| 1. |
- Bejerholm, Ulrika, et al.
(författare)
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Stöd till studier och arbete
- 2020. - 3
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Ingår i: Att leva med psykisk funktionsnedsättning : livssituation och effektiva vård- och stödinsats - livssituation och effektiva vård- och stödinsats. - 9789144126227 ; , s. 351-366
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Bokkapitel (refereegranskat)
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| 2. |
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| 3. |
- Lexén, Annika, et al.
(författare)
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Case management och integrerade vård- och stödinsatser
- 2020. - 3
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Ingår i: Att leva med psykiska funktionsnedsättning : livssituation och effektiva vård- och stödinsatser - livssituation och effektiva vård- och stödinsatser. - 9789144126227 ; , s. 417-431
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 4. |
- Liljeholm, Ulrika, et al.
(författare)
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An integrated mental health and vocational intervention : A longitudinal study on mental health changes among young adults
- 2020
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Ingår i: Nursing Open. - : Wiley. - 2054-1058. ; 7:6, s. 1755-1765
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This study aimed to investigate changes in mental health among young adults participating in an integrated mental health and vocational support intervention according to the Södertälje Supported Employment and Education model. Design: A prospective longitudinal pre–post intervention study of 12 months. Methods: Instruments on depressive symptoms, quality of life, empowerment, engagement in activities and sociodemographic characteristics were administered to 42 young adults aged 19–28 years with mood disorders. Wilcoxon signed rank tests were used to assess changes in mental health. Results: Statistically significant positive changes between baseline and 12 months were noted for quality of life and engagement in activities. Difference in empowerment scores neared significance and a statistical trend towards lower depression scores was seen, corresponding to moderate depression at baseline and less severe depression at 12 months. Conclusions: Integrated mental health and vocational services may support young adults' mental health and is suggested to be linked to their personal recovery and clinical recovery.
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| 5. |
- Liljeholm, Ulrika, et al.
(författare)
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Att utveckla arbetsidentitet hos unga vuxna med psykisk ohälsa
- 2019
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Konferensbidrag (refereegranskat)abstract
- Bakgrund: Hur vi identifierar oss är starkt kopplat till arbete. Unga vuxna är en känslig grupp när det gäller inträde på arbetsmarknaden. Om de också har psykisk ohälsa blir det ännu svårare och risken för marginalisering ökar. Likväl har arbete visat väsentlig betydelse för en personlig återhämtning. Syftet med studien var att utforska erfarenheter bland unga vuxna med psykisk ohälsa som börjar arbeta, med fokus på processen att utveckla arbetsidentitet. Ytterligare syfte var att utveckla kunskap för att förbättra kliniskt resonemang bland arbetsterapeuter och andra yrkesverksamma inom psykiatrisk rehabilitering och arbetsinriktad verksamhet i strävan att stödja unga i deras övergång i arbete och därmed vardagligt socialt och samhällsliv.Metod: Grounded teori användes som design. Materialet bestod av 13 djupintervjuer med unga vuxna med psykisk ohälsa i åldern 19-26 år, som arbetat i minst tre månader. Resultat: Att börjar arbeta bidrog med en process av inre och yttre förändring, nya känslor, utmaningar och förståelse för omvärlden. Tidigare negativa tankemönster blev mer positiva. Nya roller och aktivitetsmönster utvecklades vilket förändrade synen på egen förmåga och därigenom self-efficacy. Denna utveckling bidrog till en positiv process som gav en arbetsidentitet och nya riktningar i livet. Slutsatser: Vi antar att processen att utveckla arbetsidentitet stöder övergången till vuxen ålder och en karriärutveckling för unga vuxna med psykiska ohälsa. Resultaten stöder att utveckling av arbetsidentitet förväntas vara en del av en personlig återhämtningsprocess för individer. Stöd till unga vuxna med psykisk ohälsa genom möjligheter att arbeta är kritiskt.
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| 6. |
- Liljeholm, Ulrika, et al.
(författare)
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The Journey to My Student Identity : A Grounded Theory Study on Supported Education for Young Adults with Mental Health Problems
- 2022
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Ingår i: Journal of Psychosocial Rehabilitation and Mental Health. - : Springer. - 2198-9834 .- 2198-963X. ; , s. 203-219
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Tidskriftsartikel (refereegranskat)abstract
- Support for developing a work identity has been shown to be essential for the recovery process of young adults with mental health problems. Since research shows that the development of a student role during the educational years for these young adults may be interrupted, this time period may be relevant to explore in order to support career development and the critical transition to adulthood for this target group. To explore young adults’ experiences of participating in supported education that is integrated with vocational and mental health services, reflecting the process of developing a student identity while struggling with mental health problems. A grounded theory design was used. The material consists of 17 individual interviews with young adults aged 18–29 years who were receiving supported education. Young adults who study while having mental health problems encountered structural barriers and challenged engagement in education that created a gap between the students and the regular education system. Access to supported education was reported to decrease this gap and formed a bridge that to facilitate educational achievements. The achievements were related to several personal benefits that were important for the experience of meaning and identity development in the future. Supported education can contribute to enabling the development of student identity for young adults with mental health problems. This involves an engagement process and positive identity formation that may reduce stigma and is therefore important for the personal recovery process and career advancement.
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| 7. |
- Liljeholm, Ulrika, et al.
