| 1. |
- Asaba, Eric, et al.
(författare)
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Engaging occupations among persons at risk for stroke : A health paradox
- 2022
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 29:2, s. 116-125
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Tidskriftsartikel (refereegranskat)abstract
- Background: An occupational perspective in stroke prevention could support sustainable changes in habits and routines that could contribute to reduce modifiable risk factors. Aim: To explore engaging occupation in relation to risk for stroke by drawing on experiences from everyday life among persons with a heightened risk for stroke. Material and methods: Interviews from 14 persons with an increased risk for stroke were analysed by a constant comparative approach. Findings: The analysis resulted in the core category; the paradox of engaging occupations and health. The paradox involved aspects of engaging occupations that could provide well-being and at the same time were compromising considering stroke health. Conclusions and significance: The paradox conceptually challenges some of the core values inherent in occupational therapy regarding the relationship between engaging occupations, health and well-being. Gaining a deeper understanding of experiences of occupations and studying this in relation to health promoting or compromising characteristics of occupations, can facilitate lifestyle programs that support changes in everyday life. Moreover, programs need to be designed to offer personal relevance and to facilitate a positive balance between health compromising occupations and health promoting occupations in everyday life.
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| 2. |
- Assander, Susanne, et al.
(författare)
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ASSIST : a reablement program for older adults in Sweden - a feasibility study
- 2022
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Ingår i: BMC Geriatrics. - : Springer Nature. - 1471-2318. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Western countries emphasise the provision of assistive home care by implementing reablement services. Reablement services are offered to a limited degree in Sweden, and systematic research regarding outcomes and how reablement can be tailored to maximize benefits for older adults has been lacking. This study aimed to evaluate the feasibility of a novel reablement program (ASSIST 1.0) regarding study design and outcome measures, as well as fidelity, adherence, and acceptability of the program in a Swedish context. Method A non-randomised, quasi-experimental, mixed-method, pre/post-test design was applied with an intervention group receiving ASSIST 1.0 (n = 7) and a control group receiving regular home care (n = 10). ASSIST 1.0 was developed to empower older adults to increase their perceived performance and satisfaction of performing activities in everyday life as well as increase their perceived health, self-efficacy, and well-being. ASSIST 1.0 was founded on the concept of reablement and included three components: i) goal setting with The Canadian Occupational Performance Measure (COPM), ii) provided support to home care staff to enhance their provision of reablement, and iii) explored the incorporation and use of an information- and communication technology (ICT) to facilitate information transfer. Results Using COPM for goal setting with older adults and providing support to the staff via workshops were valuable components in the delivery of ASSIST 1.0. The ICT product encountered several challenges and could not be evaluated. COPM and EQ-5D were deemed the most important instruments. Organisational and political barriers affected the feasibility. Although, the fidelity and adherence were complied the staff perceived the program to be acceptable. Conclusion The ASSIST 1.0 program was feasible in regard of study design, delivering the intervention, and evaluating instruments that detected a change. A logical progression would be to conduct a full-scale trial. In addition, a usability study to evaluate the technological component is also recommended. With minor improvements, the ASSIST 1.0 program has the potential to contribute to the development of a home care organisation that could enhance older adults possibility to age in place at home.
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| 3. |
- Assander, Susanne, et al.
(författare)
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Individual and organisational factors in the psychosocial work environment are associated with home care staffs' job strain : a Swedish cross-sectional study
- 2022
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Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundHome care staff (HCS) provide essential service to enable older adults to age in place. However, unreasonable demands in the work environment to deliver a safe, effective service with high quality has a negative impact on the individual employee’s well-being and the care provided to the older adults. The psychosocial work environment is associated with employees' well-being, although, knowledge regarding which individual and organisational factors that contribute to job strain for HCS is limited. These factors need to be identified to develop targeted interventions and create sustainable work situations for HCS. This study aimed to explore how HCS's perceived job strain is associated with, and to what extent can be explained by, individual and organisational factors of the psychosocial work environment and psychosomatic health.MethodAn explorative cross-sectional questionnaire survey design was used in a large Swedish county. Five home care agencies with a total of 481 HCS were asked to respond to a questionnaire regarding their perceived level of job strain (Strain in Dementia Care Scale), psychosocial work environment (QPSNordic34+), and psychosomatic health (Satisfaction with Work Questionnaire). Multiple linear regression (MLR) analyses were conducted to explore the association between job strain and individual and organisational factors.ResultsIn total, 226 (46%) HCS responded to the questionnaire. Both individual and organisational factors were significant predictors of job strain and explained a variance ranging between 39 to 51% (p = 0.001). The organisational factor job demand and the individual factor feeling worried and restless was most frequently represented in these MRL models. A higher job strain was also associated with adverse outcomes regarding leadership, organisational culture and climate, and control at work.ConclusionThis study indicates that there is an intertwined complexity of individual and organisational factors that are associated with the HC's perception of job strain. Implementation of new multidimensional work strategies, such as a reablement approach, could support the development of efficient strategies for HCS and reduce the level of job strain. Policy changes for the provision of home care are also needed to support the development of a sustainable and healthy psychosocial work environment.
