| 1. |
- Arkkukangas, Marina, et al.
(författare)
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Movement toward an evidence-Based, digital fall prevention future-Perceptions from a physiotherapy perspective
- 2021
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Ingår i: Physiotherapy Theory and Practice. - : TAYLOR & FRANCIS INC. - 0959-3985 .- 1532-5040.
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Tidskriftsartikel (refereegranskat)abstract
- Background Physiotherapy plays an important role in fall prevention, and is a science- and evidence-based profession that is constantly undergoing development. Currently, the possibility of digital fall prevention is being explored; however, the perception of physiotherapists (PTs) toward a digital approach is still a sparsely investigated topic. Purpose This study aimed to explore the PT's experiences with a fall prevention exercise program used in their daily work and their thoughts regarding the use of digital support in this context. Methods Discussions were held in two focus groups with seven PTs (age: 26-48 years). A qualitative content analysis was performed. Results We identified two main categories: 1) The importance of evidence-based fall prevention exercise; and 2) Transition toward a digital fall prevention exercise approach. The participants expressed that they had time- and resource-related limitations affecting evidence-based work and adherence to fall prevention exercise programs. They stated that education and management support were required. Conclusion There is a need for fall prevention exercise to be evidence-based and prioritized in physiotherapy. The study results provide insights into the lack of adherence to fall prevention exercise programs and highlighted the need for a transition toward working digitally in the future.
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| 2. |
- Cederbom, Sara, 1973-, et al.
(författare)
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A behavioral medicine intervention for community-dwelling older adults with chronic musculoskeletal pain : Protocol for a randomized controlled trial
- 2017
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Ingår i: Journal of Pain Research. - : Dove Medical Press Ltd.. - 1178-7090. ; 10, s. 845-853
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic musculoskeletal pain is a major health problem among older adults, particularly those who live alone and/or those who are dependent on formal care. Chronic pain is associated with mobility problems, falls, fear of falling, catastrophizing thoughts, and a lower quality of life. Research shows that physical therapy interventions based on behavioral medicine approaches are beneficial for middle-aged adults with chronic pain. However, there appears to be no previous randomized controlled trials (RCTs) based on this theoretical framework that have examined the effect on older adults with chronic musculoskeletal pain who live alone at home and are dependent on formal care to manage their everyday lives. The aim of the planned study is to evaluate the effect of an individually tailored integrated physical therapy intervention based on a behavioral medicine approach compared with the effect of standard care. Methods/design: The planned study is an RCT that will include one intervention and one control group involving a total of 150 adults aged ≥75 years with chronic musculoskeletal pain who live alone at home and are dependent on formal care to manage their everyday lives. The intervention will involve a 12-week home-based individually tailored intervention that will be designed to enhance the participants’ ability to perform everyday activities by improving physical function and reducing pain-related disability and beliefs. The control group will be given standard care, including general advice about physical activity. The participants will be assessed at baseline and at 3 and 6 months after baseline. The primary outcome will be pain-related disability and physical performance. Discussion: The intervention, if effective, will have the potential to be the basis of the first evidence-based guidelines for physical therapists who work with older adults with chronic musculoskeletal pain.
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| 3. |
- Cederbom, Sara, et al.
(författare)
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A behavioral medicine intervention for older women living alone with chronic pain - a feasibility study
- 2014
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Ingår i: Clinical Interventions in Aging. - 1176-9092 .- 1178-1998. ; 9, s. 1383-1397
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Tidskriftsartikel (refereegranskat)abstract
- Background: To be an older woman, live alone, have chronic pain, and be dependent on support are all factors that may have an impact on daily life. One way to promote ability in everyday activities in people with pain-related conditions is to use individualized, integrated behavioral medicine in physical therapy interventions. How this kind of intervention works for older women living alone at home, with chronic pain, and dependent on formal care to manage their everyday lives has not been studied. The aim was to explore the feasibility of a study and to evaluate an individually tailored integrated behavioral medicine in physical therapy intervention for the target group of women. Materials and methods: The study was a 12-week randomized trial with two-group design. Primary effect outcomes were pain-related disability and morale. Secondary effect outcomes focused on pain-related beliefs, self-efficacy for exercise, concerns of falling, physical activity, and physical performance. Results: In total, 23 women agreed to participate in the study and 16 women completed the intervention. The results showed that the behavioral medicine in physical therapy intervention was feasible. No effects were seen on the primary effect outcomes. The experimental intervention seemed to improve the level of physical activity and self-efficacy for exercise. Some of the participants in both groups perceived that they could manage their everyday life in a better way after participation in the study. Conclusion: Results from this study are encouraging, but the study procedure and interventions have to be refined and tested in a larger feasibility study to be able to evaluate the effects of these kinds of interventions on pain-related disability, pain-related beliefs, self-efficacy in everyday activities, and morale in the target group. Further research is also needed to refine and evaluate effects from individualized reminder routines, support to collect self-report data, safety procedures for balance training, and training of personnel to enhance self-efficacy.