(författare)
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The process of supporting careers for young adults with mental health problems : case study of a supported education program
- 2024
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Ingår i: Journal of Psychosocial Rehabilitation and Mental Health. - : Springer Nature. - 2198-9834 .- 2198-963X. ; 11:2, s. 165-180
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Tidskriftsartikel (refereegranskat)abstract
- Mental health problems often appear at a young age. As the labour market places higher demands for education and competence, mental health services are focusing on young adults’ support needs for school and career opportunities. This study is a single case of an integrated supported education and employment unit in Sweden over an 18-month period. Multiple data sources illustrate the process of supporting careers and transition to school and work for young service users. This is a promising example of how careers can be supported through a flexible service that provides support for successful individual education and work trajectories among the youth. The service allowed for evolution of an identity process towards recovery through student and work roles.
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| 8. |
- Liljeholm, Ulrika, et al.
(författare)
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Work identity development in young adults with mental health problems
- 2019
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 27:6, s. 431-440
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Tidskriftsartikel (refereegranskat)abstract
- Background: How we identify ourselves is strongly related to employment. Young adults are a vulnerable group with regard to entering the Labor market. If they also have mental health problems, entering becomes more difficult and increases risk of early marginalization. Nevertheless, working can be essential for personal recovery process. Aims: To explore experiences of young adults with mental health problems who are starting to work, with a focus on the process of developing work identity. Methods: Grounded theory design was used. The data collection consisted of 13 in-depth interviews with young adults with mental health problems aged 19–26 years, who had worked for at least three months. Results: The experience of starting to work contributed to a process of internal and external change, new feelings, challenges, and understanding of the surrounding world. Former negative thought patterns became more positive. New roles and occupational patterns were developed and altered views on abilities, and thus self-efficacy. This development contributed to a work identity, and new directions in life. Conclusions: There is therapeutic potential in supporting work identity development, and this support can empower the personal recovery process for young adults.
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| 9. |
- Andersén, Åsa, 1975-
(författare)
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Self-efficacy, Vocational Rehabilitation and Transition to Work
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to examine the relationship between self-efficacy, individually tailored vocational rehabilitation and transition to work or studies.Study I was a cross-sectional study based on questionnaire- and registry data, investigating whether factors related to sick leave predict self-efficacy in women on long-term sick leave (n= 337) due to pain and/or mental illness. General self-efficacy was low. Anxiety and depression were the strongest predictors for low self-efficacy.Study II used longitudinal data from a randomised controlled trial, comprising partly the same women (n=401) as in Study I. Participants were allocated to either 1) assessment of multidisciplinary team and multimodal intervention (TEAM), 2) acceptance and commitment therapy (ACT), or 3) control group. Self-efficacy increased in the TEAM group in comparison with the control group.Study III had a descriptive qualitative design with individual interviews, studying participants’ (n=14) experiences with an individually tailored vocational rehabilitation project, and encounters with professionals working in it. The participants, who were on long-term sick leave due to mental illness or pain reported overall positive experiences with the project. The project was based on collaboration between authorities and motivational interviewing. The positive experiences were based on four categories: Opportunities for receiving various dimensions of support, Good overall treatment by the professionals, Satisfaction with the working methods of the project, and Opportunities for personal development.Study IV was a prospective cohort study investigating perceived self-efficacy in unemployed young adults (n= 249) aged 19-29 year with disabilities, and the association between self-efficacy and transition to work or studies. The study used questionnaire- and registry data from a vocational rehabilitation project. Higher levels of self-efficacy were associated with increased odds for ‘transition to work’. General self-efficacy was low, and young adults with lower self-efficacy reported worse self-rated health compared with those with higher self-efficacy.This thesis showed that multidisciplinary assessment with a multimodal intervention had positive effects on self-efficacy. Individually tailored vocational rehabilitation, based on cooperation and motivational interviewing, may be beneficial for individuals on long-term sick leave and the interactions between participants and the professionals may affect participants’ self-efficacy positively. Mental health needs to be considered when targeting self-efficacy in vocational rehabilitation. Furthermore, research is needed to a) clarify which components in the multidisciplinary team intervention can increase self-efficacy, b) study the effects of vocational rehabilitation based on an individual design, cooperation and motivational interviewing on self-efficacy, health and transition to work, and c) develop interventions that can increase self-efficacy and support transition to work/ studies in young adults with disabilities.
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| 10. |
- Andersson, Helene, et al.
(författare)
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Experiences of sensory input in daily occupations for people with serious mental illness
- 2021
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 28:6, s. 446-456
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is growing evidence that people with serious mental illness have impaired capacity for processing sensory inputs which affects daily occupation. Although this is known, research regarding the target groups experiences of sensory inputs in daily occupations is lacking. Aim: To investigate the experience of sensory input and strategies used in daily occupations among people with serious mental illness. Material and methods: Fourteen people with serious mental illness were interviewed regarding their experiences of sensory processing and strategies for managing sensory inputs in daily occupations. Data were analysed using content analysis. Results: Sensory processing issues affected occupational engagement and strategies to control inputs were intuitively used to cope with sensory challenges. Informants either ignored, reduced or avoided sensory inputs. Informants also enabled daily life through strategies such as creating a home that provides rest, finding a safe place, using nature and animals for relaxing and using effects of calming and alerting occupations. Discussion: Specific sensory inputs were difficult to process, which was experienced as stressful and affected occupations negatively. The results imply a need for further research exploring the management of sensory input and the use of sensory modulation approaches to enable engagement in daily activities.
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| 11. |
- Areberg, Cecilia, et al.
(författare)
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Experiences of the individual placement and support approach in persons with severe mental illness.
