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1.
  • Ahlgren, Christina, et al. (författare)
  • Engagement in New Dietary Habits : Obese Women's Experiences from Participating in a 2-Year Diet Intervention
  • 2016
  • Ingår i: International Journal of Behavioral Medicine. - : Springer. - 1070-5503 .- 1532-7558. ; 23:1, s. 84-93
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Dietary weight loss interventions most often result in weight loss, but weight maintenance on a long-term basis is the main problem in obesity treatment. There is a need for an increased understanding of the behaviour patterns involved in adopting a new dietary behavior and to maintain the behaviour over time.PURPOSE: The purpose of this paper is to explore overweight and obese middle-aged women's experiences of the dietary change processes when participating in a 2-year-long diet intervention.METHODS: Qualitative semi-structured interviews with 12 overweight and obese women (54-71 years) were made after their participation in a diet intervention programme. The programme was designed as a RCT study comparing a diet according to the Nordic nutrition recommendations (NNR diet) and a Palaeolithic diet (PD). Interviews were analysed according to Grounded Theory principles.RESULTS: A core category "Engagement phases in the process of a diet intervention" concluded the analysis. Four categories included the informants' experiences during different stages of the process of dietary change: "Honeymoon phase", "Everyday life phase", "It's up to you phase" and "Crossroads phase". The early part of the intervention period was called "Honeymoon phase" and was characterised by positive experiences, including perceived weight loss and extensive support. The next phases, the "Everyday life phase" and "It's up to you phase", contained the largest obstacles to change. The home environment appeared as a crucial factor, which could be decisive for maintenance of the new dietary habits or relapse into old habits in the last phase called "Crossroads phase".CONCLUSION: We identified various phases of engagement in the process of a long-term dietary intervention among middle-aged women. A clear personal goal and support from family and friends seem to be of major importance for long-term maintenance of new dietary habits. Gender relations within the household must be considered as a possible obstacle for women engaging in diet intervention.
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2.
  • Axelsson, Sarianne Wiklund (författare)
  • Prerequisites for sustainable life style changes among older persons with obesity and for ICT support
  • 2015
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The experiences from persons in the third age of lifestyle changes due to obesity are rarely described in research. Interventions regarding lifestyle changes and obesity show weak evidence for long-term effects. Information and communication technology (ICT) may add an important potential in interventions, but readiness among older persons and the actual needs for support must be explored. Therefore the overall aim for the thesis was to explore the prerequisites for sustainable lifestyle changes among older persons with obesity; and how this could be supported by ICT.Both qualitative and quantitative approaches were used. In paper I, 10 participants were individually interviewed about their experiences of lifestyle changes and in a multistage focus group study (paper IV), 6 participants expressed the support needed for sustainable lifestyle changes in relation to obesity. Qualitative content analysis was used. In a randomly selected population survey, 154 participants responded to an enquiry about general and health related ICT usage (paper II). They also rated scenarios for expected psychosocial impact on web based e-health services and mobile health applications (paper III).An integration of the results identified four main findings: The first finding, A never-ending process of vigilance and vulnerability, showed constant attempts of weight loss and pre-occupation on not to fail in an un-supportive environment. The second finding; Need for psychosocial support marked that the process of lifestyle changes was influenced by factors as sensibility to moods, social support and others’ attitudes. It was therefore essential for the persons to achieve emotional balance. The third finding, ICT as a possible support for adaptability, presented that older Swedes expected a positive psychosocial impact by ICT, especially in a future perspective. ICT was most valued in the domain of adaptability. The degree of usage of health related ICT, however, was low, although persons with overweight had more experience of this usage. Finally, the fourth finding; Reconstructions from weight to health expresses the needs of reconstructing focus towards health, rather than being pre-occupied with weight loss. Physical activity that was associated to joy and to have a functioning body, a body that would serve them as before, were motives to lose weight.In conclusion, this thesis illustrates that a lifestyle change due to obesity in third age is lined with vigilance not to fail and requires a great deal of endurance and effort. The potential of ICT to support lifestyle changes is likely to be substantiated by the positive expectations on ICT from a psychosocial impact perspective, especially in views of the future. Findings indicate a need for moving focus from weight towards health and to see opportunities, and that psychosocial support and enjoyable physical activity are important prerequisites for sustainable change.
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3.
  • Einarsson, Sandra, 1981-, et al. (författare)
  • Thinking and re-thinking : a qualitative study of university teachers' perspectives on the development process for a new online interprofessional education curriculum in a Swedish higher education institution
  • 2023
  • Ingår i: Nordic Studies in Education. - : Cappelen Damm Akademisk. - 1891-5914 .- 1891-5949. ; 43:3, s. 225-240
  • Tidskriftsartikel (refereegranskat)abstract
    • The objective was to reflect on the experience of working collaboratively across education programmes, departments, and faculties from the perspective of university teachers at a higher education institution. Nine teachers from five programmes working together to develop a new curriculum for interprofessional education (IPE) participated in a focus group discussion. Data were analysed using thematic analysis. Findings suggest that teacher experiences can be understood in terms of teamwork processes valued from both professional and IPE experiential variations within the group. Since findings illustrate pedagogical collaboration across department and faculty boundaries, they can inspire teachers who are planning a similar process.
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4.
  • Hammarström, Anne, et al. (författare)
  • Developing a Tool for Increasing the Awareness about Gendered and Intersectional Processes in the Clinical Assessment of Patients : A Study of Pain Rehabilitation
  • 2016
  • Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:4
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: There is a need for tools addressing gender inequality in the everyday clinical work in health care. The aim of our paper was to develop a tool for increasing the awareness of gendered and intersectional processes in clinical assessment of patients, based on a study of pain rehabilitation.METHODS: In the overarching project named "Equal care in rehabilitation" we used multiple methods (both quantitative and qualitative) in five sub studies. With a novel approach we used Grounded Theory in order to synthesize the results from our sub studies, in order to develop the gender equality tool. The gender equality tool described and developed in this article is thus based on results from sub studies about the processes of assessment and selection of patients in pain rehabilitation. Inspired by some questions in earlier tools, we posed open ended questions and inductively searched for findings and concepts relating to gendered and social selection processes in pain rehabilitation, in each of our sub studies. Through this process, the actual gender equality tool was developed as 15 questions about the process of assessing and selecting patients to pain rehabilitation. As a more comprehensive way of understanding the tool, we performed a final step of the GT analyses. Here we synthesized the results of the tool into a comprehensive model with two dimensions in relation to several possible discrimination axes.RESULTS: The process of assessing and selecting patients was visualized as a funnel, a top down process governed by gendered attitudes, rules and structures. We found that the clinicians judged inner and outer characteristics and status of patients in a gendered and intersectional way in the process of clinical decision-making which thus can be regarded as (potentially) biased with regard to gender, socio-economic status, ethnicity and age.IMPLICATIONS: The clinical implications of our tool are that the tool can be included in the systematic routine of clinical assessment of patients for both awareness raising and as a base for avoiding gender bias in clinical decision-making. The tool could also be used in team education for health professionals as an instrument for critical reflection on gender bias.CONCLUSIONS: Thus, tools for clinical assessment can be developed from empirical studies in various clinical settings. However, such a micro-level approach must be understood from a broader societal perspective including gender relations on both the macro- and the meso-level.
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5.
  • Hammarström, Anne, et al. (författare)
  • Low-Educated Women with Chronic Pain Were Less Often Selected to Multidisciplinary Rehabilitation Programs
  • 2014
  • Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: There is a lack of research about a potential education-related bias in assessment of patients with chronic pain. The aim of this study was to analyze whether low-educated men and women with chronic pain were less often selected to multidisciplinary rehabilitation than those with high education. Methods: The population consisted of consecutive patients (n = 595 women, 266 men) referred during a three-year period from mainly primary health care centers for a multidisciplinary team assessment at a pain rehabilitation clinic at a university hospital in Northern Sweden. Patient data were collected from the Swedish Quality Registry for Pain Rehabilitation National Pain Register. The outcome variable was being selected by the multidisciplinary team assessment to a multidisciplinary rehabilitation program. The independent variables were: sex, age, born outside Sweden, education, pain severity as well as the hospital, anxiety and depression scale (HADS). Results: Low-educated women were less often selected to multidisciplinary rehabilitation programs than high-educated women (OR 0.55, CI 0.30-0.98), even after control for age, being born outside Sweden, pain intensity and HADS. No significant findings were found when comparing the results between high-and low-educated men. Conclusion: Our findings can be interpreted as possible discrimination against low-educated women with chronic pain in hospital referrals to pain rehabilitation. There is a need for more gender-theoretical research emphasizing the importance of taking several power dimensions into account when analyzing possible bias in health care.
