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Tangible interaction for stroke survivors : Design recommendations
- 2017
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Ingår i: TEI 2017 - Proceedings of the 11th International Conference on Tangible, Embedded, and Embodied Interaction. - New York, NY, USA : ACM. - 9781450346764 ; , s. 597-602
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Konferensbidrag (refereegranskat)abstract
- In this paper we outline the initial stages of a human centered design process aimed at the design of novel technology (tangible interactive objects) for stroke survivors. We found it useful to support standard methods, such as interviews and focus groups, with a video prototype in order to make the concept of tangible interaction, which was novel to our users, more clear. In addition we carried out a co-design workshop together with stroke survivors. Based on these activities, we present a set of preliminary design guidelines for tangible interaction for stroke survivors.
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| 3. |
- Olafsdottir, Steinunn A., et al.
(författare)
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Developing ActivABLES for community-dwelling stroke survivors using the Medical Research Council framework for complex interventions
- 2020
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 20
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Tidskriftsartikel (refereegranskat)abstract
- Background: Novel technical solutions are called for to promote home-based exercise among community-dwelling stroke survivors supported by their caregivers. Lack of resources and knowledge about how to accomplish it, has been demonstrated. The objective of this study is to describe in detail the development of ActivABLES, a technical intervention to promote home-based exercise and physical activity engagement of community-dwelling stroke survivors with support from their caregivers. Methods: The technical development process of ActivABLES was guided by the Medical Research Council (MRC) framework for development and evaluation of complex interventions as well as by principles of human-centred design and co-design. The main steps included: (1) Synthesis of evidence supporting the inclusion of balance exercises, mobility and walking exercises and exercises for the upper arm; (2) Implementation of initial user studies with qualitative data collection from individual interviews with stroke survivors, and focus group interviews with caregivers and health professionals; (3) Preliminary testing of eight prototypes with seven stroke survivors and their caregivers. Results: After the preliminary testing of eight prototypes, four prototypes were not further developed whereas four prototypes were modified further. In addition, two new prototypes were developed, leaving six prototypes for further modification: 1) ActivFOAM for balance exercises, 2) WalkingSTARR to facilitate walking, 3) ActivBALL for hand exercises, 4) ActivSTICKS for upper arm exercises, and 5) ActivLAMP and 6) ActivTREE which both give visual feedback on progress of daily exercise and physical activities. ActivFOAM, ActivBALL and ActivSTICKS are all connected to a tablet where exercise instructions are given. All the exercise prototypes can be connected to ActivLAMP and ActivTREE to give feedback on how much exercise the user has done. Settings can be individualised and recommended daily time and/or repetition can easily be changed as the user progresses to higher activity levels. Conclusions: The development process of ActivABLES was guided by the principles of human-centred design, with iterative testing of future users, and by the MRC framework of complex intervention, with a repeated process of development and testing. This process resulted in six prototypes which are available for feasibility testing among a small group of community-dwelling stroke survivors.
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| 4. |
- Olafsdottir, Steinunn A., et al.