- 2013
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 1471-6712 .- 0283-9318. ; 27:3, s. 589-596
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Tidskriftsartikel (refereegranskat)abstract
- Scand J Caring Sci; 2012; Experiences of the individual placement and support approach in persons with severe mental illness Background: Across several research studies comparing the individual placement and support (IPS) approach to traditional vocational services, the approach has achieved employment outcomes superior to comparison conditions. However, to understand the efficacy of IPS, it is equally important to consider what is more or less effective as viewed by the IPS participants. Aim: To investigate participants' experiences of IPS participation and their experiences of receiving support from an employment specialist (ES). Method: Interviews were conducted with 17 persons with severe mental illness. The interviews were subjected to qualitative content analysis. The principles of informed consent and the voluntary nature of participation were included as ethical considerations. Results: Participation in IPS was associated with hope, meaning and an individualized support provided by the ES. The skills of the ES facilitated the relationship with the participant and the contact with the labour market. However, to make a change happen, everybody involved in IPS had to contribute. Conclusion: These findings have endorsed the guiding principles of IPS and emphasized the ES's role and skills during IPS as well as the participant's motivation.
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| 12. |
- Areberg, Cecilia, et al.
(författare)
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The effect of IPS on participants' engagement, quality of life, empowerment, and motivation: a randomized controlled trial.
- 2013
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1651-2014 .- 1103-8128. ; 20:6, s. 420-428
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective: To investigate the effectiveness of Individual Placement and Support (IPS) with regard to non-vocational outcomes among individuals with severe mental illness. Methods: A randomized controlled trial was carried out, comparing IPS with traditional vocational rehabilitation. The Empowerment Scale, the Worker Role Interview, the Profile of Occupational Engagement, and the Manchester Short Assessment of Quality of Life were administered to 120 clients, at baseline, six, and 18 months. Results: IPS participants showed higher scores in quality of life (p = 0.002), empowerment (p = 0.047), and work motivation (p = 0.033) at 18 months. Within the IPS group, a significant change in QOL was shown at six (p = 0.002) and 18 months (p = 0.000), and in occupational engagement (p = 0.003; p = 0.012). Conclusions: IPS can be part of a recovery process as individuals may increase their life satisfaction and time spent in daily occupations and community life.
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| 13. |
- Argentzell, Elisabeth, et al.
(författare)
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Opportunities and barriers for occupational engagement among residents in supported housing
- 2023
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis Group. - 1103-8128 .- 1651-2014. ; 30:1, s. 125-135
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Tidskriftsartikel (refereegranskat)abstract
- Opportunities and barriers for occupational engagement among residents in supported housing. Background Research shows that people with psychiatric disabilities view supported housing (SH) as a possibility for social contact, but also as entailing a risk of deprived self-determination. There is, however, little research on the target group's engagement in everyday occupations. Aim To explore SH residents' opportunities and barriers for occupational engagement. Materials and methods Sixteen participants were interviewed, and data was analysed using content analysis. Results An overarching theme, Struggling to create meaning and seeking affection, and three underlying categories, emerged. Finding meaning through self-chosen occupations and support focussed on receiving support, doing self-chosen occupations, and having social contacts. Feeling neglected and insecure limits engagement in occupations was related to feelings of not being seen by staff, and insecurity, which hampered daily life. The third theme was Having a negative self-image and low level of ability hinders an active life. Conclusion Residents' self-view and ability to create an inner drive for being active was important for occupational engagement, which was linked to social connectedness. Occupational based interventions and a personal recovery approach is warranted in order to facilitate needs for meaningful occupations. Significance The results from the study can be used to further develop optimal support within SH units.
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| 14. |
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Att leva med psykisk funktionsnedsättning : livssituation och effektiva vård- och stödinsatser
- 2020. - 3
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Det offentliga stödsystemet för personer med psykisk funktionsnedsättning är i dag huvudsakligen ett samhällsbaserat servicesystem med tyngdpunkt på öppna vård- och stödformer. Det finns dock brister i systemets förmåga att möta behoven hos dessa personer, liksom det finns övergripande brister i deras situation i samhället som helhet. Trots omfattande reformer kännetecknas fortfarande situationen för målgruppen av utsatthet i form av diskriminering och andra former av stigmatisering samt ekonomisk och social marginalisering. Till detta kommer upplevelser av bristande inflytande över den egna vård- och stödsituationen.Trots svårigheter att leva upp till välfärdsreformernas målsättningar och att implementera evidensbaserade och effektiva insatser på området, finns ändå anledning till optimism. Det här är den tredje reviderade upplagan av boken, där aktuell forskning om livssituationen för personer med psykisk funktionsnedsättning samt kunskap om effektiva vård- och stödinsatser presenteras. Här redovisas en mängd olika interventioner och stödformer som visar att det finns effektiva sätt att förändra situationen.Att leva med psykisk funktionsnedsättning vänder sig till studerande inom sociala eller vårdinriktade högskoleutbildningar, men också till personer inom verksamheter som i arbetet möter personer med psykisk funktionsnedsättning.
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| 15. |
- Bejerholm, Ulrika, et al.
(författare)
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Aktivitetsengagemang
- 2020. - 2
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Ingår i: Aktivitet och relation : mål och medel inom psykosocial rehabilitering - mål och medel inom psykosocial rehabilitering. - 9789144125985 ; , s. 161-179
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Bokkapitel (populärvet., debatt m.m.)
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| 16. |
- Bejerholm, Ulrika, et al.
(författare)
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Aktivitetsengagemang
- 2010. - 1
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Ingår i: Aktivitet & relation : Mål och medel inom psykosocial rehabilitering - Mål och medel inom psykosocial rehabilitering. - 9789144048680 ; , s. 161-179
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Bokkapitel (refereegranskat)
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| 17. |
- Bejerholm, Ulrika, et al.