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| 4. |
- Bergström, Aileen, et al.
(författare)
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Evaluation of manual wheelchairs by individuals with spinal cord injuries
- 2006
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Ingår i: Disability and Rehabilitation. - : Taylor & Francis. - 1748-3107 .- 1748-3115. ; 1:3, s. 175-182
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. The aim of this study was to investigate how adults with spinal cord injury assess their satisfaction regarding various aspects and use of their manual wheelchair. Method. The Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0) together with seven additional questions was sent to 205 adults with SCI. Results. One hundred and twenty-four responses were available. The QUEST 2.0 showed a high level of satisfaction with manual wheelchair properties. However, the respondents were less satisfied with the services offered. Ease of use and comfort were identified as most important. Eighty-nine percent of the respondents rated their level of satisfaction as 'quite satisfied' or 'very satisfied' in ease of using a manual wheelchair compared with 68% of the respondents that were 'quite satisfied' or 'very satisfied' with the level of comfort. A greater satisfaction of ease in propulsion indoors compared with sitting comfort in various activities was found. Conclusions. A discrepancy was shown between users not being as satisfied with comfort in sitting in various activities as opposed to satisfaction with propulsion. This indicates the need for increased knowledge and developments concerning individual solutions, incorporating comfort as well as ease of use of a manual wheelchair.
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| 5. |
- Bergström, Aileen L., et al.
(författare)
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An integrative review of information and communication technology based support interventions for carers of home dwelling older people
- 2017
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Ingår i: Technology and Disability. - : IOS Press. - 1055-4181 .- 1878-643X. ; 29:1-2, s. 1-14
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND A growing number of studies of informal carers of older people reveal positive results concerning support via Information and Communication Technologies (ICT). Systematic examination of factors that have a potential impact on carer outcomes are needed to inform future research.OBJECTIVE To explore studies concerning ICT support of adult carers of older people and to identify study characteristics that have a potential impact on carer outcomes.METHODS This integrative review includes 123 studies published since 2005. Fundamental questions for designing sensitive support interventions; ‘who, what, and how’ were applied to a synthesis of the results.RESULTS Identified characteristics from the studies responding to the who question included variables of the carers, such as their relationship with the care recipient or their ethnicity. Characteristics related to the what question related to the types of interventions, and the how question concerned the different services or programs offered, the idiosyncratic needs of the carers, and the types of technologies used.CONCLUSION Results are discussed according to micro, meso and macro levels of analysis. This extensive review can inform future studies and highlight the evidence in the area for decision makers, practitioners and/or NGOs working with innovative forms of support for carers of older people
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| 6. |
- Bergström, Aileen L., et al.