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6.
  • Lehti, Arja, et al. (författare)
  • Walking down 'Via Dolorosa' from primary health care to the specialty pain clinic : patient and professional perceptions of inequity in rehabilitation of chronic pain
  • 2017
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 31:1, s. 45-53
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To analyse patient and professional perceptions about (in)equity of care and rehabilitation of chronic pain patients from primary health care to assessment at a specialty rehabilitation clinic.SETTING AND METHODS: This qualitative study consists one focus group interview with eight general practitioners who refer patients to pain rehabilitation clinics, 10 individual interviews with patients who were assessed at a pain rehabilitation clinic and seven interviews with professionals participating in multimodal assessment teams at a pain rehabilitation clinic. Interview analysis was conducted by the grounded theory method.RESULTS: The core category Via Dolorosa, the way of suffering and pain, captured how gender and sociocultural context may contribute to advantages and disadvantages during patient journeys from primary health care to a pain rehabilitation clinic. Patients and professionals perceived pain as a low-ranking illness, and women and men used different gendered strategies to legitimise the pain and to be taken seriously. Being 'a proper patient ready to change' and having 'likeness' between patients and professionals were viewed as advantageous in rehabilitation of pain patients. Patients with higher educational levels were perceived as easier to interact with and had better access to health care. Professional thoughts about gender norms influenced the rehabilitation options. The rehabilitation programme was seen by several professionals to be better suited for women than men, which could lead to unequal care.CONCLUSION: From an equity and gender perspective, our study highlights the complexity in rehabilitation of chronic pain patients - both from patient and professional perspectives. Awareness of gendered and the biased preconceptions and norms is crucial when professionals struggle to offer equitable health care and rehabilitation.
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7.
  • Stenberg, Gunilla, Med dr, 1968-, et al. (författare)
  • Gender matters in physiotherapy
  • 2022
  • Ingår i: Physiotherapy Theory and Practice. - : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 38:13, s. 2316-2329
  • Tidskriftsartikel (refereegranskat)abstract
    • The World Health Organization states that gender has implications for health across the course of a person's life in terms of norms, roles and relations. It also has implications in rehabilitation. In this article, we argue the need of gender perspectives in the field of physiotherapy; gender matters and makes a difference in health and rehabilitation. We highlight a number of central areas where gender may be significant and give concrete examples of social gender aspects in physiotherapy practice and in diverse patient groups. We also discuss why it can be important to consider gender from an organizational perspective and how sociocultural norms and ideals relating to body, exercise and health are gendered. Further we present useful gender theories and conceptual frameworks. Finally, we outline future directions in terms of gender-sensitive intervention, physiotherapy education and a gendered application of the ICF model. We want to challenge physiotherapists and physiotherapy students to broaden knowledge and awareness of how gender may impact on physiotherapy, and how gender theory can serve as an analytical lens for a useful perspective on the development of clinical practice, education and research within physiotherapy.
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8.
  • Stålnacke, Britt-Marie, et al. (författare)
  • Is there a gender bias in recommendations for further rehabilitation in primary care of patients with chronic pain after an interdisciplinary team assessment?
  • 2015
  • Ingår i: Journal of Rehabilitation Medicine. - : Foundation of Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 47:4, s. 365-371
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To examine potential gender bias in recommendations of further examination and rehabilitation in primary care for patients with chronic musculoskeletal pain after an interdisciplinary team assessment. Methods: The population consisted of consecutive patients (n=589 women, 262 men) referred during a 3-year period from primary healthcare for assessment by interdisciplinary teams at a pain specialist rehabilitation clinic. Patient data were collected from the Swedish Quality Registry for Pain Rehabilitation. The outcome was defined as the examination or rehabilitation that was specified in the patient's record. Results: Men had a significantly higher likelihood than women of being recommended physiotherapy and radiological examination, and the gender difference was not explained by confounding variables and covariates (age, marital status, ethnicity, education, working status, pain severity, pain interference, pain sites, anxiety and depression). There was no significant gender difference in recommendations to treatment by specialist physician, occupational therapist, psychologist or social worker. Conclusion: Our findings indicate that the interdisciplinary teams in specialist healthcare may discriminate against women with chronic pain when physiotherapy and radiological investigation are recommended. The team's choice of recommendations might be influenced by gendered attitudes, but this field of research needs to be studied further.
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9.
  • Wiklund, Maria, et al. (författare)
  • Access to rehabilitation : patient perceptions of inequalities in access to specialty pain rehabilitation from a gender and intersectional perspective
  • 2016
  • Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 9
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Long-term musculoskeletal pain is common, particularly among women. Pain conditions are a concern in primary health care, and people with severe and complex pain are referred to specialty health care. There is gender bias in access, counselling, assessment, and treatment of long-term pain.Objective: This study explores patient accounts and perceptions about important (social) factors for accessing specialised pain rehabilitation from gender and intersectional equality perspectives. We aimed to identify potential biases and inequalities in accessing rehabilitation resources at a specialised rehabilitation clinic.Design: Individual semi-structured interviews were conducted with 10 adults after an assessment or completion of a specialised rehabilitation programme in northern Sweden. Qualitative content analysis was used to explore patients’ perceptions of important factors for accessing rehabilitation.Results: One main theme was formulated as Access to rehab – not a given. Three categories of perceived inequality were demonstrated: power of gender, power of social status, and power of diagnosis. Participants perceived rehabilitation as a resource that is not equally available, but dependent on factors such as gender, socio-economic status, ability to work, ethnicity, or age, and more subtle aspects of social status and habitus (e.g. appearance, fitness, and weight). The character of diagnosis received (medical versus psychiatric or social) was also noted.Conclusions: It is crucial that professionals are aware of how potential inequalities related to gender, social status, and diagnosis, and their intersections, can be created, perceived, and have influence on the processes of assessment and treatment. Reduction of social determinants of health and biases remain important within global, national, and local contexts.
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11.
  • Wiklund, Maria, 1962-, et al. (författare)
  • Subjective health complaints in older adolescents are related to perceived stress, anxiety and gender : a cross-sectional school study in Northern Sweden
  • 2012
  • Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 12:993
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Adolescent subjective health has become a public health concern in Sweden and worldwide. The purpose of this study is to investigate perceived stress and subjective health complaints among older adolescents.Methods: Data were derived from a school-based survey with a sample consisting of 16–18 year olds (n=1027), boys and girls, in high school grades 1 and 2, from different educational programs in three public high schools within a university municipality in northern Sweden. Perceived stress, self-rated health, subjective health complaints, anxiety, and depression, were measured with a questionnaire including a set of instruments.Results: A large proportion of both girls and boys reported health complaints and perceived stress. There was a clear gender difference; girls reported two to three-fold higher proportions of subjective health complaints such as headache, tiredness and sleeping difficulties, musculoskeletal pain, as well as sadness and anxiety. Pressure and demands correlated strongly with psychosomatic symptoms (r=0.71) and anxiety (r=0.71).Conclusions: The results indicate that subjective health complaints are prevalent during adolescence, especially in girls, and furthermore that perceived stress and demands may be important explanatory factors. Future studies should pay attention to the balance between gender-related demands, perceived control and social support, particularly in the school environment, in order to prevent negative strain and stress-related ill-health. The gender gap in adolescent health needs to be further explored.
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13.
  • Ahlgren, Christina, et al. (författare)
  • The meanings given to gender in studies on multimodal rehabilitation for patients with chronic musculoskeletal pain : a literature review
  • 2016
  • Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 38:23, s. 2255-2270
  • Forskningsöversikt (refereegranskat)abstract
    • Purpose: The purpose of this study is to assess and describe the meanings given to "gender" in scientific publications that evaluate multidisciplinary, interdisciplinary or multimodal rehabilitation for patients with chronic musculoskeletal pain.Method: A systematic literature search for papers evaluating multimodal rehabilitation was conducted. The PubMed and EBSCO databases were searched from 1995 to 2015. Two or three researchers independently read each paper, performed a quality assessment and coded meanings of gender using qualitative content analysis.Results: Twenty-seven papers were included in the review. Gender was used very differently in the MMR studies investigated but primarily it referred to factual differences between men and women. Only one paper provided a definition of the concept of gender and how it had been used in that study. In the content analysis, the meaning of gender formed three categories: "Gender as a factual difference", "The man is the ideal" and "Gender as a result of social role expectations".Conclusions: The meaning of the concept of gender in multimodal rehabilitation is undefined and needs to be developed further. The way the concept is used should be defined in the design and evaluation of multimodal rehabilitation in future studies.Implications for rehabilitationHealthcare professionals should reflect on gender relations in encounters with patients, selection of patients into rehabilitation programs and design of programs. In rehabilitation for chronic pain the patients' social circumstances and cultural context should be given the same consideration as biological sex and pain symptoms.