(författare)
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Arbetsrehabilitering enligt IPS
- 2012. - 1
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Ingår i: Rehabilitering och stöd till återhämtning vid psykiska funktionshinder : Möjlighetens metoder för en ny praktik - Möjlighetens metoder för en ny praktik. - 9789172057876 ; , s. 158-184
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Bokkapitel (refereegranskat)
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| 18. |
- Bejerholm, Ulrika, et al.
(författare)
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Bedömning av aktivitetsförmåga
- 2020
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Ingår i: Aktivitet och relation : mål och medel inom psykosocial rehabilitering - mål och medel inom psykosocial rehabilitering. - 9789144125985 ; , s. 197-218
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Bokkapitel (refereegranskat)
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| 19. |
- Bejerholm, Ulrika, et al.
(författare)
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Bedömning av aktivitetsförmåga
- 2010. - 2
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Ingår i: Aktivitet och relation : mål och medel inom psykosocialrehabilitering - mål och medel inom psykosocialrehabilitering. - 9789144125985 ; , s. 197-218
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Bokkapitel (populärvet., debatt m.m.)
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| 20. |
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| 21. |
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| 22. |
- Bejerholm, Ulrika, et al.
(författare)
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Empowerment in supported employment research and practice: Is it relevant?
- 2011
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Ingår i: International Journal of Social Psychiatry. - : SAGE Publications. - 1741-2854 .- 0020-7640. ; 57, s. 588-595
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This cross-sectional study is aimed at describing and investigating empowerment and its relationships with level of engagement in daily activities and community life, experienced stigma, psychopathology, and quality of life among people with mental illness entering supported employment. METHOD: The following scales were administered to 120 persons: Empowerment Scale, Profiles of Occupational Engagement Scale, Manchester Short Assessment of Quality of Life Scale, Rejection Experience Scale and Brief Psychiatric and Rating Scale. RESULTS: Higher scores of empowerment were associated with fewer symptoms and experienced stigma, a higher level of engagement in daily activities and community life, better quality of life and having work rehabilitation. Self-efficacy and self-esteem were in particular significantly correlated to depressive symptoms. Descriptive statistics enveloped the group of participants that said 'Yes I want to work' with a somewhat high mean score for empowerment, level of engagement and quality of life, but a low mean score with regard to both symptoms and experienced stigma. CONCLUSIONS: This study advocates the importance of evaluating empowerment in supported employment research and practice. The findings suggest the importance of taking into account not only monetary aspects of having a job but also social and psychological aspects such as empowerment, reduction in experienced stigma and community integration.
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| 23. |
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| 24. |
- Bejerholm, Ulrika, et al.
(författare)
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Factors related to the return to work potential in persons with severe mental illness.
- 2014
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1651-2014 .- 1103-8128. ; 21:4, s. 277-286
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective: This cross-sectional study aimed at investigating the relationship between the return to work potential, according to the Worker Role Interview (WRI) assessment, and clinical characteristics and level of empowerment and occupational engagement among persons with severe mental illness who express their own interest in working. Methods: 120 participants entered the study. The WRI, the Brief Psychiatric and Rating Scale, a sociodemographic questionnaire, the Empowerment Scale, and the Profiles of Occupational Engagement in Severe mental illness were used for data collection. Correlation and regression analyses were used for statistics. Results: The return to work potential was significantly associated with having fewer symptoms, rehabilitation support or productive activities, and higher levels of engagement and empowerment. A younger age had an inverse relation to the lifestyle component in WRI. Depressive symptoms and occupational engagement explained 42% of the variance. Conclusions: The findings support the use of an empowerment approach, taking into account the clients' symptoms, age, and time use. In addition, involvement in vocational support and productive activities may be advantageous early on in the recovery process.
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| 25. |
- Bejerholm, Ulrika, et al.
(författare)
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From national incentives of implementing Individual Placement and Support to the impact on the service users' quality of life, and view on support
- 2015
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Ingår i: ENMESH 2015 : Eleventh International Conference of the European Network For Mental Health Service Research; Closing the gap between research and policy in mental health. - : ENMESH. ; , s. 153-154
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Konferensbidrag (refereegranskat)abstract
- Introduction: It is a challenge to translate evidence-based-research into practice in a way that meets the needs of the service users. The effectiveness of the IPS vocational rehabilitation approach in terms of gaining competitive employment is well known. During the last three years, IPS has been widely implemented in Community Mental Health Service in Sweden, with financial support from the government. Within this context, we aimed to investigate the benefits of IPS as experienced by some of the serviceusers in addition to them increasing their job opportunities.Methods: Based on a one group pre-test and post-test design (one year), we administered instruments targeting activity and community integration (POES-S) and quality of life (MANSA) among 117 service users from four sites. We also addressed their satisfactionwith the IPS service (MY VIEW) and therapeutic relationship with the IPS-employment specialist (STAR) after one year. Descriptive and comparative statistics were applied.Results: Significant differences and increase of scores were found between measurement points with regard to both activity and community integration and quality of life. Satisfaction with service and therapeutic relationships were scored well above the midpoint of the scales after one year.Conclusions: The results indicate that national incentives to implement IPSbenefits the way of life of the users and is a valued service.
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| 26. |
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| 27. |
- Bejerholm, Ulrika, et al.
