| 1. |
- Cederfeldt, Marie, 1957, et al.
(författare)
-
A longitudinal study of cognitive impairments in relation to activities in daily life
- 2009
-
Ingår i: AT-FORUM, Äldres vardag, 6-8 maj-2009, Älvsjömässan i Stockholm.
-
Konferensbidrag (refereegranskat)abstract
- Objective: To examine whether there were any differences in recovery in performance of personal activities of daily living (P-ADL) in relation to cognitive impairments pre- and poststroke from discharge to 6 and 12 months in elderly persons. Methods: Forty-five elderly persons after stroke were assessed at discharge from the hospital at 6 and at 12 months. A questionnaire was used to evaluate the person´s prestroke cognitive status. P-ADL was assessed with the Barthel Index. The Mini Mental State Examination and neuropsychological tests were used to measure cognitive functions. Results: Persons with cognitive impairments before and after stroke did not improve in P-ADL from the acute phase until 6 and 12 months, while persons with intact cognition pre- and poststroke did. Conclusion: Since cognitive problems pre- and poststroke hinder recovery in P-ADL, it is important to be aware of the connection between cognitive impairment and activity limitations in planning the optimal rehabilitation. Key words: ADL, cognitive dysfunction, elderly, longitudinal, prestroke, stroke
|
|
| 2. |
- Cederfeldt, Marie, 1957, et al.
(författare)
-
Concurrent validity of the Executive Function Performance Test in people with mild stroke
- 2011
-
Ingår i: The British Journal of Occupational Therapy. - 0308-0226 .- 1477-6006. ; 74:9, s. 443-449
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Studies have shown that executive dysfunction is common in adults after stroke. Occupational therapists working in acute care assess the performance of activities of daily living; most instruments focus on personal care. However, the assessment of instrumental activities of daily living has been shown to discriminate executive dysfunction more effectively. An instrument for assessing executive dysfunction in more complex activities that is easy to handle in acute care is consequently required for clinical use. The Executive Function Performance Test (EFPT) was recently introduced into Sweden. The purpose of this study was to evaluate the concurrent validity of the EFPT in acute care for patients with mild stroke. Method: Twenty-three patients from an acute stroke unit were assessed with both the EFPT and the Assessment of Motor and Process Skills (AMPS). Results: The correlation between the EFPT and the AMPS assessments was highly significant (p = 0.003) and the concurrent validity was rho = 0.61. Conclusion: Since there is a risk that adult patients with mild stroke are discharged without rehabilitation, and there is a lack of a relevant instrument for occupational therapists that discriminates executive dysfunction in acute stroke care, the EFPT may be a suitable instrument to use with these patients.
|
|
| 3. |
- Cederfeldt, Marie, 1957, et al.
(författare)
-
En prospektiv studie om kognitiv nedsättning i relation till aktiviteter i det dagliga livet - Göteborgs Kognitiva Stroke Studie för Äldre
- 2008
-
Ingår i: Läkarstämman i Göteborg 2008.