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14.
  • Alex, Lena, et al. (författare)
  • Beyond a Dichotomous View of the Concepts of 'Sex' and 'Gender' Focus Group Discussions among Gender Researchers at a Medical Faculty
  • 2012
  • Ingår i: PLOS ONE. - : Public library of science. - 1932-6203. ; 7:11, s. e50275-
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: The concepts of 'sex' and 'gender' are both of vital importance in medicine and health sciences. However, the meaning of these concepts has seldom been discussed in the medical literature. The aim of this study was to explore what the concepts of 'sex' and 'gender' meant for gender researchers based in a medical faculty. Methods: Sixteen researchers took part in focus group discussions. The analysis was performed in several steps. The participating researchers read the text and discussed ideas for analysis in national and international workshops. The data were analysed using qualitative content analysis. The authors performed independent preliminary analyses, which were further developed and intensively discussed between the authors. Results: The analysis of meanings of the concepts of 'sex' and 'gender' for gender researchers based in a medical faculty resulted in three categories; "Sex as more than biology", with the subcategories 'sex' is not simply biological, 'sex' as classification, and 'sex' as fluid and changeable; "Gender as a multiplicity of power-related constructions", with the subcategories: 'gender' as constructions, 'gender' power dimensions, and 'gender' as doing femininities and masculinities; "'Sex and gender as interwoven", with the subcategories: 'sex' and 'gender' as inseparable and embodying 'sex' and 'gender'. Conclusions: Gender researchers within medicine pointed out the importance of looking beyond a dichotomous view of the concepts of 'sex' and 'gender'. The perception of the concepts was that 'sex' and 'gender' were intertwined. Further research is needed to explore how 'sex' and 'gender' interact.
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15.
  • Andersdotter Sandström, Anna, et al. (författare)
  • Patients with stress-induced exhaustion disorder and their experiences of physical activity prescription in a group context
  • 2023
  • Ingår i: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 16:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Physical activity is a useful means to improve symptoms and memory performance to some extent in individuals with stress-induced exhaustion disorder. Individuals in this group commonly do not need to reach the recommended levels of physical activity. Developing methods to support physical activity as a lasting behaviour is important.Objective: The aim of the study was to explore the processes involved when using physical activity prescription as part of rehabilitation in a group context for individuals with stress-induced exhaustion disorder.Method: A total of 27 individuals with stress-induced exhaustion disorder participated in six focus groups. The informants underwent a multimodal intervention including prescription of physical activity. The physical activity prescription had a cognitive behaviour approach and included information about physical activity, home assignments and goal setting. The data was analysed with grounded theory method using constant comparison.Results: The analysis of the data was developed into the core category ‘trying to integrate physical activity into daily life in a sustainable way’, and three categories: ‘acceptance of being good enough’, ‘learning physical activity by doing’ and ‘advocation for physical activity in rehabilitation’. The informants identified that during the physical activity prescription sessions they learned what physical activity was, what was ‘good enough’ in terms of dose and intensity of physical activity, and how to listen to the body’s signals. These insights, in combination with performing physical activity during home assignments and reflecting with peers, helped them incorporate physical activity in a new and sustainable way. A need for more customised physical activity with the ability to adjust to individual circumstances was requested.Conclusion: Prescription of physical activity in a group context may be a useful method of managing and adjusting physical activity in a sustainable way for individuals with stress-induced exhaustion disorder. However, identifying people who need more tailored support is important.
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16.
  • Björck van Dijken, Christina, et al. (författare)
  • Low back pain, lifestyle factors and physical activity: a population-based study.
  • 2008
  • Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 40:10, s. 864-869
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective and designThe prevalence of low back pain was assessed in relation to physical activity, for both work and leisure activities, in a randomly selected population in the northern part of Sweden. Additionally, the associations between age, sex, level of education, lifestyle factors, demographic characteristics, and low back pain were evaluated. Subjects: A total of 5798 subjects aged 25–79 years were selected randomly from a geographically well-defined area in northern Sweden. Methods: Additional questions concerning people's experience of low back pain were added to the questionnaire of the World Health Organization MONICA (MONItoring of trends and determinants in CArdiovascular disease) health survey with the aim of investigating prevalence rates and factors associated with low back pain. Results: Forty-one percent of the participants reported having low back pain (of these 55% were women and 45% men). The prevalence rate was highest in the age group 55–64 years. Chronic low back pain was the most frequent occurring problem. Of those with low back pain, 43% of the women and 37% of the men reported having continuous low back pain for more than 6 months. Individuals with low back pain often experienced a more physically heavy workload at work and lower physical activity during leisure time, and they were also more likely to have been smokers, have had higher body mass index, lived in smaller communities, and were less educated than people without low back pain. Conclusion: Low back pain seems to be associated with physical activity at work and in leisure time, certain lifestyle factors and demographic characteristics.
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17.
  • Christianson, Monica, et al. (författare)
  • Sex and gender traps and springboards : a focus group study among gender researchers in medicine and health sciences
  • 2012
  • Ingår i: Health Care for Women International. - : Taylor & Francis Group. - 0739-9332 .- 1096-4665. ; 33:8, s. 739-755
  • Tidskriftsartikel (refereegranskat)abstract
    • We explored the difficulties that gender researchers encounter in their research and the strategies they use for solving these problems. Sixteen Swedish researchers, all women, took part in focus group discussions; the data were analyzed using qualitative content analysis. The problems reported fell into four main categories: the ambiguity of the concepts of sex and gender; traps associated with dichotomization; difficulties with communication; and issues around publication. Categories of suggested problem-solving strategies were adaptation, pragmatism, addressing the complexities, and definition of terms. Here the specific views of gender researchers in medicine and health sciences-"medical insiders"-bring new challenges into focus.
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18.
  • Eliasson, Kristina, et al. (författare)
  • Ergonomists’ experiences of executing occupational health surveillance for workers exposed to hand-intensive work : a qualitative exploration
  • 2022
  • Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: In order to reduce work-related upper limb disorders, the Swedish Work Environment Authority introduced an occupational health surveillance targeting hand-intensive work. A process model, aimed at supporting the employers as well as the occupational health service provider (i.e., ergonomist) in the work process with the occupational health surveillance, was developed. The objective of this qualitative study was to explore ergonomists’ experiences of the execution of occupational health surveillance for hand-intensive work when following the novel process model as well as factors influencing the execution.Methods: Semi-structured individual interviews were conducted with ten ergonomists on one occasion regarding their experience of following the work process. Qualitative content analysis with an inductive approach was used for analyzing the data.Results: The ergonomists’ experiences were summarized in one theme “A joint roadmap supporting a participatory process” and two categories “Clear structure provided by the components” and “The process influenced by collaboration and context”. The ergonomists valued being guided by the systematics of the model, which provided structure and clarity in their work. Factors affecting the execution were related to communication deficiencies and uncertainties regarding expectations between different roles and functions (e.g., ergonomists and contact person, lack of information to workers). Additional factors, for instance, companies’ routines and the ergonomist’s intra-organizational support, such as access to IT-resources, could also affect the process.Conclusions: The findings reveal that this process model facilitates the ergonomists’ work and cooperation with a client company. However, the process model needs to be developed and accompanied by a guideline with information related to the process, including e.g., description of a start-up meeting and of the roles/functions of the involved parties.
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20.