(författare)
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Implementation of the Recovery Guide in inpatient mental health services in Sweden-A process evaluation study
- 2022
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Ingår i: Health Expectations. - : Wiley. - 1369-6513 .- 1369-7625. ; 25:4, s. 1405-1417
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Tidskriftsartikel (refereegranskat)abstract
- Background: Involving service users in inpatient care and recovery planning has gained interest worldwide. Our purpose was to evaluate the process of implementation of a coproduced Recovery Guide (RG) intervention in 22 inpatient wards in Sweden, in terms of context, implementation process and mechanisms of impact over 12 months.Methods: A mixed method design and a process evaluation framework were used to guide data collection and to deductively analyze perspectives and descriptive statistics of delivery from three stakeholder groups.Results: Results showed that although initial contextual barriers were present (e.g., lack of resources, and interest, uncertainty in the organization, a dominant illness perspective), it was possible to implement the RG in 14 wards, where 53% of admitted service users received the intervention. Legitimacy of the intervention, engaged managers and staff, capacity of staff and ward organization, coproduction and continuous support from user organization were critical mediators. Mechanisms of impact concerned (1) a new perspective on mental health, well-being and recovery, (2) capacity building of a recovery approach in inpatient settings and (3) a meaningful outlet for users' thoughts and feelings on recovery, sharing narratives and influencing care and goals.Conclusions: The RG intervention has the potential to promote a recovery approach in inpatient mental health services (MHSs). Coproduction among stakeholders created trust and a sustainable implementation that made it possible for wards to resume implementation when contextual barriers had been resolved.Patient and public contribution: The current study involved stakeholders including a service user organization, the public, first-line managers and staff (including peer support workers) in inpatient and community MHS and researchers, who greatly contributed to the implementation programme, including codesign of the RG intervention as well as coproduction of the implementation in inpatient MHS. All authors have their own lived experiences of mental health problems as a service user or as a relative.
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| 28. |
- Bejerholm, Ulrika, et al.
(författare)
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Individual Placement and Support for persons with alcohol and drug addiction in a Swedish context (IPS-ADAS) : study protocol for a randomised controlled trial
- 2024
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Ingår i: Trials. - : Springer Nature. - 1745-6215. ; 25:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Employment is a vital source for experiencing well-being and lowering the risk of long-term social marginalisation and poverty. For persons with alcohol and drug addiction, it may also improve sobriety. However, the unemployment situation for this group reflects the knowledge gap in effective interventions to support employment. While Individual Placement and Support (IPS) is recognised as evidence-based supported employment for those with serious mental health problems, no scientific evidence for the target group of addiction exists to date. The aim of the present IPS for Alcohol and Drug Addiction in Sweden (IPS-ADAS) trial is to study whether IPS has an effect on gaining employment for this group. Methods: The IPS-ADAS trial is a multisite, pragmatic, parallel, and single-blinded, superiority randomised controlled trial (RCT). Participants (N = 330) will be randomly assigned (1:1) and participate in IPS plus treatment as usual within Addiction Services (IPS + TAU) or Traditional Vocational Rehabilitation (TVR) available plus TAU (TVR + TAU) for 12 months. The principle of intention-to-treat (ITT) will be applied. The hypothesis is that a significantly larger proportion of IPS + TAU participants will be employed for > 1 day (primary outcome), reach employment sooner, work more hours and longer periods of time, and have a higher income as compared to TVR + TAU participants at 18-month follow-up. We further anticipate that those who benefit from IPS + TAU will use less alcohol and drugs, experience better health, and use less care and support, including support from the justice system, in comparison to TVR + TAU participants, at 6, 12, and 18 months. A supplementary process evaluation, using the IPS Fidelity Scale (25 items) and adhered interviews will address delivery and receipt of the IPS as well as contextual hinders and barriers for coproduction and implementation. Working age (18–65), willingness to work, unemployment, participation in an information meeting about the RCT, treatment for addiction diagnosis, and being financially supported by welfare, constitute eligible criteria. Discussion: A primary study on the effectiveness of IPS on employment for the new target group of addictions will add to the international IPS knowledge base and inform national policy to include the underrepresented group in working life. Trial registration: WHO International Clinical Trials Registry Platform ISRCTN10492363. Registered on 14 August 2023.
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| 29. |
- Bejerholm, Ulrika, et al.
(författare)
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Individual Placement and Support for persons with alcohol and drug addiction in a Swedish context (IPS-ADAS) : study protocol for a randomised controlled trial
- 2024
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Ingår i: Trials. - : Springer Nature. - 1745-6215. ; 25:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Employment is a vital source for experiencing well-being and lowering the risk of long-term social marginalisation and poverty. For persons with alcohol and drug addiction, it may also improve sobriety. However, the unemployment situation for this group reflects the knowledge gap in effective interventions to support employment. While Individual Placement and Support (IPS) is recognised as evidence-based supported employment for those with serious mental health problems, no scientific evidence for the target group of addiction exists to date. The aim of the present IPS for Alcohol and Drug Addiction in Sweden (IPS-ADAS) trial is to study whether IPS has an effect on gaining employment for this group. Methods: The IPS-ADAS trial is a multisite, pragmatic, parallel, and single-blinded, superiority randomised controlled trial (RCT). Participants (N = 330) will be randomly assigned (1:1) and participate in IPS plus treatment as usual within Addiction Services (IPS + TAU) or Traditional Vocational Rehabilitation (TVR) available plus TAU (TVR + TAU) for 12 months. The principle of intention-to-treat (ITT) will be applied. The hypothesis is that a significantly larger proportion of IPS + TAU participants will be employed for > 1 day (primary outcome), reach employment sooner, work more hours and longer periods of time, and have a higher income as compared to TVR + TAU participants at 18-month follow-up. We further anticipate that those who benefit from IPS + TAU will use less alcohol and drugs, experience better health, and use less care and support, including support from the justice system, in comparison to TVR + TAU participants, at 6, 12, and 18 months. A supplementary process evaluation, using the IPS Fidelity Scale (25 items) and adhered interviews will address delivery and receipt of the IPS as well as contextual hinders and barriers for coproduction and implementation. Working age (18–65), willingness to work, unemployment, participation in an information meeting about the RCT, treatment for addiction diagnosis, and being financially supported by welfare, constitute eligible criteria. Discussion: A primary study on the effectiveness of IPS on employment for the new target group of addictions will add to the international IPS knowledge base and inform national policy to include the underrepresented group in working life. Trial registration: WHO International Clinical Trials Registry Platform ISRCTN10492363. Registered on 14 August 2023.