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| 4. |
- Cederbom, Sara, 1973-, et al.
(författare)
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A qualitative study exploring physical therapists’ views on the Otago Exercise Programme for fall prevention : a stepping stone to “age in place” and to give faith in the future
- 2020
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Ingår i: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 38:1, s. 132-140
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Tidskriftsartikel (refereegranskat)abstract
- Background: One of the most effective interventions to prevent falls is exercise. A commonly used program that prevents falls is the Otago Exercise Programme (OEP). Despite this, user-based knowledge of its applicability in real-world settings for older adults who are dependent on formal care in their homes is lacking. Purposes: To explore how physical therapists (PTs) experience the applicability of the OEP in clinical practice for home-dwelling older adults who are dependent on formal home care and to determine their beliefs regarding the benefits of the OEP for living longer at home. Methods: Semi-structured interviews were conducted with 17 physical therapists. Data were analyzed using qualitative thematic analysis. Results: The OEP was described by PTs to be applicable in clinical practice. Their experience was that the OEP seemed to be meaningful and to have a strong relationship with everyday activities. The OEP improved physical function, mood, self-efficacy, and participation in social activities in older adults, as well as provided faith in the future. Conclusion: The OEP is suitable for use in a primary care setting, and according to the perceptions of physical therapists, the OEP contributes to older adults' capability to live longer at home.
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| 5. |
- Cederbom, Sara
(författare)
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Ability in everyday activities and morale among older women with chronic musculoskeletal pain living alone : a behavioural medicine approach in physiotherapy
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall purpose of this thesis was to utilise a behavioural medicine approach in physiotherapy to study how older women with chronic musculoskeletal pain, who live alone and are dependent on formal care, perceive their everyday lives and to explore how their ability to perform everyday activities and morale could be promoted.
Method: This thesis used a descriptive, correlative design (Study I), a randomised two-group design (Study III) and a qualitative inductive explorative design (Study II and IV). Participants in Studies I-III: Older women (≥65 years) with chronic musculoskeletal pain, who live alone, are able to walk with or without walking aids indoors and are dependent on formal care to manage their everyday lives. Study IV: Home help service staff who were involved in study III. Results: The results showed that many different factors appeared to have impact on the women’s health, everyday activities and morale. The target group of older women seemed to report the same pain-related problems, the same degree of pain-related disability and the same beliefs as those found in previous research on older individuals with chronic pain conditions. Despite their chronic musculoskeletal pain and other health complaints as well as their dependencies on others to manage their everyday lives, the results show how important it was for the women to live at home for as long as possible. A key factor in promoting the ability to perform everyday activities among the women was having a daily rhythm in a supportive environment. Another key factor in this context was the home help service staff, who had a strong will and desire to promote their care recipients’ independence and quality of life. Nonetheless, the resource that the staff represent could most likely be utilised in a better way. The behavioural medicine in physiotherapy intervention showed that more support from physiotherapists and home help services staff is needed to enhance the effect of this type of intervention among the target group. Nevertheless, the results imply that this type of intervention may improve levels of physical activity, self- efficacy in relation to exercise and management of everyday life, but further research is needed in larger samples. Conclusions: This thesis demonstrates that there are many different factors that seem to affect the women’s health, ability in everyday activities and morale. The women describe how their ability in everyday activities can be promoted by performing their everyday activities in a daily rhythm, and home help service staff are a key resource in this context. Moreover, physical activity, self-efficacy in relation to exercise and management of everyday life can be improved by a behavioural medicine-based physiotherapy intervention in the target group. To promote the women’s abilities in everyday activities, to improve their morale and, in the end, to enable the target group of women to be “ageing in place” in the best possible way, society and health care professionals may have to pay them special attention.
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| 6. |
- Cederbom, Sara, et al.
(författare)
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Chronic pain among older women living alone. A study focusing on disability and morale.