-
Konferensbidrag (refereegranskat)abstract
- Det saknas studier om hur kognitiva nedsättningar pre-och poststroke påverkar vardagsaktiviteterna för äldre personer efter ett år. Syftet var att undersöka om det var någon skillnad i P-ADL från akutskedet till 12 månader hos äldre personer efter stroke med eller utan kognitiva nedsättningar pre- och poststroke. Äldre personer drabbade av stroke (n=45) inkluderades. Bedömningar utfördes vid utskrivning, 6 och 12 månader. Medianålderna var 77 år. Åstrands frågeformulär användes för att intervjua anhöriga om patientens kognitiva status prestroke. DSM-III användes också för diagnosen prestroke demens. Bartel Index användes för att bedöma P-ADL. Mini Mental State Examination (MMSE) och ett neuropsykologiskt test batteri användes för att bedöma kognitiv funktion. Resultat: Ej publicerat än
|
|
| 4. |
- Cederfeldt, Marie, 1957
(författare)
-
Executive dysfunctions in elderly persons with mild stroke
- 2011
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- ABSTRACT The overall aim of this thesis was to examine the performance of personal activities of daily living (P-ADL) related to cognitive and executive dysfunctions in elderly patients with mild stroke in the acute care and after 12 months, and to evaluate the instrument Executive Function Performance Test (EFPT) in persons with mild stroke. Methods: In the first study elderly patients with stroke (n = 60) referred to geriatric rehabilitation were included. Assessments were carried out at admission and at discharge. The median age of the group was 77 years. In the second study 45 of the above patients were assessed at discharge from hospital and at 6 and at 12 months after stroke onset. The Cognitive Impairment Questionnaire (CIMP-QUEST) was used to interview a close relative about the patient’s cognitive status. P-ADL was assessed with the Barthel Index (BI), and the Mini Mental State Examination (MMSE) and a neuropsychological test battery were used to measure cognitive dysfunctions. The National Institute of Health Stroke Scale (NIHSS) was used to measure neurological deficits. Analyses were made using non-parametrical statistical methods. In the third study four occupational therapist raters (two pairs) made 34 assessments of patients with mild stroke in a stroke unit with the instrument EFPT to evaluate the inter-rater reliability. In the fourth study patients with mild stroke (n=23) from an acute stroke unit were assessed in order to evaluate the concurrent validity of the EFPT. Results: In the first study neither the presence of pre-stroke dementia nor the cognitive status after stroke onset among these elderly patients influenced P-ADL at admission or at discharge in the acute phase after stroke. In the second study persons with cognitive- and executive dysfunctions before and after stroke did not improve in P-ADL from the acute phase until 6 and 12 months, while persons with intact cognition pre- and post-stroke did. In the third study the inter-rater reliability for the EFPT was very good. The median percentage agreement was 88 %. There was no occasional disagreement between the raters. One of 20 items had a significant systematic disagreement. In the fourth study, the correlation between the EFPT and the AMPS assessments was highly significant and the concurrent validity was moderate. Conclusion: These findings may indicate that the recovery of P-ADL in elderly patients after stroke is influenced by more factors than cognition or that assessment of P-ADL does not always detect cognitive dysfunctions. The results demonstrate the importance of using more complex activities in assessing the patient’s activity status since executive dysfunctions are more easily detected in tests with instrumental activities in daily life. Since there is a risk that some patients with mild stroke will be discharged without any rehabilitation, and occupational therapists have up till now lacked a relevant instrument for detecting problems with executive skills in acute stroke care, it is suggested that the EFPT is a suitable instrument for use in these patients.
|
|
| 5. |
- Cederfeldt, Marie, 1957, et al.
(författare)
-
Influence of cognition on personal activities of daily living (P-ADL) in
- 2007
-
Ingår i: Nordisk konferens för arbetsterapeuter i Stockholm 2007.
-
Konferensbidrag (refereegranskat)abstract
- This study examines how prestroke dementia and cognitive dysfunction after stroke influence the personal activities of daily living (P-ADL) in elderly patients in the acute phase after stroke. Elderly patients (n = 60) referred to geriatric rehabilitation were included. Assessments were carried out at admission and evaluated at discharge from the geriatric ward. The median age of the group was 77 years. Åstrand’s questionnaire was used to interview a close relative about the patient’s prestroke cognitive status. P-ADL was assessed with the Barthel Index (BI). The Mini Mental State Examination (MMSE) and a neuropsychological test battery were used to measure cognitive functions. Analyses were made using non-parametrical methods. In the acute phase after stroke, neither the presence of prestroke dementia nor the cognitive status after stroke onset among these elderly patients influenced P-ADL at admission or at discharge. Prestroke dementia and cognitive dysfunction’s were found to be common after stroke onset, however this did not have any impact on dependence in P-ADL in these elderly patients at admission or at discharge.
|
|
| 6. |
- Cederfeldt, Marie, 1957, et al.
(författare)
-
Influence of cognition on personal activities of daily living (P-ADL) in the acute phase - The Gothenburg Cognitive Stroke Study in Elderly
- 2006
-
Ingår i: Läkarstämman i Göteborg 2006.