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| 30. |
- Bejerholm, Ulrika, et al.
(författare)
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Individual placement and support illustrated in the Swedish welfare system: A case study
- 2011
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Ingår i: Journal of Vocational Rehabilitation. - 1052-2263. ; 35:1, s. 59-72
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Tidskriftsartikel (refereegranskat)abstract
- Individual Placement and Support (IPS) results in more people with severe mental illness obtaining employment in comparison to traditional vocational rehabilitation approaches. The implementation challenges of IPS vary across countries and contexts. However, the implications for IPS delivery and thus the IPS principles have not been studied in Sweden, which this embedded case study aims to investigate. The study was bounded by a single case, which was equivalent to the implementation of IPS in a Swedish city over 18 months. Data was collected from multiple units of information and consisted of interviews, documents and audio materials. A content analysis was used. The results showed that the first four IPS principles were challenged by the welfare system. Work capacity, in terms of amount of working hours per week, was evaluated differently in IPS and in the welfare system's prevocational services. In addition, the type of welfare benefit was decisive for IPS delivery and could be withdrawn if the IPS participant did not enter the prevocational rehabilitation situated within the welfare service. The differences of vocational approaches as experienced by professionals led to frustration, but also positive statements regarding how to increase integration between the welfare services and IPS. The authors discuss the tangible result and suggestive recommendations are made.
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| 31. |
- Bejerholm, Ulrika, et al.
(författare)
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Individual Placement and Support in Sweden-A randomized controlled trial
- 2015
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 69:1, s. 57-66
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Tidskriftsartikel (refereegranskat)abstract
- Background: Currently there is no evidence on the effectiveness of Individual Placement and Support (IPS) in Sweden. Aims: To determine the effectiveness of IPS on vocational outcomes among people with severe mental illness (SMI) in a Swedish context. A secondary aim was to evaluate a community integration effect. Methods: A randomized controlled trial with a parallel design was used. Mental health outpatients with SMI were randomized to IPS or traditional vocational rehabilitation (TVR) services. The allocation status was assessor-blinded. The primary outcome was competitive employment. All vocational outcomes were collected continuously, and socio-demographic and clinical variables at baseline, 6 and 18 months. The trial is registered with ClinicalTrials.gov: NCT00960024. Results: One hundred and twenty participants were randomized. Eighty seven per cent were assessed after 6 months, and 73% after 18 months. IPS was more effective than TVR in terms of gaining employment at 18-month follow-up (46% vs. 11%; difference 36%, 95% CI 18-54), along with the amount of working hours and weeks, longer job tenure periods and income. Cox regression analysis showed that IPS participants gained employment five times quicker than those in TVR. Ninety per cent of the IPS participants became involved in work, internships or education, i.e. activities integrated in mainstream community settings, while 24% in the TVR group achieved this. Conclusions: IPS is effective in a Swedish context in terms of gaining employment and becoming integrated within the local community. The welfare system presented obstacles for gaining competitive employment directly and it was indicated that internships delayed time to first competitive employment.
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| 32. |
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| 33. |
- Bejerholm, Ulrika
(författare)
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Occupational Balance in People with Schizophrenia
- 2010
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Ingår i: Occupational Therapy in Mental Health. - : Informa UK Limited. - 0164-212X .- 1541-3101. ; 26:1, s. 1-17
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to illuminate the concept of occupational balance and to study its relation to occupational engagement as assessed by the POES, health related factors, and quality of life among 72 persons with schizophrenia. Three constructs: being under-occupied, being over-occupied, and having occupational balance, were developed to help assess occupational balance. The inter-reliability testing of occupational balance resulted in good agreement on average. The descriptive statistics showed that 32 participants were deemed to be under-occupied, 35 participants had occupational balance, while five participants were over-occupied. Significant statistical differences were found between the subgroups of being under-occupied and having occupational balance regarding negative symptoms, sense of coherence and quality of life.
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| 34. |
- Bejerholm, Ulrika, et al.
(författare)
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Occupational engagement in persons with schizophrenia: relationships to self-related variables, psychopathology, and quality of life.
- 2007
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Ingår i: American Journal of Occupational Therapy. - 0272-9490. ; 61:1, s. 21-32
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Tidskriftsartikel (refereegranskat)abstract
- Previous research suggests that having schizophrenia involves not being fully equipped to engage in daily occupations. This study was aimed at exploring relationships between occupational engagement and the issues of self-related variables, psychiatric symptoms, and quality of life. Seventy-four outpatients with schizophrenia entered the study. Instruments used in this study were Profile of Occupational Engagement in People with Schizophrenia, Locus of Control, Mastery, Sense of Coherence, Brief Psychiatric Rating Scale, and Lancashire Quality of Life Profile. The results showed that a high level of occupational engagement was related to higher ratings of self-related variables, fewer psychiatric symptoms, and better ratings of quality of life, and vice versa. A significant difference and a linear trend were found among the three subgroups of different levels of occupational engagement and the estimated variables. In the regression model, negative symptoms and internal locus of control together explained 47% of the variance in occupational engagement. The results add a new dimension to understanding mental health and suggest the importance of assessing the level of occupational engagement.