(författare)
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Feasibility of ActivABLES to promote home-based exercise and physical activity of community-dwelling stroke survivors with support from caregivers : A mixed methods study
- 2020
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Technical applications can promote home-based exercise and physical activity of community-dwelling stroke survivors. Caregivers are often able and willing to assist with home-based exercise and physical activity but lack the knowledge and resources to do so. ActivABLES was established to promote home-based exercise and physical activity among community-dwelling stroke survivors, with support from their caregivers. The aim of our study is to investigate the feasibility of ActivABLES in terms of acceptability, demand, implementation and practicality. METHODS: A convergent design of mixed methods research in which quantitative results were combined with personal experiences of a four-week use of ActivABLES by community-dwelling stroke survivors with support from their caregivers. Data collection before, during and after the four-week period included the Berg Balance Scale (BBS), Activities-Specific Balance Confidence Scale (ABC), Timed-Up-and-Go (TUG) and Five Times Sit to Stand Test (5xSST) and data from motion detectors. Semi-structured interviews were conducted with stroke survivors and caregivers after the four-week period. Descriptive statistics were used for quantitative data. Qualitative data was analysed with direct content analysis. Themes were identified related to the domains of feasibility: acceptability, demand, implementation and practicality. Data was integrated by examining any (dis)congruence in the quantitative and qualitative findings. RESULTS: Ten stroke survivors aged 55-79 years participated with their informal caregivers. Functional improvements were shown in BBS (+ 2.5), ABC (+ 0.9), TUG (- 4.2) and 5xSST (- 2.7). More physical activity was detected with motion detectors (stand up/sit down + 2, number of steps + 227, standing + 0.3 h, hours sitting/lying - 0.3 h). The qualitative interviews identified themes for each feasibility domain: (i) acceptability: appreciation, functional improvements, self-initiated activities and expressed potential for future stroke survivors; (2) demand: reported use, interest in further use and need for follow-up; (3) implementation: importance of feedback, variety of exercises and progression of exercises and (4) practicality: need for support and technical problems. The quantitative and qualitative findings converged well with each other and supported the feasibility of ActivABLES. CONCLUSIONS: ActivABLES is feasible and can be a good asset for stroke survivors with slight or moderate disability to use in their homes. Further studies are needed with larger samples.
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| 5. |
- Hjaltadottir, Ingibjörg, et al.
(författare)
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Health status and functional profile at admission of nursing home residents in Iceland over 11-year period.
- 2011
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Ingår i: International journal of older people nursing. - : Wiley. - 1748-3743 .- 1748-3735.
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Tidskriftsartikel (refereegranskat)abstract
- Health status and functional profile at admission of nursing home residents in Iceland over 11-year period. International Journal of Older People Nursing doi: 10.1111/j.1748-3743.2011.00287.x Background. The knowledge over time of the health status and changes in care needs of newly admitted nursing home residents is limited. Objectives. To investigate trends in residents' health status and functional profile at admission to nursing homes and compare rural and capital areas in Iceland over an 11-year period. Design. Retrospective analysis of nursing home data over 11 years (1996-2006). Participants. Residents, who had been assessed with the Minimum Data Set assessment within 90 days from admittance (n = 2206). Method. Non-parametric tests for descriptive statistics and linear regressions were used to analyse time trends. Results. The mean age ranged from 80.1 to 82.8, and women accounted for 52.7% to 67.1%. The level of independency indicated intact cognitive performance in 28.6-61.4% and in 42.5-68% in activities of daily living performance. A weak, but significant, linear trend was seen in residents' health becoming less stable, their cognitive performance improving, more pain being reported and greater participation in social activities over the 11 years. Conclusion. Some residents might have stayed at home longer had they been given appropriate home care and the opportunity of rehabilitation. Pain management and social activities are areas where more staff knowledge seems to be needed. Implications for practice. Resources to enable old people to remain at home need to be explored before their entry into nursing homes. Whereas providing services at the appropriate level is important for society as well as older people.