  • Eskilsson, Therese, 1970-, et al. (författare)
  • Hopeful struggling for health : Experiences of participating in computerized cognitive training and aerobic training for persons with stress-related exhaustion disorder
  • 2020
  • Ingår i: Scandinavian Journal of Psychology. - : Wiley-Blackwell. - 0036-5564 .- 1467-9450. ; 61:3, s. 361-68
  • Tidskriftsartikel (refereegranskat)abstract
    • It is important to understand how people with exhaustion disorder (ED) perceive interventions aiming to facilitate cognitive functioning. Therefore, the overall aim of this study was to explore experiences from persons with ED after participating in a 12-week intervention of either computerized cognitive training or aerobic training. Both interventions were performed in addition to a multimodal rehabilitation programme. Thirteen participants, 11 women and 2 men, were interviewed about pros and cons with participating in the training. The interviews were analysed with Qualitative Content Analysis. The analyses resulted in the theme hopeful struggling for health and the categories support, motivation and sensations. It was hard work recovering from ED. Support from others who are in the same situation, family members, and technology and routines for the training were strongly emphasized as beneficial for recovery. Timing, i.e., matching activities to the rehabilitation programme, getting feedback and perceiving joy in the training were important for motivation. Participants in both interventions experienced positive sensations with improved memory performance, everyday life functioning and increased faith in the prospect of recovery. However, it is important to consider various aspects of support and motivation in both computerized cognitive training and aerobic training to enable participants to pursue their participation.
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24.
  • Fjellman-Wiklund, Anncristine, et al. (författare)
  • Musculoskeletal and general health problems of acoustic guitar, electric guitar, electric bass, and banjo players
  • 2006
  • Ingår i: Medical problems of performing artists. - 0885-1158 .- 1938-2766. ; 21:4, s. 169-176
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this cross-sectional study was to describe self-reported problems among guitarists and to examine differences associated with type of guitar played. Data for the study were extracted from the University of North Texas Musician Health Survey (UNT-MHS) data set. Subjects for the present study (n = 520) were included if they identified acoustic guitar, electric guitar, electric bass or banjo as their primary instrument. Prevalences for musculoskeletal problems were determined for the total group, by guitar-specific groups, and by gender. Prevalences for nonmusculoskeletal, overall health problems were established for the whole guitar group and by instrument. Of the total subjects, 81% reported one or more musculoskeletal problems. The acoustic guitar group reported the highest prevalence (83%), followed by the banjo (78%), electric bass (77%), and electric guitar groups (74%). The highest site-specific prevalences for the whole group were the left fingers (32.9%), left wrist (29.8%), and left hand (24.7%). Regarding nonmusculoskeletal problems, 66% of the total group perceived stress due to work environment as a moderate to high problem. The total group reported mostly problems with fatigue, depression, headache, and eye strain. The overall findings of the study show that musculoskeletal problems as well as stress-related health problems are a major concern for the guitar community.
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25.
  • Fjellman-Wiklund, Anncristine, 1955-, et al. (författare)
  • Musculoskeletal discomfort of music teachers : an eight-year perspective and psychosocial work factors
  • 1998
  • Ingår i: International journal of occupational and environmental health. - : Forlaget Thomson. - 1077-3525 .- 2049-3967. ; 4:2, s. 89-98
  • Tidskriftsartikel (refereegranskat)abstract
    • Musicians at all levels of performance, especially string players, are known to have a high prevalence of work-related musculoskeletal disorders. The disorders seem to be most common in the neck, shoulders and low back. In 1988, a survey of the work-related musculoskeletal disorders of 36 music teachers was carried out at a music school in northern Sweden. In 1996, the teachers were reinvestigated. The study also included an investigation of the psychosocial work environment according to the Karasek demand-control theory, as well as measurements of upper-arm elevation during a working day in five violin teachers. The results showed that music teachers, like other professional musicians, often experience discomfort in the neck, shoulders, and low back. The discomfort tended to be of long duration, increasing over the years. The psychosocial work environment was characterized by high psychological demands and low authority over decisions. This was compensated for through good social support. The work required skill and creativity but was monotonous. The measurements of upper-arm elevation indicated considerable variations in shoulder positions between teachers. There were also differences in the work done with the right and left arms, with repetitive motions more commonly involving the right arm. Approximately a fourth of the working day was spent with the arm elevated 30-90 degrees. The relationships between upper-arm movements and ratings of discomfort were moderate.
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26.
  • Fjellman-Wiklund, Anncristine, 1955- (författare)
  • Musicianship and teaching : aspects of musculoskeletal disorders, physical and psychosocial work factors in musicians with focus on music teachers
  • 2003
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Musculoskeletal disorders are common among musicians at all levels of performance. Since music teachers train our future musicians it is important to understand their work environment. By creating good examples of a healthy work environment, they can teach their students how to stay healthy and to prevent pain. The aim of this thesis was to study the work environment of music teachers at municipal music schools, with regard to physical and psychosocial factors and musculoskeletal disorders with the focus on neck and shoulder disorders. An additional aim was to investigate the variability of the playing technique in string players and to investigate if they could play with greater variation in the trapezius muscle activity pattern after a training intervention program.In a cross-sectional study at 23 municipal music schools, 171 out of the 208 (82%) music teachers reported that they had experienced work related musculoskeletal disorders (WMSDs) during the previous year. Women reported significantly more symptoms in the neck, the shoulders and the upper back compared to men. Both physical and psychosocial work factors were associated with neck and shoulder disorders. For women “high mental work demands” and “teaching at many schools” could be seen as risk factors and for men “lifting”, “playing the guitar” and “low social support at work” were risk factors.The occurrence of WMSDs was also investigated, over an eight-year period, in music teachers at one music school. The result showed that neck, shoulder and lower back disorders were common and tended to be of long duration and to increase over the years.In an interview study, nine music teachers focused on what they perceived to be important for their health and well-being. Replenishing and using up energy was found to be the core category. Creativity in the music and working with other musicians were perceived as sources of energy, while the goals of the organisation were experienced as stressful and used up energy. Whether the work was regarded as pedagogical or musical could affect the perception of health and the strategies for dealing with the strains of work.In two studies using electromyography, the variation in the trapezius muscle activity pattern in string musicians was investigated. The results suggested that each musician could repeat their muscular activity pattern in a similar way between two playing sessions. No difference was found in the trapezius muscle activity between five violinists who trained basic Body Awareness Therapy (BAT), a technique having its roots in Tai Chi Chuan tradition, compared to a reference group of nine violinists who did not take part in any training. However, the training group perceived positive changes in breathing, muscular tension, postural control and concentration during practice sessions.Neck and shoulder disorders were associated with physical and psychosocial factors at work. A process of replenishing and using up energy was important for music teachers’ health. The playing technique in string musicians seemed to be repeatable but difficult to affect over a short-term period. For future musicians it is crucial to learn good working technique at an early age. In the learning process the music teacher is a vital role model.
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27.
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28.
  • Fjellman-Wiklund, Anncristine, et al. (författare)
  • Patients' perceived treatment need owing to temporomandibular disorders and perceptions of related treatment in dentistry : a mixed method study
  • 2019
  • Ingår i: Journal of Oral Rehabilitation. - : Wiley-Blackwell. - 1365-2842 .- 0305-182X. ; 46:9, s. 792-799
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: To easily identify patients who could benefit from a temporomandibular disorder (TMD) examination, three screening questions (3Q/TMD) have been introduced in large parts of Sweden. The questions are related to a TMD diagnosis. However, how the questions relate to a treatment need is unknown.Objectives: The first aim of the study was to identify predicting factors for perceived treatment need among adult individuals who screened positive to the 3Q/TMD. The second aim was to explore individuals' thoughts and experiences related to treatment of their TMD complaint.Methods: This mixed‐method study with a case‐control design was conducted in Västerbotten, Sweden, during 2014. Individuals who screened positive to at least one of the 3Q/TMD questions were allocated 3Q‐positives, whereas those with negative answers to all questions were allocated 3Q‐negatives. In total, 300 individuals (140 randomly selected 3Q‐positives, and 160 age‐ and gender‐matched 3Q‐negatives) were included. All individuals answered questions related to treatment need. The answers were analysed in a qualitative approach with qualitative content analysis.Results: In total, 81% of 3Q‐positives expressed a treatment need related to their TMD symptoms. The perceived treatment need was predicted by frequent pain (Q1) and frequent functional disturbances (Q3). Among the 3Q‐positives, 54% reported mistrust in dentists' ability to treat TMD symptoms. The informants expressed a need for information about their symptoms and possible treatment options.Conclusion: Affirmative answers to 3Q/TMD were associated with TMD treatment need. Dentists should give advice to patients with TMD symptoms and address their concerns.
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29.
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30.