(författare)
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Combined life satisfaction of persons with stroke and their caregivers : associations with caregiver burden and the impact of stroke
- 2011
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Ingår i: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525. ; 9, s. 1-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Little is known about the life satisfaction of the person with stroke combined with their caregiver, i.e. the dyad, despite the fact that life satisfaction is an important rehabilitation outcome. The aim of this study was to describe the dyads combined life satisfaction and to understand this in relationship to the perceived impact of stroke in everyday life and caregiver burden. Methods: In this cross-sectional study, the life satisfaction of persons and their informal caregivers was measured in 81 dyads one year post stroke. Their global life satisfaction, measured with LiSat-11, was combined to a dyad score and the dyads were then categorized as satisfied, dissatisfied or discordant. The groups were compared and analyzed regarding levels of caregiver burden, measured with the Caregiver Burden scale, and the perceived impact of stroke in everyday life, measured with the Stroke Impact Scale (SIS). Results: The satisfied dyads comprised 40%, dissatisfied 26% and those that were discordant 34%. The satisfied dyads reported a significantly lower impact of the stroke in everyday life compared with the dyads that were not satisfied. As expected, dyads that were not satisfied reported a significantly greater caregiver burden compared with the satisfied dyads. The discordant group was further broken down into a group of dissatisfied and satisfied caregivers. The caregivers that were not satisfied in the discordant group perceived a significantly greater level of caregiver burden compared with the satisfied group. Even caregivers who were satisfied with life but whose care recipients were not satisfied reported caregiver burden. Conclusions: Measuring combined life satisfaction provides a unique focus and appears to be a feasible way of attaining the dyads' perspective. The findings suggest that those dyads with a discordant life satisfaction could be vulnerable because of the caregivers' reported caregiver burden. These findings support the importance of a dyadic perspective and add to the understanding of the reciprocal influences between the caregiver and recipient. This knowledge has clinical implications and contributes to the identification of possible vulnerable dyads in need of tailored support.
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| 7. |
- Bergström, Aileen L., et al.
(författare)
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Complex negotiations : The lived experience of enacting agency after a stroke
- 2015
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 22:1, s. 43-53
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This qualitative, longitudinal, descriptive study aimed to understand the lived experience of enacting agency, and to describe the phenomenon of agency and the meaning structure of the phenomenon during the year after a stroke. Agency is defined as making things happen in everyday life through one's actions. Methods: This study followed six persons (three men and three women, ages 63 to 89), interviewed on four separate occasions. Interview data were analysed using the Empirical Phenomenological Psychological method. Results: The main findings showed that the participants experienced enacting agency in their everyday lives after stroke as negotiating different characteristics over a span of time, a range of difficulty, and in a number of activities, making these negotiations complex. The four characteristics described how the participants made things happen in their everyday lives through managing their disrupted bodies, taking into account their past and envisioning their futures, dealing with the world outside themselves, and negotiating through internal dialogues. Conclusions: This empirical evidence regarding negotiations challenges traditional definitions of agency and a new definition of agency is proposed. Understanding clients' complex negotiations and offering innovative solutions to train in real-life situations may help in the process of enabling occupations after a stroke.
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| 8. |
- Bergström, Aileen L., et al.
(författare)
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Participation in everyday life and life satisfaction in persons with stroke and their caregivers 3–6 months after onset
- 2015
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 47:6, s. 508-515
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore and describe persons with stroke and their caregivers' restrictions in participation in everyday occupations, i.e. occupational gaps, 3-6 months post-stroke, in relation to life satisfaction, combined life satisfaction, caregiver burden, perceived impact of stroke, and activities of daily living. Design: Cross-sectional study. Subjects: Persons with stroke and their caregivers (105 dyads). Methods: The Occupational Gaps Questionnaire, Life Satisfaction Checklist, Caregiver Burden Scale, Stroke Impact Scale and Barthel Index were used. Correlations were analysed with Spearman's rank, and regression analyses used life satisfaction as the dependent variable. Results: At least one person in 86% of the dyads perceived restrictions in participation, with the most common gap in travelling for pleasure. Correlations were low between the numbers of occupational gaps and life satisfaction (R=-0.33, R=-0.31); however, life satisfaction accounted for occupational gaps both for persons with stroke and for caregivers. A greater number of occupational gaps were perceived in the dyads with combined low levels of life satisfaction compared with those with combined high levels of life satisfaction. Conclusion: Participation in everyday occupations is related to life satisfaction even for caregivers of persons with stroke. The results of this study add to our knowledge about the stroke-caregiver dyad and will help to inform family-centred approaches within stroke rehabilitation.