-
Konferensbidrag (refereegranskat)abstract
- This study examines how prestroke dementia and cognitive dysfunction after stroke influence the personal activities of daily living (P-ADL) in elderly patients in the acute phase after stroke. Elderly patients (n = 60) referred to geriatric rehabilitation were included. Assessments were carried out at admission and evaluated at discharge from the geriatric ward. The median age of the group was 77 years. Åstrand’s questionnaire was used to interview a close relative about the patient’s prestroke cognitive status. P-ADL was assessed with the Barthel Index (BI). The Mini Mental State Examination (MMSE) and a neuropsychological test battery were used to measure cognitive functions. Analyses were made using non-parametrical methods. In the acute phase after stroke, neither the presence of prestroke dementia nor the cognitive status after stroke onset among these elderly patients influenced P-ADL at admission or at discharge. Prestroke dementia and cognitive dysfunction’s were found to be common after stroke onset, however this did not have any impact on dependence in P-ADL in these elderly patients at admission or at discharge.
|
|
| 7. |
- Cederfeldt, Marie, 1957, et al.
(författare)
-
Influence of cognition on personal activities of daily living (P-ADL) in the acute phase: the Gothenburg Cognitive Stroke Study in Elderly.
- 2009
-
Ingår i: Archives of gerontology and geriatrics. - : Elsevier BV. - 1872-6976 .- 0167-4943. ; 49:1, s. 118-22
-
Tidskriftsartikel (refereegranskat)abstract
- This study examines how prestroke dementia and cognitive dysfunction after stroke influence the personal activities of daily living (P-ADL) in elderly patients in the acute phase after stroke. Elderly stroke patients (n=60) referred to geriatric rehabilitation were included. Assessments were carried out at admission and evaluated at discharge from the geriatric ward. The median age of the group was 77 years. Astrand's questionnaire was used to interview a close relative about the patient's prestroke cognitive status. P-ADL was assessed with the Barthel Index (BI). The Mini Mental State Examination (MMSE) and a neuropsychological test battery were used to measure cognitive functions. Analyses were made using non-parametrical methods. In the acute phase after stroke, neither the presence of prestroke dementia nor the cognitive status after stroke onset among these elderly patients influenced P-ADL at admission or at discharge. Prestroke dementia and cognitive dysfunction's were found to be common after stroke onset, however this did not have any impact on dependence in P-ADL in these elderly patients at admission or at discharge.
|
|
| 8. |
- Cederfeldt, Marie, 1957, et al.
(författare)
-
Inter-rater reliability and face validity of the Executive Function Performance Test (EFPT)
- 2015
-
Ingår i: British Journal of Occupational Therapy. - : SAGE Publications. - 0308-0226 .- 1477-6006. ; 78:9, s. 563-569
-
Tidskriftsartikel (refereegranskat)abstract
- Occupational therapists need an instrument to assess executive dysfunctions before patients are discharged from acute wards. The Executive Function Performance Test (EFPT) appears to be suitable, since it evaluates dysfunctions in complex activities. The aim of this study was to translate the EFPT from English into Swedish and to evaluate its properties when used with older persons with mild stroke in an acute setting. Method The study consisted of three parts: (1) a translation procedure using a forward and backward method; (2) evaluation of face validity; (3) inter-rater reliability by four raters (two pairs) who made 34 assessments in 17 older patients with mild stroke in an acute ward. Results The inter-rater reliability for the EFPT was good. The median was 88% of the percentage agreement. No occasional disagreement was found between the raters, but there was a systematic disagreement in one out of 20 items. The translation and face validity process resulted in further clarification of the semantic and cultural equivalence of the EFPT, and the manual was changed accordingly. Conclusion This study showed that inter-rater reliability was good and that the EFPT was found to be an interesting assessment, although further research is needed.
|
|
| 9. |
- Cederfeldt, Marie, 1957, et al.
(författare)
-
Mellanbedömarreliabilitet av instrumentet Executive Function Performance Test (EFPT)
- 2011
-
Ingår i: Poster.