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| 6. |
- Hjaltadottir, Ingibjörg
(författare)
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ICELANDIC NURSING HOME RESIDENTS: THEIR MORTALITY, HEALTH, FUNCTIONAL PROFILE, AND CARE QUALITY, USING THE MINIMUM DATA SET OVER TIME
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to investigate trends over time in residents’ health status, functional profile and predictors of mortality at admission to Icelandic nursing homes and in addition to determine upper and lower thresholds for Minimum Data Set (MDS) Quality Indicators, to investigate the prevalence of quality indicators over time and their association with the health status and functional profile of residents in Icelandic nursing homes. Studies I and II included 2,206 persons assessed over 11 years (1996-2006). In study III a modified Delphi method and a panel of 12 members were used to determine the thresholds for Minimum Data Set Quality Indicators. Data from residents (N=2,247 representing 47 nursing homes) were analysed, applying the thresholds developed. In study IV the sample was 11,034 MDS assessments of 3,694 residents (2003-2009) and in the framework the sample was 11,912 MDS assessments of 3,704 residents (1999-2009). Study I showed that 28.6-61.4% of residents had intact cognitive performance and 42.5-68% were independent in ADL performance. A weak, but significant, linear trend over the eleven years was seen in residents' health becoming less stable, their cognitive performance improving, more pain being reported and greater participation in social activities. Study II showed that the median survival time was 31 months. No significant difference was detected in the mortality rate between cohorts. Age, gender (HR 1.52), place admitted from (HR 1.27), ADL functioning (HR 1.33-1.80), health stability (HR 1.61-16.12) and ability to engage in social activities (HR 1.51-1.65) were significant predictors of mortality. In study III upper and lower thresholds for 20 Minimum Data Set Quality Indicators were established. Residents not having a quality indicator present numbered from 32.5-99.3% depending on the indicator in question. The quality indicators with the median value above the upper threshold, indicating poor care, were: depression (49.4%); symptoms of depression without antidepressant (18.2%); use of 9 or more medications (63.8%); anti-anxiety or hypnotic drug use (69.2%); little or no activity (52.5%). Findings from study IV showed that 16 out of 20 quality indicators increased in prevalence, indicating a decline in quality of care (p< 0.05) over the study period. In 12 out of 20 indicators the prevalence was lower than 25%. One quality indicator showed improvement, i.e. ‘Bladder and bowel incontinence without a toileting plan’ from 17.4% in 2003 decreasing to 11.5% in 2009 (p<0.001). Residents’ health and functional status partially explained the increased prevalence of the quality indicators over time. At admittance many residents had a relatively high level of independence, the mortality rate did not change over the study period and health stability and ADL performance were strong predictors of mortality. More than 50% died within 3 years, and almost a third of the residents may have needed palliative care within a year of admission. Pain management, social engagement and palliative care are areas where more staff knowledge seems to be needed. The thresholds established aims for Icelandic nursing homes, uncovering areas of care requiring improvement. Icelandic nursing homes seem to be doing best in handling incontinence and nutritional care, and in several quality indicators the prevalence was quite low. The areas of care that indicated poor care and needed improvement included treatment of depression, number of medications and resident activity level. Quality Indicator results and trends over time can be used for improvement, planning of services and staff knowledge.
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| 7. |
- Hjaltadottir, Ingibjörg, et al.
(författare)
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Predicting mortality of residents at admission to nursing home: A longitudinal cohort study
- 2011
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: An increasing numbers of deaths occur in nursing homes. Knowledge of the course of development over the years in death rates and predictors of mortality is important for officials responsible for organizing care to be able to ensure that staff is knowledgeable in the areas of care needed. The aim of this study was to investigate the time from residents' admission to Icelandic nursing homes to death and the predictive power of demographic variables, health status (health stability, pain, depression and cognitive performance) and functional profile (ADL and social engagement) for 3-year mortality in yearly cohorts from 1996-2006. Methods: The samples consisted of residents (N=2206) admitted to nursing homes in Iceland in 1996-2006, who were assessed once at baseline with a Minimum Data Set (MDS) within 90 days of their admittance to the nursing home. The follow-up time for survival of each cohort was 36 months from admission. Based on Kaplan-Meier analysis (log rank test) and non-parametric correlation analyses (Spearman's rho), variables associated with survival time with a p-value < 0.05 were entered into a multivariate Cox regression model. Results: The median survival time was 31 months, and no significant difference was detected in the mortality rate between cohorts. Age, gender (HR 1.52), place admitted from (HR 1.27), ADL functioning (HR 1.33-1.80), health stability (HR 1.61-16.12) and ability to engage in social activities (HR 1.51-1.65) were significant predictors of mortality. A total of 28.8% of residents died within a year, 43.4% within two years and 53.1% of the residents died within 3 years. Conclusion: It is noteworthy that despite financial constraints, the mortality rate did not change over the study period. Health stability was a strong predictor of mortality, in addition to ADL performance. Considering these variables is thus valuable when deciding on the type of service an elderly person needs. The mortality rate showed that more than 50% died within 3 years, and almost a third of the residents may have needed palliative care within a year of admission. Considering the short survival time from admission, it seems relevant that staff is trained in providing palliative care as much as restorative care.