  • Fjellman-Wiklund, Anncristine, et al. (författare)
  • Reach the Person behind the Dementia Physical Therapists' Reflections and Strategies when Composing Physical Training
  • 2016
  • Ingår i: PLOS ONE. - : Public library science. - 1932-6203. ; 11:12
  • Tidskriftsartikel (refereegranskat)abstract
    • Dementia is a disease characterized by cognitive impairment and physical decline that worsens over time. Exercise is one lifestyle factor that has been identified as a potential means of reducing or delaying progression of the symptoms of dementia, maximizing function and independence. The purpose of this study was to explore physical therapists' (PTs) experiences and reflections on facilitating high-intensity functional exercise with older people living with dementia, in residential care home settings. The study used a qualitative design based on interviews, individually or in small groups, with seven PTs engaged as leaders in the training of older people with dementia. The interviews were analyzed with a modified Grounded Theory method with focus on constant comparisons. To increase trustworthiness the study used triangulation within investigators and member checking. The core category "Discover and act in the moment-learn over time" reflects how the PTs continuously developed their own learning in an iterative process. They built on previous knowledge to communicate with residents and staff and to tailor the high intensity training in relation to each individual at that time point. The category "Be on your toes" highlights how the PTs searched for sufficient information about each individual, before and during training, by eliciting the person's current status from staff and by interpreting the person's body language. The category "Build a bond with a palette of strategies" describes the importance of confirmation to build up trust and the use of group members and the room to create an interplay between exercise and social interaction. These findings highlight the continuous iterative process of building on existing knowledge, sharing and reflecting, being alert to any alterations needed for individuals that day, communication skills (both with residents and staff) and building a relationship and trust with residents in the effective delivery of high intensity functional exercise to older people living with dementia in care settings.
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31.
  • Fjellman-Wiklund, Anncristine, et al. (författare)
  • Retrospective experiences of individuals two decades after anterior cruciate ligament injury : a process of re-orientation towards acceptance
  • 2022
  • Ingår i: Disability and Rehabilitation. - : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 44:21, s. 6267-6276
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Individual perspectives of long-term consequences decades after anterior cruciate ligament (ACL) injury are unexplored. We addressed experiences and the impact on life of former athletes >20 years post-ACL injury.Methods: Individual interviews, analysed using Grounded Theory, were conducted with 18 persons injured mainly during soccer 20–29 years ago.Results: A theoretical model was developed with the core category Re-orientation towards acceptance, overarching three categories illustrating the long-term process post-injury. Initially the persons felt like disaster had struck; their main recall was strong pain followed by reduced physical ability and fear of movement and re-injury. In the aftermaths of injury, no participant reached the pre-injury level of physical activity. Over the years, they struggled with difficult decisions, such as whether to partake or refrain from different physical activities, often ending-up being less physically active and thereby gaining body weight. Fear of pain and re-injury was however perceived mainly as psychological rather than resulting from physical limitations. Despite negative consequences and adjustments over the years, participants still found their present life situation manageable or even satisfying.Conclusion: ACL injury rehabilitation should support coping strategies e.g., also related to fear of re-injury and desirable physical activity levels, also with increasing age.IMPLICATIONS FOR REHABILITATIONMore than 20 years after the ACL injury, the individuals despite re-orientation towards acceptance and a settlement with their life situation, still had fear of both pain and re-injury of the knee, with concerns about physical activity and gaining of body weight. Patients with ACL injury may need better individual guidance and health advice on how to remain physically active, to find suitable exercises and to maintain a healthy body weight. Education related to pain, treatment choices, physical activity, injury mechanisms in participatory discussions with the patient about the ACL injury may be beneficial early in the rehabilitation process to avoid catastrophizing and avoidance behaviour. ACL injury rehabilitation needs to address coping strategies incorporating the psychological aspects of suffering an ACL injury, including fear of movement/secondary injury, in order to support return-to-sport and/or re-orientation over time.
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32.
  • Fjellman-Wiklund, Anncristine, et al. (författare)
  • Take charge : Patients' experiences during participation in a rehabilitation programme for burnout
  • 2010
  • Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 42:5, s. 475-481
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The aim of this study was to explore the experiences of patients with burnout during a rehabilitation programme.Patients and methods: Eighteen patients with burnout were interviewed at the end of a one-year rehabilitation programme. The programme consisted of 2 groups, one with a focus on cognitively-oriented behavioural rehabilitation and Qigong and 1 with a focus on Qigong alone. The interviews were analysed using the grounded theory method.Results: One core category, Take Charge, and 6 categories emerged. The core category represents a beneficial recovery process that helped the patients to take control of their lives. The common starting point for the process is presented in the 3 categories of Good encounters, Affirmation and Group cohesiveness. The categories were basic conditions for continuing development during rehabilitation. In the categories Get to know myself, How can I be the one I want to be? and Choice of track, the more group-specific tools are included, through which the patients adopted a new way of behaving.Conclusion: Patients in both groups experienced group participation as being beneficial for recovery and regaining control of their lives, although in somewhat different way. An experience of affirmation and support from health professionals and group participants is of importance for behavioural change
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33.
  • Geithner, Christina A., et al. (författare)
  • Relative Age Effects in Women’s Ice Hockey : Contributions of Body Size and Maturity Status
  • 2018
  • Ingår i: Women in Sport & Physical Activity Journal. - : Human Kinetics. - 1063-6161 .- 1938-1581. ; 26:2, s. 124-133
  • Tidskriftsartikel (refereegranskat)abstract
    • Research on relative age effects (RAEs) in women’s ice hockey is lacking data on participant characteristics, particularly body size and maturity status. The purposes of our study were to investigate RAEs in women’s ice hockey players from two countries, and to determine whether RAE patterns could be explained by chronological age, body size, and maturity status. Participants were 54 Swedish elite and 63 Canadian university players. Birthdates were coded by quartiles (Q1–Q4). Weight and height were obtained, and body mass index and chronological age were calculated for each player. Players recalled age at menarche, and maturity status was classified as early, average, or late relative to population-specific means. Chi-square (χ2), odds ratios (OR), 95% confidence intervals (CI) and effect sizes (Cohen’s w) were calculated using population data across quartiles and for pairwise comparisons between quartiles. Descriptive statistics and MANOVAs were run by quartile and by country. Significant RAEs were found for Canadian players across quartiles (p < .05), along with a Q2 phenomenon (Q2: Q3, Q2: Q4, p < .05). Swedish players were overrepresented in Q3 (Q3: Q4, p < .05). Q4 was significantly underrepresented in both countries (p < .05). The oldest, earliest maturing, and shortest players in both countries were clustered in Q2, whereas the next oldest and latest maturing Swedish players were found in Q3. Age, physical factors, and interactions may contribute to overrepresentations in Q2 and Q3. These findings do not suggest the same bias for greater relative age and maturity found in male ice hockey.
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34.
  • Halvarsson, Sara, et al. (författare)
  • From authority to coach : parents' experiences of streching as a home programme for childrern with cerebral palsy
  • 2010
  • Ingår i: Advances in Physiotherapy. - : Informa UK Limited. - 1403-8196 .- 1651-1948. ; 12:4, s. 208-216
  • Tidskriftsartikel (refereegranskat)abstract
    • Stretching is a common treatment for children with cerebral palsy, carried out by parents together with their children in the home. The aim of the present study was to explore parents’ experiences of carrying out stretching as a home programme. In order to capture the informants’ own perceptions and experiences, a qualitative method, the Grounded Theory, was chosen. Fifteen semi-structured interviews with parents, using open-ended questions, were analysed. One core category, “From authority to coach”, and two categories, “Prerequisites for parenting during stretching” and “Child and parent interaction”, emerged. The parents described a gradual development of their own role in the home stretching programme, from that of an authority, when the child was young, to that of a coach when the child grew older. With this gradual development came an increased level of participation from the child, enabling stretching to be carried out regularly. According to the parents, stretching could not be carried out without the child's active participation. Along with the process, the parents perceived increasing stress through added pressure and demands. Mobility, time, coping strategies for stress and support from professionals, in particular physiotherapists, were important prerequisites for parents to help their child best with stretching exercises. Read More: http://informahealthcare.com/doi/abs/10.3109/14038196.2010.528023
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35.