- 2014
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Ingår i: European Journal of Physiotherapy. - 2167-9169 .- 2167-9177. ; 16:3, s. 139-150
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate 1)how older women who are living alone perceive chronic musculoskeletal pain,Activities of Daily Living (ADL), physical activity, affective distress,pain-related beliefs, pain management, and rate pain-related disability andmorale, 2) the relationships betweendemographic variables, ADL, physical activity, affective distress, pain-relatedbeliefs, and pain management with pain-related disability and morale.Method: The study had across-sectional and correlational design. Sixty women, living alone with chronicpain and community support aged ≥65 years were included.Results: The women were on average 81 years old and had lived with pain forabout 21.5 years. They reported low scores of affective distress,catastrophizing thoughts and self-efficacy, high scores of fear of movement,low degrees of pain-related disability, and low levels of morale. The multiple regression analysisshowed that only catastrophizing thoughts significantlyexplained the variation in pain-related disability, and both affective distress and catastrophizing thoughtssignificantly explained the variation in morale. Conclusion: These older women livingalone with chronic pain reported similar prevalence ofchronic pain and pain-related disability but lower morale when comparingthe results with similar studies about older people in the same age group orolder people who are in need of help to manage their daily life. The only variable that was independely associated to bothpain-related disability and morale was catastrophizing. Further researchshould focus on identifying catastrophizing thougts,and also on developing a rehabilitation program based on a biopsychosocialperspective with the goal to decrease catastrophizing, pain-relateddisability, and increase morale for this target group
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| 7. |
- Cederbom, Sara, 1973-, et al.
(författare)
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Effects of a behavioral medicine intervention on pain, health, and behavior among community-dwelling older adults : a randomized controlled trial
- 2019
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Ingår i: Clinical Interventions in Aging. - : Informa UK Limited. - 1176-9092 .- 1178-1998. ; 14, s. 1207-1220
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of the study was to evaluate the effects of an intervention, based on a behavioral medicine approach in physical therapy (BMPI), on pain-related disability and physical performance as well as on pain severity, pain catastrophizing, physical activity levels, falls efficacy, and health-related quality of life (HRQL) by comparing the effects to standard care.Patients and methods: The study was a pragmatic randomized controlled trial with a two-group design and included measurements preintervention and postintervention and a 12-week follow-up. In total, 105 older adults, aged >75 years with chronic musculoskeletal pain living alone at home and dependent on formal care to manage their everyday lives, were included in the study. All statistical analyses were performed using an intention to treat approach.Results: The intervention, based on a behavioral medicine approach, compared to usual care, had a positive effect on pain-related disability, pain severity, level of physical activity, HRQL, management of everyday life, and self-efficacy.Conclusion: BMPI can be a suitable evidence-based intervention for community-dwelling older adults, even for those who are very old and frail. BMPI can support and promote an active aging and "age in place" for the target population, which is currently the main goal of all interventions in this field.
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| 8. |
- Cederbom, Sara, et al.
(författare)
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Home Help Service Staffs' Descriptions of Their Role in Promoting Everyday Activities Among Older People in Sweden Who Are Dependent on Formal Care.
- 2017
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Ingår i: Journal of Applied Gerontology. - : SAGE Publications. - 0733-4648 .- 1552-4523. ; 36:8, s. 971-992
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Tidskriftsartikel (refereegranskat)abstract
- The study aimed to explore how home help service staff described their role in improving the abilities of older people, in particular, older women with chronic pain who are dependent on formal care, to perform everyday activities. Three focus group interviews were conducted, and a qualitative inductive thematic content analysis was used. The analysis resulted in one theme: struggling to improve the care recipients' opportunities for independence but being inhibited by complex environmental factors. By encouraging the care recipients to perform everyday activities, the staff perceived themselves to both maintain and improve their care recipients' independence and quality of life. An important goal for society and health care professionals is to improve older people's abilities to "age in place" and to enable them to age independently while maintaining their quality of life. A key resource is home help service staff, and this resource should be utilized in the best possible way.
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| 9. |
- Cederbom, Sara, et al.