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| 9. |
- Bergström, Aileen L
(författare)
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Participation in everyday occupations and life satisfaction in the stroke-caregiver dyad
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In order to develop knowledge that can be used within rehabilitation after stroke, the general aim was to explore participation in everyday occupations and the relation to life satisfaction in persons with stroke and within the caregiver dyad. Furthermore, the aim was to understand and describe the lived experience of persons enacting agency in everyday occupations during the first year after stroke. The aim of study I was to understand the lived experience of enacting agency (i.e. making things happen by ones’ actions in everyday life) and to describe the phenomenon of agency during the year after stroke. This was done with a phenomenological approach. Studies I and II had a prospective, longitudinal design and the aim of study II was to explore the extent of and the factors associated with restrictions in participation in everyday occupations i.e. occupational gaps, 12 months after stroke and to identify factors at 3 months that predicted occupational gaps 12 months after stroke. Studies III-IV used a cross-sectional design and study III described the combined life satisfaction of the stroke-caregiver dyad and investigated the association of the combined life satisfaction with the perceived impact of the stroke and the caregivers’ caregiver burden one year after stroke. The aim of study IV was to explore and describe persons’ with stroke and their caregivers’ restrictions in participation in everyday occupations three months after study inclusion and to depict this in relation to their life satisfaction, the dyads combined life satisfaction, caregiver burden, perceived impact of stroke and ADL ability. The findings in study I showed that persons after a stroke experienced the process of enacting agency as complex negotiations of varied and changing aspects in different situations. The four characteristics that described how the participants enacted agency concerned how they managed their perturbed bodies, took into account the past and envisioned the future, dealt with the world outside themselves, and negotiated through internal dialogues. Restrictions in participation i.e. occupational gaps, were perceived by 83% of persons with stroke and almost half of the caregivers, three months after study inclusion (study IV), and 45% of the persons with stroke, one year after the incident (study II). Three months after stroke, ADL ability, social participation and not being born in Sweden predicted occupational gaps at 12 months (study II). Occupational gaps were associated with life satisfaction one year after stroke (study II) but there was a low correlation between the number of occupational gaps for the persons with stroke and their life satisfaction, 3 months after study inclusion. This also regarded the caregivers (study IV). Almost two-thirds of the stroke-caregiver dyads gave congruent responses regarding their global life satisfaction. Dyads, where both persons had a low life satisfaction; 26% and 38%, respectively (studies III-IV), experienced caregiver burden, stroke impact, and occupational gaps to a greater extent, compared with those dyads where both persons were satisfied (study III-IV). Persons use complex negotiations to participate in everyday occupations after stroke and may need client-centered support. Their process of enacting agency challenges existing definitions of agency. Also, determining predictors of occupational gaps may facilitate identification of persons risking participation restrictions. A dyadic perspective regarding life satisfaction and life after stroke can provide information about potential vulnerable persons or dyads. This knowledge can be used clinically to prevent restrictions in participation in everyday occupations for both individuals and dyads affected by stroke.
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| 10. |
- Bergström, Aileen, et al.
(författare)
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Phronesis: Recognising a neglected dimension of knowledge within occupational therapy research
- 2024
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis Group. - 1103-8128 .- 1651-2014. ; 31:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Phronesis is a way of knowing, implying wisdom, experiences, and reflections that guide our judgements. Phronesis, important for learning, is a neglected form of knowledge when applied to research.Aim: To examine how phronesis is conceptualised and practiced in three research projects.Method: Data from eight interviews with researchers involved in three research projects was generated. The interview material was analysed. A theoretical matrix of contemporary understanding of phronesis was applied to the material.Result: Examples of phronesis from three research projects in occupational therapy are presented according to categories of contemporary phronesis; acknowledging embodiment, embracing humility, using perceptiveness, and practicing reflexivity.Significance: This unique approach of analysing research projects contributes to the understanding of phronesis and its implications for research, providing valuable insights into the researchers’ praxis in their respective projectsConclusion: There is a need for a greater recognition of phronesis as a dimension of knowledge within all types of research, and within the discipline. By not recognising phronesis as a legitimate form of knowledge, the discipline perpetuates a superiority of knowledge from episteme that dominates our ways of learning about the world around us and where the type of knowledge gleaned from phronesis is consequently marginalised.
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| 11. |
- Bergström, Aileen, et al.