  • Hammarström, Anne, et al. (författare)
  • Central gender theoretical concepts in health research : the state of the art
  • 2014
  • Ingår i: Journal of Epidemiology and Community Health. - : BMJ Publishing Group Ltd. - 0143-005X .- 1470-2738. ; 68:2, s. 185-190
  • Tidskriftsartikel (refereegranskat)abstract
    • Despite increasing awareness of the importance of gender perspectives in health science, there is conceptual confusion regarding the meaning and the use of central gender theoretical concepts. We argue that it is essential to clarify how central concepts are used within gender theory and how to apply them to health research. We identify six gender theoretical concepts as central and interlinked-but problematic and ambiguous in health science: sex, gender, intersectionality, embodiment, gender equity and gender equality. Our recommendations are that: the concepts sex and gender can benefit from a gender relational theoretical approach (ie, a focus on social processes and structures) but with additional attention to the interrelations between sex and gender; intersectionality should go beyond additive analyses to study complex intersections between the major factors which potentially influence health and ensure that gendered power relations and social context are included; we need to be aware of the various meanings given to embodiment, which achieve an integration of gender and health and attend to different levels of analyses to varying degrees; and appreciate that gender equality concerns absence of discrimination between women and men while gender equity focuses on women's and men's health needs, whether similar or different. We conclude that there is a constant need to justify and clarify our use of these concepts in order to advance gender theoretical development. Our analysis is an invitation for dialogue but also a call to make more effective use of the knowledge base which has already developed among gender theorists in health sciences in the manner proposed in this paper.
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36.
  • Hammarström, Anne, et al. (författare)
  • Experiences of barriers and facilitators to weight-loss in a diet intervention : a qualitative study of women in Northern Sweden
  • 2014
  • Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 14, s. 59-
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: There is a lack of research about the experiences of participating in weight-reducing interventions. The aim of this study was to explore barriers and facilitators to weight-loss experienced by participants in a diet intervention for middle-aged to older women in the general population in Northern Sweden.METHOD: In the intervention the women were randomised to eat either a Palaeolithic-type diet or a diet according to Nordic Nutrition recommendations for 24 months. A strategic selection was made of women from the two intervention groups as well as from the drop-outs in relation to social class, civil status and age. Thematic structured interviews were performed with twelve women and analysed with qualitative content analyses.RESULTS: The results showed that the women in the dietary intervention experienced two main barriers - struggling with self (related to difficulties in changing food habits, health problems, lack of self-control and insecurity) and struggling with implementing the diet (related to social relations and project-related difficulties) - and two main facilitators- striving for self-determination (related to having clear goals) and receiving support (from family/friends as well as from the project) - for weight-loss. There was a greater emphasis on barriers than on facilitators.CONCLUSION: It is important to also include drop-outs from diet interventions in order to fully understand barriers to weight-loss. A gender-relational approach can bring new insights into understanding experiences of barriers to weight-loss.
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37.
  • Hariz, Gun-Marie, et al. (författare)
  • Patients' perceptions of life shift after deep brain stimulation for primary dystonia : a qualitative study
  • 2011
  • Ingår i: Movement Disorders. - : Wiley. - 0885-3185 .- 1531-8257. ; 26:11, s. 2101-2106
  • Tidskriftsartikel (refereegranskat)abstract
    • Studies of deep brain stimulation for dystonia have shown significant motor improvement. However, patients' perceptions of surgery and its effects have been less studied. We aimed to explore perceptions of changes in life in patients with primary dystonia after deep brain stimulation. Thirteen patients underwent thematic interviews 8-60 months after pallidal deep brain stimulation. Interviews were transcribed verbatim and analyzed with grounded theory. Patients described a profound impact of dystonia on daily life. After surgery, physical changes with a more upright posture and fewer spasms translated into an easier, more satisfying life with greater confidence. Notwithstanding this positive outcome, the transition from a limited life before surgery to opportunities for a better life exhibited obstacles: The "new life" after deep brain stimulation was stressful, including concern about being dependent on the stimulator as well as having to deal with interfering side effects from deep brain stimulation. The whole coping process meant that patients had to quickly shift focus from struggling to adapt to a slowly progressive disorder to adjustment to a life with possibilities, but also with new challenges. In this demanding transition process, patients wished to be offered better professional guidance and support. Even though deep brain stimulation provides people with primary dystonia with a potential for better mobility and more confidence, patients experienced new challenges and expressed the need for support and counseling after surgery. Grounded theory is a useful method to highlight patients' own experience and contributes to a deeper understanding of the impact of deep brain stimulation on patients with dystonia.
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38.
  • Henriksson, Tommy, 1981-, et al. (författare)
  • Correlation between Off-ice Strength and Power Variables and Skating Performance in Women's Ice Hockey
  • 2015
  • Ingår i: Medicine & Science in Sports & Exercise. - : Wolters Kluwer. - 0195-9131 .- 1530-0315. ; 47:5S, s. 962-962
  • Tidskriftsartikel (refereegranskat)abstract
    • The relationship between off-ice tests and skating performance has not been previously investigated in elite women ice hockey players (WIHP).PURPOSE: The aim of this study was to investigate the relationship between off-ice strength-, and power- variables and different components of skating performance in Elite WIHP. METHODS: Elite WIHP (n=32) age: 18.3±2.1 years, were evaluated via physiological tests of; Vertical power (squat jump (SJ) and countermovement jump (CMJ)); Horizontal power (standing long jump on two legs (SLJ) on one leg (SLJR) and 20m linear sprinting); Strength (isometric leg pull, squat and isokinetic leg extension on 90° and 210° (Iso90, Iso210)). Right leg measurements were selected for the isokinetic leg extension and SLJ(R). Skating performance was assessed on-ice via three agility tests; S-cornering agility skate (SCAS), Transition agility skate (TAS), Cone agility skate (CAS), and anaerobic endurance test; Modified repeat sprint skate (MRSS). Pearson ́s bivariate correlations were used to investigate the associations between physical variables and on-ice variables. Statistical significance was set to p<.05.RESULTS: SLJR, SLJ, Iso90, Iso210, isometric leg-pull and 20m sprint were correlated with TAS, r = .698 (p.001), r = .509 (p.026), r = -.514 (p.050), r = -.529 (p.043), -.479 (p.038) and r = .631 (p.007) respectively. SLJR and Iso90 was correlated with SCAS, r = -.619 (p.005) and r = -.520 (p.047). SLJR, SLJ, CMJ and Iso210 were correlated to MRSS, r = -.588 (p.01), r = -.539 (p.021), r = -.482 (p.037) and r = -.544 (p.04) respectively. CAS was not significantly correlated with any of the physiological tests.CONCLUSIONS: Off-ice power and strength tests were significantly correlated to skating performance in elite WIHP. 
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39.
  • Henriksson, Tommy, 1981-, et al. (författare)
  • Laboratory- and field-based testing as predictors of skating performance in competetive-level female ice hockey
  • 2016
  • Ingår i: Open Access Journal of Sports Medicine. - 1179-1543. ; 7, s. 81-88
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: The purpose of this study was to examine whether field-based and/or laboratory-based assessments are valid tools for predicting key performance characteristics of skating in competitive-level female hockey players.DESIGN: Cross-sectional study.METHODS: Twenty-three female ice hockey players aged 15-25 years (body mass: 66.1±6.3 kg; height: 169.5±5.5 cm), with 10.6±3.2 years playing experience volunteered to participate in the study. The field-based assessments included 20 m sprint, squat jump, countermovement jump, 30-second repeated jump test, standing long jump, single-leg standing long jump, 20 m shuttle run test, isometric leg pull, one-repetition maximum bench press, and one-repetition maximum squats. The laboratory-based assessments included body composition (dual energy X-ray absorptiometry), maximal aerobic power, and isokinetic strength (Biodex). The on-ice tests included agility cornering s-turn, cone agility skate, transition agility skate, and modified repeat skate sprint. Data were analyzed using stepwise multivariate linear regression analysis. Linear regression analysis was used to establish the relationship between key performance characteristics of skating and the predictor variables.RESULTS: Regression models (adj R2) for the on-ice variables ranged from 0.244 to 0.663 for the field-based assessments and from 0.136 to 0.420 for the laboratory-based assessments. Single-leg tests were the strongest predictors for key performance characteristics of skating. Single leg standing long jump alone explained 57.1%, 38.1%, and 29.1% of the variance in skating time during transition agility skate, agility cornering s-turn, and modified repeat skate sprint, respectively. Isokinetic peak torque in the quadriceps at 90° explained 42.0% and 32.2% of the variance in skating time during agility cornering s-turn and modified repeat skate sprint, respectively.CONCLUSION: Field-based assessments, particularly single-leg tests, are an adequate substitute to more expensive and time-consuming laboratory assessments if the purpose is to gain knowledge about key performance characteristics of skating.