(författare)
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Impact of the fall prevention Otago Exercise Programme on pain among community-dwelling older adults : a short- and long-term follow-up study
- 2019
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Ingår i: Clinical Interventions in Aging. - 1176-9092 .- 1178-1998. ; 14, s. 721-726
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pain is a major public health issue among community-dwelling older adults, with a prevalence of 45-80%. In addition to being strongly associated with reduced physical function, loss of independence, psychological distress, lower quality of life, and risk of earlier death. Recent research has also found that pain in older adults is associated with a higher risk of falls, which itself is another major health concern. Long-term and high-intensity pain are predictors of chronic pain and pain-related disability. Therefore, establishing an evidence-based intervention that can reduce both pain and falls in older adults is of high importance.Purpose: This study aimed to investigate whether a home-based fall-preventive exercise-program can reduce pain in the target population over both the short and long term.Patients and methods: This was a quasi-experimental study with a 1-group pretest-posttest design. We included 119 participants who had participated in a recent 2-year fall prevention intervention in a randomized controlled trial. The intervention included exercises based on the Otago Exercise Programme (OEP), an individually tailored and prescribed program that involves home-based exercises supervised by a physiotherapist. Pain was measured using an item from the EuroQol-5D questionnaire.Results: Pain was significantly reduced from baseline (n=119) at 3 (n=105, p=0.003), 12 (n=96, p=0.041), and 24 (n=80, p=0.028) months following the commencement of OEP-based exercises.Conclusions: These results indicate that the OEP could be a suitable evidence-based program for both pain management and fall prevention among community-dwelling older people who live with pain and are at a higher risk of falling. Our study highlights an effective technique for better pain management and fall prevention in older adults.
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| 10. |
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| 11. |
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| 12. |
- Cederbom, Sara, et al.
(författare)
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The importance of a daily rhythm in a supportive environment- promoting ability in daily activities among older women livingalone with chronic pain
- 2014
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 36:24, s. 2050-2058
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to explore how older women living alone with chronic musculoskeletal pain, describe their ability in performing activities in everyday life and what could promote their ability in activities in everyday life as well as their perceived meaning of a changed ability to perform activities in everyday life. Method: Qualitative interviews were conducted with 12 women, and an inductive content analysis was used. Results: The results showed the importance of a daily rhythm of activities. Activities included in the daily rhythm were socializing with family and friends, physical activities, doing own activities as well as activities supported by relatives and the community. The activities described by the women also promoted their ability in activities in everyday life. Other findings were the women's perceived meaning of being independent and maintaining that independency, along with the meaning of accepting and adapting to a changed life situation. Conclusion: This paper concludes that it is important to be sensitive of individual needs regarding the daily rhythm of activities when health-care professionals intervene in the activities in everyday life of older women living alone, promote the women's independency, and enable them to participate in the community.
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| 13. |
- Cederbom, Sara, 1973-, et al.
(författare)
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The perceptions of older adults living with chronic musculoskeletal pain about participating in an intervention based on a behavioral medicine approach to physical therapy
- 2019
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Ingår i: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 36:10, s. 1118-1129
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is evidence that interventions based on a behavioral medicine approach to physical therapy (BMPI) are beneficial for older adults living with chronic pain; however, knowledge of the perceptions of older people regarding their participation in BMPI is lacking. Aim: The aim of this study was to describe the perceptions of older people about being participants in a home-based BMPI. Methods: Semi-structured interviews were conducted with 12 older adults living with chronic pain and participating in a BMPI. Data were analyzed using qualitative content analysis. Results: The respondents highlighted the importance of the home-based and individualized nature of the intervention. They perceived the support from the physical therapist (PT) as significant for their motivation and goal attainment. The benefits of the intervention were described in physical, psychological, social, and functional terms and as enabling participants to live at home for longer. Conclusion: The results show that participation in a BMPI was perceived as a positive and meaningful experience. Support from a PT is crucial to encouraging behavioral changes. Finally, participation in a BMPI may contribute to the ability of participants to "age in place" for longer.
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| 14. |
- Cederbom, Sara, 1973-, et al.