-
Konferensbidrag (refereegranskat)abstract
- Bakgrund: Studier har visat att nedsatt exekutiv funktion är vanligt hos personer som fått stroke. Arbetsterapeuter som arbetar inom akutvården bedömer hur patienten klarar aktiviteter i det dagliga livet, men de flesta instrumenten som används är inom personlig vård. Instrument som bedömer mer komplexa aktiviteter har visat sig vara de mest effektiva avseende att upptäcka nedsatt exekutiv funktion. Eftersom instrumentet Assessment of Motor and Process Skills (AMPS) kan vara allt för omfattande att göra i den akuta fasen, skulle det kunna vara användbart att ha ett instrument som är mer lätthanterbart i det akuta skedet. Executive Function Performance Test (EFPT) är ett bedömningsinstrument som nyligen introducerats i Sverige. Studier saknas avseende validitet och reliabilitet utifrån Svenska förhållande. När ett nytt instrument skall användas är det viktigt att det har god validitet och reliabilitet. Syftet med denna studie var att utvärdera innehållsvaliditet och inter-bedömar validitet. Metoden innefattar en “forward” och en “backward” översättning av EFPT och en utvärdering av interbedömar reliabilitet genom att sjutton patienter från en stroke enhet har bedömts av två oberoende arbetsterapeuter. Studien är ett samarbete med kärnsjukhuset i Skövde. Resultatet håller på att analyseras och preliminära resultat kommer att presenteras på AT-forum.
|
|
| 10. |
- Cederfeldt, Marie, 1957, et al.
(författare)
-
Occupational Status as documented in records for stroke inpatients in Sweden
- 2003
-
Ingår i: Scandinavien Journal of Occupational Therapy. ; :10, s. 81-87
-
Tidskriftsartikel (refereegranskat)abstract
- The Swedish literature shows shortcomings in the documentation of occupational therapy in patient records, especially goal setting and evaluation at discharge. Modern society has adopted the language of medicine as a framework for organizing all health service, and the law and regulations do not clearly define how to document goals, or how to record the evaluation of the interventions. Improvements are needed. Since ‘‘occupational performance’’ is a current concept in goal setting and evaluation of occupational therapy, the aim of this study was to obtain an understanding of how occupational performance is documented for stroke inpatients. Twenty occupational therapy records from stroke inpatients at a hospital in Sweden were analysed, using the method of constant comparison. ‘‘Occupational status’’ was found to be the core concept, which includes occupational performance ‘‘areas’’ and ‘‘aspects’’ assessed in pre-stroke, at admission, and at discharge. The ‘‘areas’’ were personal care, meal preparation, and transfer at home. The ‘‘aspects’’ taken into consideration were independence, difficulty, problem related to impairment, patient contribution, safety, and physical environment. The study revealed that, as far as stroke inpatients are concerned, occupational therapists regularly documented occupational areas and assessed six aspects of occupational performance. Key words: occupational performance, occupational performance aspects, occupational status, occupational therapy records, stroke inpatients.
|
|
| 11. |
- Cederfeldt, Marie, 1957, et al.
(författare)
-
Occupational Status as documented in records for stroke inpatients in Sweden
- 2002
-
Ingår i: Arbetsterapeuternas världskongress i Stockholm 2002.
-
Konferensbidrag (refereegranskat)abstract
- The Swedish literature shows shortcomings in the documentation of occupational therapy in patient records, especially goal setting and evaluation at discharge. Modern society has adopted the language of medicine as a framework for organizing all health service, and the law and regulations do not clearly define how to document goals, or how to record the evaluation of the interventions. Improvements are needed. Since ‘‘occupational performance’’ is a current concept in goal setting and evaluation of occupational therapy, the aim of this study was to obtain an understanding of how occupational performance is documented for stroke inpatients. Twenty occupational therapy records from stroke inpatients at a hospital in Sweden were analysed, using the method of constant comparison. ‘‘Occupational status’’ was found to be the core concept, which includes occupational performance ‘‘areas’’ and ‘‘aspects’’ assessed in pre-stroke, at admission, and at discharge. The ‘‘areas’’ were personal care, meal preparation, and transfer at home. The ‘‘aspects’’ taken into consideration were independence, difficulty, problem related to impairment, patient contribution, safety, and physical environment. The study revealed that, as far as stroke inpatients are concerned, occupational therapists regularly documented occupational areas and assessed six aspects of occupational performance.
|
|
| 12. |
- Cederfeldt, Marie, 1957, et al.