(författare)
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The jigsaw puzzle of activities for mastering daily life; service recipients and professionals’ perceptions of gains and changes attributed to reablement : A qualitative meta-synthesis
- 2022
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Taylor and Francis Ltd.. - 1103-8128 .- 1651-2014. ; , s. 1-12
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Forskningsöversikt (refereegranskat)abstract
- Background: Reablement services are intended to make a difference in the daily lives of older adults. Outcomes are often described in terms of independence, improving quality of life, improving ADL functioning, or reducing services. However, little is known if the older adults or next-of-kin experience these outcomes when talking about participating in reablement services. Aim: This study aims to explore how older adults, next-of-kin, and professionals narrate the reablement recipients’ possible outcomes as gains and changes in everyday life during and after the reablement period. Materials and methods : This meta-synthesis included 13 studies. Data were analyzed with a meta-ethnographic approach, searching for overarching metaphors, in three stages. Results: The metaphor ‘the jigsaw puzzle of activities for mastering daily life again’ illustrates that re-assembling everyday life after reablement is not a straightforward process of gains and changes but includes several daily activities that must be organized and fit together. To obtain a deeper understanding of the participants’ gains, and changes after reablement, we use the theoretical framework of ‘doing, being, becoming, and belonging’. Conclusion: The findings indicate the complexity of reablement services as well as the need for a holistic approach. Significance: Outcome measures should be meaningful for reablement recipients.
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| 12. |
- Hellman, Therese, et al.
(författare)
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Return to work after stroke : Important aspects shared and contrasted by five stakeholder groups
- 2016
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Ingår i: Work. - 1051-9815 .- 1875-9270. ; 55:4, s. 901-911
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Poor co-operation between the various stakeholders underscores the need for reviewing important factors that facilitate return to work (RTW) after stroke. OBJECTIVE: To explore and describe important aspects expressed by Swedish stakeholders in the RTW process for persons post stroke and to contrast the stakeholders' aspects exploring different perspectives that may influence optimal RTW. METHODS: Data from seven focus group interviews with the stakeholders were analyzed using qualitative content analysis. RESULTS: Three main categories made up the findings; the prolonged RTW process, the need for extended knowledge, and the assessment of work ability in the RTW process. Despite the stakeholders' agreement on these important aspects, they presented divergent views of the categories, representing their diverse agendas. CONCLUSIONS: A stroke coordinator may remediate the stakeholders' divergent perspectives. The coordinator should be versed in stroke specific knowledge and in a person centered approach to inform the decision process regarding RTW, while finding optimal solutions within regulatory boundary conditions. A coordinator could increase collaboration of the various stakeholders, provide support and coordinate services for the client with stroke and the employer throughout the whole process facilitating RTW after stroke. Future studies are needed to confirm this proposal.
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| 13. |
- Patomella, Ann-Helen, et al.
(författare)
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Primary prevention of stroke : randomised controlled pilot trial protocol on engaging everyday activities promoting health
- 2019
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 9:11
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionStroke is a globally common disease that has detrimental effects on the individual and, more broadly, on society. Lifestyle change can contribute to reducing risk factors for stroke. Although a healthy lifestyle has direct benefits, sustaining and incorporating healthy activities into everyday life is a challenge. Engaging everyday activities have the potential to support lifestyle change and to promote sustainable activity patterns. Current healthcare is failing to reduce modifiable risk factors in people at risk, and in addition to current practice, there is a need for systematic and efficient non-pharmacological and non-surgical stroke-prevention strategies. The aim of the pilot study was to increase knowledge about the effects of a prevention programme and its feasibility to promote sustainable and healthy activity patterns among persons at risk of stroke.Methods and analysisThe proposed pilot study will be a two-armed randomised, assessor-blinded, parallel pilot trial. The study will include feasibility data, investigating acceptability and delivery of the intervention. Persons at risk of stroke (n=60) will be included in a mobile phone-supported prevention programme. The 10-week programme will be conducted at primary healthcare clinics, combining group meetings and online resources to support self-management of lifestyle change. Main outcomes are stroke risk, lifestyle habits and healthy activity patterns. Assessments will be performed at baseline and at follow-up (immediately following the end of the programme and at 6 and 12 months). Effects of the programme will be analysed using inferential statistics. Feasibility will be analysed using both qualitative and quantitative methods.Ethics and disseminationThe study has been approved by the Regional Ethical Review Board in Stockholm, Sweden, being granted reference numbers 2015/834-31, 2016/2203-32 and 2019/01444. Study results will be disseminated through peer-review journals and presentations to mixed audiences at regional and international conferences. Trial registration number NCT03730701.
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| 14. |
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