(författare)
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The tensions between micro-, meso- and macro-levels : physiotherapists’ views of their role towards fall prevention in the community – a qualitative study
- 2020
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Falls are a global public health concern. Physiotherapists are a key resource in this context, but there is sparse knowledge about how they perceive their role in the primary care setting. Therefore, the purpose of the present study is to explore physical therapists’ (PTs) view of how they experience and perceive their role working with fall prevention in a community care setting.Methods: Semi-structured interviews were conducted with 17 physiotherapists. Data were analysed using a qualitative thematic analysis.Results: The analysis resulted in a core theme and three subthemes. The core theme was ‘capability to cope with the tensions between the micro-, meso- and macro-levels in fall, prevention’, which indicated the importance of an evolving multifaceted, evidence based and innovative physiotherapy role. A key factor for this role is to take an integrative biopsychosocial approach based on how biological and psychosocial factors are uniquely related in fall prevention. The three themes were as follows: 1) always moving and changing: the competent explorative knowledge-hungry clinician’s multifaceted role; 2) multiprofessional – but in the end alone; 3) reaching out – from the bottom to the top. Success in the role of physiotherapists in fall prevention depends on the empowering leadership and working culture, as well as on the time and multifaceted professional competence of the clinicians.Conclusion: Our findings indicate that the PTs’ role reflects their abilities to change and improve their professional work in accordance with evidence based knowledge. To ensure good quality the PTs focused on the special needs of the patients, evidence-based fall prevention, interdisciplinary team work, good clinical competences, good skills in communication, and interpersonal relations. Attention should be placed on the importance of biopsychosocial perspective framing in the actual clinical and political context. The PTs saw the need for working at the micro-, meso- and macro-levels to succeed in the work of fall prevention.
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| 15. |
- Cederbom, Sara, 1973-
(författare)
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Äldre och smärta
- 2012. - 1
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Ingår i: Äldres hälsa. - Lund : Studentlitteratur. - 9789144073125 ; , s. 49-57
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Bokkapitel (populärvet., debatt m.m.)
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| 16. |
- Umb-Carlsson, Õie, MD, 1953-, et al.
(författare)
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Older adults’ experiences with mHealth for fall prevention exercise : usability and promotion of behavior change strategies
- 2020
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Ingår i: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 37:21
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Tidskriftsartikel (refereegranskat)abstract
- Background: With the rapidly growing aging population, older adults need to stay healthy andactive for a longer time. Mobile health (mHealth) solutions could help support, prevent, or delayfunctional decline and falls in old age.Purpose: The aim was to explore older persons’ experiences of a mobile application for fallprevention exercise, and to identify what possible behavior change techniques to include in thefurther development of the application.Methods: Two focus groups were conducted with 12 older adults (seven women and five men) 70to 83 years of age. A qualitative content analysis was performed.Results: Two main results emerged: 1) external facilitators for using the application; and 2)internal facilitators for using the application and perceived gains, in addition 10 behavior changetechniques were identified.Conclusion: With support, an application could be adapted for older adults to manage, motivate,and adhere to fall prevention exercise. To achieve long-term adherence to health behaviorchanges, behavior change strategies and techniques are recommended to be included in furtherdevelopment of the fallprevention application.
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| 17. |
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| 18. |
- von Heideken Wågert, Petra, Docent, 1977-, et al.
(författare)
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Everyday life in older men living alone - a complex view needing a biopsychosocial perspective
- 2020
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Ingår i: Disability and Rehabilitation. - ABINGDON : TAYLOR & FRANCIS LTD. - 0963-8288 .- 1464-5165. ; 42:1, s. 44-52
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To explore how older men living alone, describe their everyday activities and their abilities as well as how they could be helped in everyday life.MATERIALS AND METHODS: Qualitative semi-structured interviews were analysed with inductive content analysis. Eight men aged 65+ years were included. They were all living alone, albeit with home help services. They were able to walk and had sufficient cognitive ability.RESULTS: The analysis resulted in one theme "A driving force of managing activities and overcome hindering factors requires a broad spectrum of prerequisites for participating in everyday life" with the following four categories: Importance of everyday activities; individual prerequisites enabling everyday activities; body and mind inhibit, and react to the decreased, abilities; and importance of the environment.CONCLUSIONS: The results generate a complex view of older men's everyday life. It is important for older men's independence that health care and rehabilitation staff adopt a comprehensive view and work from a biopsychosocial (BPS) perspective. Implications for rehabilitation To be an older man living alone might mean a decreased health and good health is a strong predictor for increased abilities in everyday activities. The living situation of older men living alone is not well studied and needs to be explored to a greater extend, especially from their own perspective. An interaction of biological, psychological, and social factors was expressed as important for older men's everyday life, in accordance with the biopsychosocial (BPS) model. The expressed importance of participation as well as performing both physical and social activities reflects the need of individualised goals in rehabilitation according to the behavioural medicine approach. It is of outmost importance that health care and rehabilitation staff in contact with this group has a comprehensive view and works from a biopsychosocial (BPS) perspective, for maintenance of the older men's independence in everyday life.
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| 19. |
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