(författare)
-
Occupational Status as documented in records for stroke inpatients in Sweden
- 2004
-
Ingår i: Europeisk kongress i Aten för arbetsterapeuter.
-
Konferensbidrag (refereegranskat)abstract
- The Swedish literature shows shortcomings in the documentation of occupational therapy in patient records, especially goal setting and evaluation at discharge. Modern society has adopted the language of medicine as a framework for organizing all health service, and the law and regulations do not clearly define how to document goals, or how to record the evaluation of the interventions. Improvements are needed. Since ‘‘occupational performance’’ is a current concept in goal setting and evaluation of occupational therapy, the aim of this study was to obtain an understanding of how occupational performance is documented for stroke inpatients. Twenty occupational therapy records from stroke inpatients at a hospital in Sweden were analysed, using the method of constant comparison. ‘‘Occupational status’’ was found to be the core concept, which includes occupational performance ‘‘areas’’ and ‘‘aspects’’ assessed in pre-stroke, at admission, and at discharge. The ‘‘areas’’ were personal care, meal preparation, and transfer at home. The ‘‘aspects’’ taken into consideration were independence, difficulty, problem related to impairment, patient contribution, safety, and physical environment. The study revealed that, as far as stroke inpatients are concerned, occupational therapists regularly documented occupational areas and assessed six aspects of occupational performance.
|
|
| 13. |
- Cederfeldt, Marie, 1957, et al.
(författare)
-
Recovery in personal care related to cognitive impairment before and after stroke - a one-year follow-up
- 2010
-
Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 122:6, s. 430-437
-
Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective: To examine whether there were any differences in the recovery in performance of personal activities of daily living (P-ADL) in elderly persons in relation to cognitive impairments pre- and poststroke from discharge to 6 and 12 months in elderly persons. Methods: Forty-five elderly persons after stroke were assessed at discharge from hospital and at 6 and at 12 months after stroke onset. A questionnaire posed to the next of kin was used to evaluate the person´s pre- and poststroke cognitive status. P-ADL was assessed with the Barthel Index. The Mini Mental State Examination and neuropsychological tests were used to measure cognitive functions after stroke. The National Institute of Health Stroke Scale was used to measure neurological deficits. Results: Persons with cognitive impairments before and after stroke did not improve in P-ADL from the acute phase until 6 and 12 months, while persons with intact cognition pre- and post stroke did. Conclusion: Since cognitive problems pre- and poststroke hinder recovery in P-ADL, it is important to understand the connection between cognitive impairment and activity limitations when planning the optimal rehabilitation, which could include special compensation strategies, learnt by the patients, cognitive assistive devices and/or appropriate personal support trained in meaningful activities in daily life in their natural environment.
|
|
| 14. |
- Gutiérrez Pérez, Cristina, 1972, et al.
(författare)
-
High frequency of cognitive dysfunction before stroke in the elderly
- 2011
-
Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 1099-1166 .- 0885-6230. ; 26:6, s. 622-629
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives We examined cognitive functions before and in acute phase of stroke studying frequency and profile of cognitive impairment and relationships between cognitive status.MethodsSeventy-four patients with early phase after stroke and 49 healthy controls were included and examined using the Mini-Mental State Examination (MMSE) and a battery of neuropsychological tests. Cognitive status before stroke-onset was investigated using Cognitive Impairment Questionnaire.ResultsCognitive impairments were present in 96% of patients after stroke onset using the battery of neuropsychological tests and in 39% of patients using the MMSE, but in only 9% of controls. Seventy-six percent exhibited reduced executive function and 75% reduced psychomotor tempo. Cognitive dysfunction was present in 52% before stroke onset without any impact on the frequency of impairment in the various cognitive areas in early phase after stroke.ConclusionsCognitive impairment is frequent before the onset of stroke among older people and may partially explain the very high frequency of cognitive impairment observed after stroke onset.
|
|
