| 1. |
- Jönsson, Marie, 1966-, et al.
(författare)
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Barriers and Opportunities in Daily Occupations : From the Perspective of the Older Readmitted People
- 2019
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Konferensbidrag (refereegranskat)abstract
- Introduction: Older people admitted to hospital are at risk of decreased ability to perform ADL, lower quality of life and dependency after discharge. There is also a higher risk for readmission to hospital shortly after discharge. To be old and repeatedly seeking acute care is also more than a medical problem. Their repeated contacts with the healthcare system may be due to a dependency on others that may affect daily occupations at home. The specific needs of this group of older people have been poorly described from these older persons perspective.Objectives: The objective of this study was to describe barriers and opportunities in daily occupations for older people repeatedly readmitted to hospital and now discharged to home.Methods: Sixteen participants (≥75 years) readmitted to hospital for the third time within a 12 -month period were interviewed in their homes after discharge from an acute medical ward about two weeks after their latest hospital stay. A qualitative content analysis was used for analysis.Results: An overarching theme was found, trying to manage an unpredictable everyday life. Three categories and seven subcategories were identified, which represented barriers and opportunities for their daily occupations. The categories were Dealing with an unstable day, Dealing with social relations and Dealing with the health care system. These categories were important for maintaining daily occupations for most of the participants.Conclusion: To the extent the older person had the opportunity to perform daily occupations, this was seen as important and contributed to maintain abilities. Close contact with relatives was essential to the performance of daily occupations at home, and for the old person without contact with relatives this was a barrier to occupation and increased their vulnerability. Therefore, occupational interventions and appropriate support are required in acute care and these must be communicated at discharge. Interventions and timed support are of particular importance for those who do not have close social relations at home.
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| 2. |
- Jönsson, Marie, 1966-, et al.
(författare)
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Close relatives' perspectives of everyday activities at home for older adults repeatedly readmitted to hospital : A qualitative study
- 2024
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Ingår i: British Journal of Occupational Therapy. - : Sage Publications. - 0308-0226 .- 1477-6006. ; :1, s. 39-48
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Relatives are important when older adults return home after a hospital stay. The aim of this study was to describe close relatives' perspectives of the everyday activities of older adults who are repeatedly readmitted to hospital and discharged to home.Methods: A semi-structured interview was performed to collect data from twenty relatives (aged 45-82 years). Data were analysed using a deductive qualitative content analysis based on the results of a previous study within this field.Results: The overall theme 'In need of support to manage an unpredictable everyday life' shows that the older adults often needed support in everyday activities. In the two categories 'Difficulties in dealing with an unstable day' and 'Managing an unstable day' and the 10 subcategories, close relatives described that the older adults needed support in various ways from relatives or other individuals. Close contact was important for how everyday activities worked at home and in maintaining social contacts and contact with healthcare.Conclusion: It was found that social needs, such as social contacts/activities, are just as important to assess at discharge as medical and functional needs.
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| 3. |
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| 4. |
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| 5. |
- Jönsson, Marie, 1966-, et al.
(författare)
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Everyday activities at home : Experiences of older repeatedly readmitted people
- 2022
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa Healthcare. - 1103-8128 .- 1651-2014. ; 29:7, s. 555-562
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Limitations in everyday activities are a risk factor for hospital readmission. Despite this, few studies have focussed on everyday activities of repeatedly readmitted older people. The experiences and specific needs of this group have been poorly described regarding their everyday activities at home. A deeper understanding may help occupational therapists and other health professions to facilitate readiness for this group at and after discharge. The aim of this study was, therefore, to describe the experiences of performing everyday activities of older people repeatedly readmitted to hospital and discharged to home.METHODS: A qualitative interview study was used to collect data from sixteen participants (75 years and older). Data were analysed using qualitative content analysis.RESULTS: One theme 'trying to manage an unpredictable everyday life' and two categories describe experiences of everyday activities at home. The participants expressed the importance of continuing everyday activities after discharge where support from relatives and healthcare seemed to be of importance.CONCLUSION: It was found that performance of everyday activities and contact with family members were of importance in their everyday life. Therefore, assessments and support were of particular importance for the group of older people who do not have close social relations at home.