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| 35. |
- Bejerholm, Ulrika
(författare)
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Occupational Perspectives on Health in People with Schizophrenia
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The thesis has provided with systematic information about how people with schizophrenia live their everyday life, and the results have shown significant relationships between occupational perspectives and health. The thesis departed in two in-depth studies that concerned time use and occupational engagement in relation to what people with schizophrenia do in their everyday life, with whom they are with, where they are and how they perceive and experience what they do, as reflected by time-use diaries. The first study showed that most time was spent alone, at home, where few occupational situations worked as a routine, providing a structure in terms of familiarity of habits. The second study showed that the participants functioned at different levels of occupational engagement, which ranged from performing mostly quiet activities alone, at home, with few routines and a little sense of meaning, to having ongoing occupational engagement that were interpreted as having meaning, in a greater variety of social and geographical environments. In particular, the function of performing quiet activities, the different ways of being social and of interpreting on experiences, have provided with new aspects that concern the occupational behaviour in people with schizophrenia. Based of these findings elucidated so far, the third and fourth study concerned the development of a reliable and valid instrument, the Profiles of Occupational Engagement in people with Schizophrenia. In study four and five, the POES was used to assess occupational engagement in relation to health related variables. The results showed that a high level of occupational engagement was related to higher ratings of self-related variables, fewer psychiatric symptoms, and better ratings of quality of life, and vice versa. The results of this thesis add a new dimension to understanding mental health. Consequently, identifying the level of occupational engagement in clients with schizophrenia is imperative to, understanding occupational balance and disability, the forming of a supporting relationship, providing appropriate occupational challenges and environmental support with intention to facilitate self-definition.
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| 36. |
- Bejerholm, Ulrika, et al.
(författare)
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Personal recovery within positive psychiatry
- 2018
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 72:6, s. 420-430
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Tidskriftsartikel (refereegranskat)abstract
- Background: One goal within positive psychiatry is to support the personal recovery of persons with mental illness and providing opportunities for well-being. Aim: The current article aims to introduce readers to the concept of personal recovery and the potential and importance of recovery-oriented services and measures. Methods: A literature review was conducted to help consider the domains of ‘personal recovery’, ‘recovery-oriented services/interventions’, and ‘measures’. A database search was complemented with a web-based search. Both medical subject heading (MESH) terms and free-text search terms were used. Results: Literature from research journals, grey literature, and websites were included. Within this context, recovery does not refer to a cure but involves a process in which a person acts as an agent to develop new goals and meaning in life, despite and beyond limitations posed by the illness and its consequences. A positive focus on recovery is in sharp contrast to historical deterministic and pessimistic concepts of mental illnesses. Recovery-oriented services such as peer support, assertive community treatment, supported employment/education/housing, illness self-management, and decreasing self-stigma are highlighted. A review of 27 measures that focus on personal recovery and promotion of well-being are also discussed. Conclusions: The literature overview presents perspectives and knowledge of how to develop positive psychiatry, how mental health services and their partner organizations may become more recovery oriented and help persons reach well-being and a better quality of life. This study is limited to a narrative review and may precede future systematic reviews.
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| 37. |
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| 38. |
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| 39. |
- Bejerholm, Ulrika, et al.
(författare)
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Profiles of occupational engagement in persons with schizophrenia, POES: Development of a new instrument based on time diaries
- 2006
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Ingår i: British Journal of Occupational Therapy. - 1477-6006. ; 69:2, s. 58-68
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Tidskriftsartikel (refereegranskat)abstract
- Previous time-use research suggests that it is highly relevant for an occupational therapist to estimate time use and occupational engagement in order to understand some of the determinants of wellbeing for people with schizophrenia. This article describes the development and the testing of the psychometric properties of an instrument, Profiles of Occupational Engagement in people with Schizophrenia (POES), with the aim of helping to interpret and evaluate time-use diaries and thus providing a systematic description of status regarding occupational engagement. The first part of POES involves completion of time-use diaries and the second part, the assessment, is based on nine items that are rated on a four-point ordinal scale. The time-use diaries of 41 people with schizophrenia and the judgements from 12 occupational therapists were used in the study. A test of content validation involved experts from Sweden and the United Kingdom and resulted in two stages of revisions. The strength of agreement between two raters resulted in a mean weighted kappa of 0.70. Internal consistency was calculated for both raters separately and the alpha coefficients were 0.97 and 0.95. This study provides initial support for the content validity, interrater agreement and internal consistency of POES. Based on the judgements of the occupational therapists in this study, POES seems to have good clinical utility. However, further research on the clinical utility as well as the criterion validity of the construct is warranted.
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| 40. |
- Bejerholm, Ulrika, et al.
(författare)
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Rasch Analysis of the Profiles of Occupational Engagement in people with Severe mental illness (POES) instrument
- 2015
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Ingår i: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The Profiles of Occupational Engagement in people with Severe mental illness (POES) instrument was developed to study time use profiles of occupations and measure the extent they are characterized by engagement. However, the dimensional factors are not known. The aim of the present study was to establish the internal construct validity of the POES using the Rasch measurement model. Methods: A sample of 192 outpatients in Sweden was administered the POES and data were subjected to Rasch analysis. Results: The POES showed good fit to the Rasch model after accommodation for local dependency. The nine items had high reliability as measured by person separation index, and no threshold disordering was present. Differential item functioning analysis showed no significant differences across groups of age, sex, diagnosis, or country of origin. Conclusion: The POES is a unidimensional scale that represents a continuum of occupational engagement. The transformed POES sum score can be used on an interval scale to measure status and changes in occupational engagement in mental health practice and research.
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| 41. |
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| 42. |
- Bejerholm, Ulrika
(författare)
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Relationships between occupational engagement and status of and satisfaction with sociodemographic factors in a group of people with schizophrenia.