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| 8. |
- Hjaltadottir, Ingibjörg, et al.
(författare)
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Quality of care in Icelandic nursing homes measured with Minimum Data Set quality indicators: Retrospective analysis of nursing home data over 7 years.
- 2012
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Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 1873-491X .- 0020-7489.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The increasing need for long-term care as well as diminished financial resources may compromise the quality of care of older people. Thus the need for clinically based quality of care monitoring to guide development of long-term services has been pointed out. OBJECTIVES: The aim of this study was to investigate trends in quality of care during 2003-2009 as reflected in the Minimum Data Set quality indicator outcome in Icelandic nursing homes and to investigate the association of Minimum Data Set quality indicators with residents' health status (health stability, pain, depression and cognitive performance) and functional profile (activities of daily living and social engagement). DESIGN: Retrospective analysis of nursing home data over 7 years. METHODS: The sample used for analysis was 11,034 Minimum Data Set assessments of 3694 residents living in Icelandic nursing homes in 2003-2009. Minimum Data Set quality indicators were used to measure quality of care. The chi-square test for trend and multivariate logistic regression were used to analyse the data. RESULTS: The mean age of residents during the period of the study ranged from 82.3 (SD 9.1) to 85.1 (SD 8.3) and women accounted for from 65.2% to 67.8%. Findings for 16 out of 20 quality indicators indicated a decline in quality of care (p<0.05), although in 12 out of 20 indicators the prevalence was lower than 25%. One quality indicator showed improvement, i.e. for "Bladder and bowel incontinence without a toileting plan" from 17.4% in 2003 decreasing to 11.5% in 2009 (p<0.001). Residents' health and functional status partially explain the increased prevalence of the quality indicators over time. CONCLUSION: Further developments in quality of care in Icelandic nursing homes need to be monitored as well as the association between residents' health and functional status and the Minimum Data Set quality indicator outcome. The areas of care where the Minimum Data Set quality indicators showed need for improvement included treatment of depression, number of medications, resident activity level and behavioural symptoms.
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| 9. |
- Hjaltadottir, Ingibjörg, et al.
(författare)
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Thresholds for Minimum Data Set Quality Indicators Developed and Applied in Icelandic Nursing Homes.
- 2012
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Ingår i: Journal of Nursing Care Quality. - 1550-5065. ; 27:3, s. 266-276
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Tidskriftsartikel (refereegranskat)abstract
- A modified Delphi method was used to determine thresholds for Minimum Data Set quality indicators for Icelandic nursing homes. The thresholds were then applied to quality outcomes in Icelandic nursing homes for the year 2009. The thresholds indicate areas of good or poor care and can be used for planning services. Icelandic nursing homes seem to be doing best in incontinence and nutritional care. However, improvement is needed in care practices for depression, medication, and activity.
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| 10. |
- Magnusson, Charlotte, et al.
(författare)
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Interactive Balance and Walking Training for Stroke Survivors
- 2019
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Ingår i: 13th EAI International Conference on Pervasive Computing Technologies for Healthcare - Demos and Posters. - : EAI. - 9781631901843
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Konferensbidrag (refereegranskat)abstract
- In the ActivAbles and STARR projects we have developed interactive training tools for stroke survivors. A prototype system includes an interactive balance foam pad, feedback lamps and a step counting game app which all connect to a central server. The feedback is designed to be inclusive - designs are multimodal, and the setup is flexible and can easily be adapted. We describe the system and report results from a feasibility study with 10 stroke survivors who used the system for a longer period in the home.
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