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40.
  • Henriksson, Tommy, 1981-, et al. (författare)
  • Performance profiling of female ice hockey players by country and position
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • Purpose: The purposes of this study were to determine whether physiological qualities and on- ice skating performance differ by country and by position in women’s ice hockey.Design: Cross-sectional study.Methods: A total of 109 female ice hockey players volunteered for the study: 45 players from Sweden (19.38 ± 2.56 years; body mass 69.43 ± 7.05 kg: height 169.83 ± 5.03 cm) and 64 players from Canada (19.84 ± 1.62 years; body mass 68.28 ± 7.72 kg: height 166.14 ± 13.67 cm). Anthropometric assessments included estimated body composition using skinfold measurements. Physiological assessments included tests for acceleration, strength, power and aerobic endurance. Performance assessments included on-ice agility and anaerobic tests. Data were analyzed for mean differences by country and position using a two-way ANOVA.Results: The Swedish players had less body fat (p=.007), more lean mass (p=.005), and higher Beep test scores (p=.001). The Canadian players performed better on leg strength (p=.026), acceleration (p=.001), single leg standing long jumps (right leg p=.002, left leg p=.030) and the modified repeat sprint skate (MRSS) (p=.029). Positional comparisons between forwards (F) and defenders (D) showed no significant differences. F and D performed better than goalies (G) on the beep test (p=.002 and p=.002, respectively).Conclusion: The findings showed that the physiological profile for the female ice hockey players in this sample differed by country. The results indicate that the Canadian profile may be better adapted for on-ice performance. No performance differences were found between F and D. G are subjected to completely different requirements, due to variation in equipment and movement patterns, and should not be compared to F and D.
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41.
  • Henriksson, Tommy, 1981- (författare)
  • Physiological- and Socio-Cultural Conditions for Performance in Women's Ice Hockey
  • 2017
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background: The ice hockey community is founded on masculine norms and values, and the hockey rink is often described as “the home of men’s ice hockey”. Despite a growing popularity, women’s ice hockey has low priority in comparison to the men’s game. On top of that, the women’s game does not allow body checking, which makes it deviant from what some see as “the real game of ice hockey”. The checking prohibition causes physiological requirements to differ from the men’s game, and since women are underrepresented in ice hockey research, not much is known regarding the physiological- and socio-cultural conditions of women’s ice hockey. The overall aim of this doctoral thesis is to investigate physiological- and socio-cultural conditions important for performance in women’s ice hockey.Methods: This thesis is unique in terms of the interdisciplinary approach between physiology and gender science, and the inclusion of studies based on both qualitative and quantitative research methods. Qualitative thematic interviews with ice hockey coaches from Sweden, Canada, and the United States were used to explore socio-cultural conditions in relation to performance and sport development (Paper I). Relative age effect (RAE) in relation to maturity status was examined through anthropometric measurements and a player questionnaire (Paper II). Physiological field- and laboratory assessments were used to investigate physiological conditions and performance in female competitive ice hockey players from Sweden (Paper III-IV), and players from Canada (Paper IV).Results: The findings from Paper I suggest that coaches need to maintain a holistic approach to coaching to be able to coordinate and optimize the effects based on available conditions. Socio-cultural conditions, such as structural and financial support, are mentioned as important to support opportunities in women’s ice hockey. Furthermore, the results (Paper I) show that female players in Canada and the United States have superior opportunities compared to female players in Sweden. These advantages are mainly attributed to the support provided by the North American education systems. The findings from Paper II suggest that the relative age effect (RAEs) in women’s hockey are also influenced by socio-cultural conditions. Significant RAE (p<.05) was found for Swedish players born in the third quartile (Q3) and for Canadian player born in the second quartile (Q2). Players born in the fourth quartile (Q4) are significantly (p<.05) underrepresentated in both countries. Players tend to be average or late maturers, but no differences can be found by country or position. The findings from Paper III show that field-based assessments are comparable to laboratory assessments with the purpose of predicting skating performance. The Prediction models accounted for 13.6 % to 42 % (laboratory-based models) and 24.4 to 66.3 % (field-based models) of the variance in skating time. Regardless of assessment method, uni-lateral assessments are superior to bi-lateral assessments. The results support the use of field-based assessments in Paper IV. The findings from Paper IV show various physiological profiles for female Swedish and Canadian players. Swedish players had less body fat (p=.007), more lean mass (p=.005), and greater aerobic fitness measured with the20-meter shuttle run beep test (p=<.001). Canadian players had greater maximal isometric leg strength (p=.026), exhibit a greater running acceleration (p=<.001), performed better in single leg standing long jumps (right leg p=.002, left leg p=.030), and showed better anaerobic endurance (p=.029) on- ice. No significant differences can be found between forwards and defenders.Conclusion: The findings of this study show that physiological- and socio-cultural conditions should both be considered in relation to performance in women’s ice hockey. For example, the various physiological profiles are probably an effect of the different socio-cultural conditions in Sweden and Canada. The Canadian profile may be better adapted to performance in ice hockey, but further research is needed to establish a relationship. Since women’s ice hockey often has somewhat limited resources, this knowledge may help optimize the effect of the available resources, and thus improve performance. Improved performance may have a positive long-term effect on the symbolic view of women’s ice hockey. Women can probably further optimize their physical performance in relation to their current conditions. But for permanent changes to occur, power structures in sport must also change. Women themselves have limited opportunities to affect the dominating gender norms and values in ice hockey.
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42.
  • Henriksson, Tommy, 1981-, et al. (författare)
  • Running a team is like laying a puzzle : elite coaches' experiences of women's ice hockey
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • Purpose: The aim of the study was to explore aspects important for sport development and performance in women’s ice hockey, and to reflect on the conditions in Sweden and in North America.Method: Data were collected using individual interviews analyzed by qualitative content analysis. The sample including eight ice hockey coaches, two women and six men from being active coaches for female teams on the highest national level.Result: The analysis resulted in the theme “Coaching with a holistic approach” and three categories; “Individually oriented and humane leadership”, “Insight and understanding of performance requirements”, and “Necessary conditions for sport development”. The results displayed the complex task of managing a top-level team. In order to coordinate available preconditions into a beneficial environment for the players to develop and perform, the coached had adopted a holistic approach to coaching. A holistic approach to coaching was considered necessary to promote human-, as well as athletic-development in WIH.Conclusion: This study suggests that leadership, conditions and requirement of the game, are interrelated and all has to be considered to meet the requirements of the sport and provide opportunities for development. Furthermore, we suggest WIH would benefit from being treated as its own unique experience, instead of being compared to MIH.
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43.
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44.
  • Holm, Sara (författare)
  • Children and Adolescents with Pain in Primary care : Biopsychosocial determinants and behavioral medicine treatment in a physical therapy framework
  • 2014
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Pain during childhood and adolescents is prevalent and longstanding pain can have severe consequences for children, their families and in the long run for the society. Persisting pain influences many aspects of life and pain-related disability is often associated with impairment, decreased health-related quality of life, school functioning, participation in social life, emotional well-being, and with increased healthcare utilization. The overall aim was to explore, with cross-sectional design, pain conditions, to identify biopsychosocial determinants and their association with pain-related disability, and to study the feasibility of applying a behavioral medicine treatment for adolescents experiencing musculoskeletal pain using randomized controlled design and multimethod approach. Samples of children and adolescents and their parents seeking primary care physical therapy for a pain condition, and a sample of treating physical therapists were included.The results showed that some children had profiles of biopsychosocial determinants that could increase the risk for long-term pain-related disability. Many had long pain duration and multiple pain locations. Girls reported higher levels of catastrophizing compared to boys, who in turn used more behavioral distraction generally regarded as a positive coping strategy.Behavioral medicine treatment, based on a biopsychosocial approach, targeting adolescents with pain was shown to be feasible for use in primary care, with promising outcomes. Tailoring of the treatment was suboptimal but the effect of behavioral medicine treatment in pain-related disability exceeded the effect of the control treatment. The satisfaction with treatment content and results were high for both the control- and experimental condition, significantly higher for the experimental condition as rated by participants. Learning and delivering the behavioral medicine intervention was perceived challenging but rewarding by the treating physical therapists. The biopsychosocial approach in tailoring the treatment, and dialogs with parents were identified as key aspects in the behavioral medicine treatment program.In conclusion, in children seeking primary care for pain, the factors associated with pain-related disability were complex and interrelated. The findings highlight the importance for primary care health care providers to apply a biopsychosocial approach in assessment and treatment, for improvement of activities and participation, and thereby helping children and adolescents regain health.