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| 6. |
- Jönsson, Marie, 1966-
(författare)
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Everyday activities in older adults readmitted to hospital
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The coordination of health care and social care at discharge are particularly important for older adults with complex health and social needs, as approximately 30 % of these persons are readmitted to hospital on an unplanned basis within three months of discharge. In order to provide adequate care for this group of older adults, we need a deeper understanding of their experiences regarding their functional ability at hospital and at home.The overall aim of this thesis was to describe older readmitted adults in terms of their abilities at hospital, everyday activities at home and of healthcare professionals’ conception of the care of older adults. Four studies were conducted using descriptive design. Data were gathered using four different methods of data collection. In this thesis, older readmitted adults are, defined as persons aged 75 years or older who have been readmitted to hospital on an unplanned basis three or more times within 12 months. In Study I, older adults readmitted to hospital (n=60), were assessed regarding personal activities of daily living, cognitive function, risk of falls, pressure sores and malnutrition. They were compared with samples from the general population. In order to describe everyday activities at home, semi-structured interviews were carried out with older readmitted adults (n=16) in Study II, and with close relatives (n=20) in Study III. In Study IV, focus group interviews were performed with healthcare professionals (n=29) about care at discharge and which measures that may be appropriate in order to prevent readmission.The major findings were that the participants had a higher risk of pressure sores, falls and dependency on ADL at hospital compared to age-matched samples. 40% of the participants had a cognitive limitation. At home, older adults strived to perform everyday activities but the ability was limited. Close relatives described that social relations were fundamental to perform everyday activities and social activities at home. Healthcare professionals stated that older readmitted adults were vulnerable. Multidisciplinary teamwork and geriatric expertise were fundamental but were perceived as lacking. Medical resources and rehabilitation resources should be developed and include rapid follow-up appointments at home in order to prevent readmission.Overall, health care and social care must identify this group and offer preventive assessments and interventions.
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| 7. |
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| 8. |
- Jönsson, Marie, 1966-, et al.
(författare)
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Possibilities and hindrances in daily occupations for older readmitted people discharged to home
- 2018
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Konferensbidrag (refereegranskat)abstract
- Introduction: Older people admitted to hospital are at risk of decreased ability to perform ADL, lower quality of life and dependency after discharge. There is also a higher risk for readmission to hospital shortly after discharge. The specific needs of this group of older people have been poorly described from these older peoples’ perspective. A deeper understanding may help the occupational therapist and other health professions to choose interventions in order to maintain daily occupations for this group. The aim of this study was to describe barriers and opportunities in daily occupations for older people repeatedly readmitted to hospital and now discharged to home.Methods: Sixteen participants 75 years and older were interviewed in their homes after discharge from an acute medical ward. A qualitative content analysis was used to analyze barriers and opportunities in daily occupations.Results: An overarching theme was found trying to manage an unpredictable everyday life. Three categories and seven subcategories were identified representing barriers and opportunities. The categories were Dealing with an unstable day, Dealing with social relations and Dealing with the health care system. These were important for maintaining daily occupations for most of the participants.Conclusion: The result indicates that daily occupations and contact from relatives were of importance. Therefore, appropriate support and occupational interventions are required in acute care and these must be communicated at discharge. Occupational therapy interventions and timed support are of particular importance for the group of older people who do not have close social relations at home.
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| 9. |
- Matérne, Marie, 1967-, et al.