- 2010
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1651-2014 .- 1103-8128. ; 17, s. 244-254
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Tidskriftsartikel (refereegranskat)abstract
- Abstract The present study is part of a larger project investigating occupational engagement and health in a group of people with schizophrenia. This study was aimed at extending this knowledge base with regard to occupational engagement and sociodemographic factors. Seventy-four outpatients participated in the study. The Profile of Occupational Engagement in People with Schizophrenia, the Lancashire Quality of Life Profile scale and a standardized questionnaire were used to gather data. Contrary to what was expected, occupational engagement was not associated with a certain type of schizophrenia, being younger or older, or gender. The results showed that a high level of occupational engagement was related to greater satisfaction with the participants' social and living situation, having a reliable alliance and a close friend, school-leaving age, living in a flat, and working or studying. Satisfaction with living independently, having had a recent experience of accomplishment, and working together explained 55% of the variance in occupational engagement. Occupational therapists should thus focus on and promote social engagement appropriate to the client's level of engagement, the client's opportunity and ability to work, his/her experience of accomplishment, and, most importantly, satisfaction with the home and living situation.
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| 43. |
- Bejerholm, Ulrika, et al.
(författare)
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Supported employment adapted for people with affective disorders—A randomized controlled trial
- 2017
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Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327. ; 207, s. 212-220
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Tidskriftsartikel (refereegranskat)abstract
- Background While effective vocational methods for gaining employment exist for people with schizophrenia and similar conditions, no evidence exists with regard to people with affective disorders. We aimed to study the effectiveness of a newly developed Individual Enabling and Support (IES) model adapted for the target group and compared to traditional vocational rehabilitation (TVR). Methods An assessor-blinded randomized controlled trial (RCT) with a parallel design was performed. Sixty-one participants received IES or TVR. The primary outcome was employment rate at 12-month follow-up. Secondary vocational outcomes, depression severity, and quality of life were also studied. Trial register number is ISRCTN93470551. Results IES was more effective for employment compared to TVR (42.4% vs. 4%; difference 38%, 95% CI 0.12–0.55). Significant group differences were present in secondary vocational outcomes (hours and weeks employed, time to employment), and depression severity. The IES-group had significantly lowering in depression scores and increased quality of life scores during the intervention period. Limitations This RCT was limited by the small sample size due to restriction of recruitment to middle-sized cities within geographically diverse sites in southern Sweden. Larger trials are needed, also in primary health care and employment services settings. Conclusions IES is more effective than TVR for attaining employment and improving depressive symptoms. On a societal level, IES closes the time and service gap between treatment and employment, and thus lowers sick-leave costs. © 2016
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| 44. |
- Bejerholm, Ulrika, et al.
(författare)
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Sysselsättning- betydelse och utformning
- 2011. - 2
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Ingår i: Psykiatri för baspersonal : Kunskap för en evidensbaserad praktik - Kunskap för en evidensbaserad praktik. - 9789172057937 ; , s. 197-217
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Bokkapitel (refereegranskat)
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| 45. |
- Bejerholm, Ulrika, et al.
(författare)
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Sysselsättning - betydelse och utformning
- 2009
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Ingår i: Psykiatri för baspersonal : kunskap för en evidensbaserad praktik - kunskap för en evidensbaserad praktik. - 9789172056848 ; , s. 178-198
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Bokkapitel (populärvet., debatt m.m.)
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| 46. |
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| 47. |
- Bejerholm, Ulrika, et al.
(författare)
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Time use and occupational performance among persons with schizophrenia
- 2004
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Ingår i: Occupational Therapy in Mental Health. - 0164-212X. ; 20:1, s. 27-47
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Tidskriftsartikel (refereegranskat)abstract
- The human occupational/activity pattern is a product of person–occupation–environment interaction, it is of importance to explore all these factors to understand the daily occupational pattern among persons with schizophrenia. This study aimed to describe the time use of 10 persons with schizophrenia, reflecting the participants’ daily occupations, social and geographical environments, and emotional reaction and reflection on their occupational performance.
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| 48. |
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| 49. |
- Bejerholm, Ulrika, et al.
(författare)
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Vardagslivet
- 2005
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Ingår i: Att leva med psykiska funktionshinder – livssituation och effektiva stödinsatser. - 9144033168 ; , s. 103-103
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Det här kapitlet tar upp hur vardagslivet kan te sig för personer som har ett psykiskt funktionshinder. Vardagen består för oss människor av olika sysslor, och vi upplever dem på olika sätt och de betyder olika saker. Många av dem utförs automatiskt utan reflektion, som exempelvis att duscha på morgonen eller att handla på hemvägen från jobbet. Det kan sägas vara en slags autopilot inkopplad som gör att minimalt med energi och koncentration behöver läggas på sådana uppgifter. Andra saker som utförs kräver mer koncentration och innebär kanske anspänning, som att hålla ett föredrag eller klättra i berg. För en person som drabbats av psykisk sjukdom slås mycket av autopilotfunktionen ut, och därmed blir vardagens olika sysslor en ansträngande och ibland övermäktig uppgift. Vardagslivet får ett annorlunda utseende, och det vanliga mönstret av arbete, fritid, vila och egenvård förändras. Även upplevelsen av det som en person gör förändras vanligtvis. Rent generellt kan det sägas att det psy
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| 50. |
- Bejerholm, Ulrika, et al.
(författare)
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Vardagslivet
- 2014. - 2
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Ingår i: Att leva med psykisk funktionsnedsättning : Livssituation och effektiva vård- och stödinsatser - Livssituation och effektiva vård- och stödinsatser. - 9789144083872 ; , s. 117-137
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Bokkapitel (refereegranskat)
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