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45.
  • Häggqvist, Beatrice, et al. (författare)
  • "The balancing act". Licensed practical nurse experiences of falls and fall prevention : a qualitative study
  • 2012
  • Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 12, s. 62-
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Falls are common in old age and may have serious consequences. There are many strategies to predict and prevent falls from occurring in long-term care and hospitals. The aim of this study was to describe licensed practical nurse experiences of predicting and preventing further falls when working with patients who had experienced a fall-related fracture. Licensed practical nurses are the main caretakers that work most closely with the patients.Methods: A qualitative study of focus groups interviews and field observations was done. 15 licensed practical nurses from a rehabilitation ward and an acute ward in a hospital in northern Sweden were interviewed. Content was analyzed using qualitative content analysis.Results: The result of the licensed practical nurse thoughts and experiences about risk of falling and fall prevention work is represented in one theme, "the balancing act". The theme includes three categories: "the right to decide", "the constant watch", and "the ongoing negotiation" as well as nine subcategories. The analysis showed similarities and differences between rehabilitation and acute wards. At both wards it was a core strategy in the licensed practical nurse work to always be ready and to pay attention to patients' appearance and behavior. At the rehabilitation ward, it was an explicit working task to judge the patients' risk of falling and to be active to prevent falls. At the acute ward, the words "risk of falling" were not used and fall prevention were not discussed; instead the licensed practical nurses used for example "dizzy and pale". The results also indicated differences in components that facilitate workplace learning and knowledge transfer.Conclusions: Differences between the wards are most probably rooted in organizational differences. When it is expected by the leadership, licensed practical nurses can express patient risk of falling, share their observations with others, and take actions to prevent falls. The climate and the structure of the ward are essential if licensed practical nurses are to be encouraged to routinely consider risk of falling and implement risk reduction strategies.
  •  
46.
  • Ilgunas, Aurelija, et al. (författare)
  • Conceptualizing the clinical decision-making process in managing temporomandibular disorders : a qualitative study
  • 2021
  • Ingår i: European Journal of Oral Sciences. - : John Wiley & Sons. - 0909-8836 .- 1600-0722. ; 129:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Management of patients with temporomandibular disorders (TMD) appears to be more challenging than for other dental conditions. This study aimed to explore the decision-making process in TMD management, and thereby to conceptualize the decision-making process in dentistry. Individual semi-structured interviews were conducted during 2018 and 2019 with a purposive sample of 22 general dental practitioners from the Public Dental Healthcare Services and private practices in the Region of Västerbotten, Northern Sweden. The interviews were analysed using the Grounded Theory approach of Charmaz. Data analysis resulted in the core category 'Combining own competence and others' expectations in the desire to do the right thing'. The dentists showed interest in and a desire to apply professional knowledge, but also reflected on challenges and complexity in the decision-making process forTMD. The challenges were primarily related to organisational factors and lack of self-confidence. This identifies a need for re-organisation of daily clinical management in dentistry, and a need for more postgraduate training to improve self-confidence. The complexity of the decision-making process for TMD makes the study findings applicable in other dental situations.
  •  
47.
  • Ilgunas, Aurelia, et al. (författare)
  • Patients' experiences of temporomandibular disorders and related treatment
  • 2023
  • Ingår i: BMC Oral Health. - : BioMed Central (BMC). - 1472-6831. ; 23:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Temporomandibular disorders (TMD) are common and therefore managed by dentists on a daily basis. However, patients with TMD consistently go undetected and therefore untreated in dentistry. The reasons for these shortcomings have not been fully explored, specifically with regard to patients’ perspectives. Therefore, this study aimed to explore patients’ experiences of TMD and related treatment, with special focus on the experiences of having TMD, factors related to seeking care, and perspectives on received treatment.Methods: Purposive sampling was used to recruit adult patients at the Public Dental Health services (PDHS) in the Region of Västerbotten, Sweden, during 2019. Individual semi-structured interviews were conducted and analysed using Qualitative Content Analysis. Sixteen patients were interviewed (ten women and six men, 20–65 years). The interviews probed the patients’ perspectives of having TMD, seeking care, and receiving treatment. All participants were also examined according to the Diagnostic Criteria for TMD (DC/TMD) and qualified for at least one DC/TMD diagnosis.Results: The data analysis led to the main theme Seeking care when the situation becomes untenable, but dental care fails to meet all needs. The patients expressed worry and social discomfort because of the symptoms but still strived to have an as normal daily life as possible. However, severe symptoms and associated consequences compelled them to seek professional help. Experiences of distrust together with challenges to access the PDHS were identified and related to the patients’ unfulfilled expectations.Conclusions: Patients’ reported experiences indicate that receiving timely and appropriate care is more of an unfulfilled expectation than the current state of management of patients with TMD in dentistry.
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48.
  •  
49.
  • Johansson, Lena, et al. (författare)
  • Ventilated patients' experiences of body awareness at an intensive care unit
  • 2005
  • Ingår i: Advances in Physiotherapy. - : Taylor & Francis. - 1403-8196 .- 1651-1948. ; 7, s. 154-161
  • Tidskriftsartikel (refereegranskat)abstract
    • Treatment with mechanical ventilation (MV) in an intensive care unit (ICU) can cause extensive problems for patients.There is, however, a dearth of research investigation into how ICU treatment affects a person’s body image. The aim of thisstudy was to enhance the knowledge and understanding of body awareness and body image in persons treated with MV in anICU. In order to capture the informants’ own perceptions and experiences, a qualitative method of Grounded Theory waschosen. Seven thematic in-depth interviews were carried out with former ICU patients. To increase credibility, triangulationof researchers and reference group checking was used. The analysis resulted in the core category Limited possibilitiesto act, which relates to the informants’ experiences of not being able to act as they normally would. The core category wasderived from the experiences of feeling like another person, the perceptions of not being in contact with their body andreality and the feeling of being restrained. This study adds a perspective of body awareness to the interpretations of ICUpatients’ experiences. It emphasizes the experience and movement aspects of the body and that physiotherapists have animportant role in the rehabilitation of ICU patients.
  •  
50.
  • Lindelöf, Nina, et al. (författare)
  • A focus groups study of staff team experiences of providing interdisciplinary rehabilitation for people with dementia and their caregivers : a co-creative journey
  • 2023
  • Ingår i: BMC Geriatrics. - London : BioMed Central (BMC). - 1471-2318. ; 23:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The World Health Organization claims that rehabilitation is important to meet the needs of persons with dementia. Rehabilitation programmes, however, are not routinely available. Person-centred, multidimensional, and interdisciplinary rehabilitation can increase the opportunities for older adults with dementia and their informal primary caregivers to continue to live an active life and participate in society. To our knowledge, staff team experiences of such rehabilitation programmes, involving older adults with dementia and their informal caregivers has not been previously explored.Methods: The aim of this qualitative focus group study was to explore the experiences of a comprehensive staff team providing person-centred multidimensional, interdisciplinary rehabilitation to community-dwelling older adults with dementia, including education and support for informal primary caregivers. The 13 staff team members comprised 10 professions who, during a 16-week intervention period, provided individualised interventions while involving the rehabilitation participants. After the rehabilitation period the staff team members were divided in two focus groups who met on three occasions each (in total six focus groups) and discussed their experiences. The Grounded Theory method was used for data collection and analysis.Results: The analysis resulted in four categories: Achieving involvement in rehabilitation is challenging, Considering various realities by acting as a link, Offering time and continuity create added value, and Creating a holistic view through knowledge exchange, and the core category: Refining a co-creative process towards making a difference. The core category resembles the collaboration that the staff had within their teams, which included participants with dementia and caregivers, and with the goal that the intervention should make a difference for the participants. This was conducted with flexibility in a collaborative and creative process.Conclusions: The staff team perceived that by working in comprehensive teams they could provide individualised rehabilitation in creative collaboration with the participants through interaction, knowledge exchange, time and continuity, coordination and flexibility, and a holistic view. Challenges to overcome were the involvement of the person with dementia in goal setting and the mediating role of the staff team members. The staff pointed out that by refinement they could achieve well-functioning, competence-enhancing and timesaving teamwork.
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