(författare)
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Residential care staff are the key to quality of health care for adults with profound intellectual and multiple disabilities in Sweden
- 2022
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Ingår i: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: People with profound intellectual and multiple disabilities (PIMD) have combined severe intellectual and physical disability and need extensive health care support. They cannot communicate by spoken language and need around the clock support. The health care for people with PIMD is typically provided by a number of different health care services in collaboration with residential care staff and their managers. The quality of health care for people with PIMD are important due to their limited ability to communicate their needs. The aim of this study was to explore residential care staff and manager's experiences and views of health care services for adults with PIMD.METHODS: Thirteen semi-structured interviews with residential care staff (n = 7) and managers (n = 6) were conducted and analysed using qualitative content analysis.RESULTS: The informants expressed a variety of experiences, under the theme was Quality of health care is enhanced through residential care staff. The theme was comprised of four subthemes: (1) Individually tailored support promotes quality, (2) Accessibility requires adaptation and prioritization by healthcare providers, (3) Disability competence promotes quality and safety and (4) Complex collaboration conditions between the person with PIMD, residential care staff and disability health care.CONCLUSIONS: The residential care staff create quality of care in their role as representatives for adults with PIMD. The care situation is complex and requires adequate competence in the disability, the individual's needs and adaptations to ensure quality of health care. It is also important to build collaboration with other services that are involved in the care of people with PIMD.
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| 10. |
- Roshanai, Afsaneh, et al.
(författare)
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Psychometric Properties of the Original Version of the Assessment of Time Management Skills
- 2021
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Ingår i: American Journal of Occupational Therapy. - : American Occupational Therapy Association. - 0272-9490 .- 1943-7676. ; 75:Suppl. 2
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Time management is a key OT intervention component. Valid and reliable instruments are essential for evaluating rehabilitation and OT interventions. The results of this study show that the Assessment of Time Management Skills has good measurement properties and consistent and replicable items and is useful in English-speaking countries. It can provide valid measures of time management skills, organization and planning skills, and regulation of emotion in a general population and presumably also a population with cognitive impairment.
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| 11. |
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| 12. |
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| 13. |
- Adaszak, Sofie, 1980-, et al.
(författare)
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Navigating barriers and facilitators to support victims of violence in a close relationship with cognitive disability : Social workers´ perspectives
- 2023
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The risk of violence in close relationships is higher for people with cognitive disabilities than in the general population. This is due to social isolation, and physical or financial dependence on others in everyday activities. To enable adequate protection for these victims, social workers need to take decisions and provide support that is based on knowledge about both violence and disability-related needs. By contrast, people with cognitive disabilities are de facto less likely to be provided with support adapted to their needs. Therefore, this study explores how social workers navigate barriers and facilitating aspects to support victims of violence with cognitive disabilities.Data were collected in individual interviews with 18 social workers, and analysed using content analysis. The inclusion criteria were 3 years or more experience in identifying and/or assessing exposure to violence in close relationships among people with cognitive disabilities.The emerging categories illustrate how social workers face dilemmas when navigating the balance between individuals’ rights for self-determination and complex needs for protection and support. The policies that frame social workers' practice in Sweden are discussed in relation to the need for flexible interventions and accessible support based on interprofessional collaboration related to violence and cognitive disability. The categories also problematize the power dynamics involved and how different actors’ experiences, values, and power influence the support process. The different actors involved add to the complexity that social workers need to navigate.This presentation focus on how social workers' practice is governed and hindered by policy, a focus on individuals' rights for self-determination, and the need to support and protect a group that may have difficulties to identify both violence and their needs for support.
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| 14. |
- Arvidsson, Patrik, et al.
(författare)
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Evaluation of the group intervention "Let's Get Organized" for improving time management, organisational, and planning skills in people with mild intellectual disability
- 2023
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Pharma Intelligence UK Ltd.. - 1103-8128 .- 1651-2014. ; 30:8, s. 1257-1266
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Limited time management skills cause problems in daily life for people with mild intellectual disability (ID) and "Let's Get Organized" (LGO) is a promising manual-based occupational therapy group intervention aiming to support management skills.AIMS/OBJECTIVES: To evaluate the applicability of the Swedish version of LGO-S by i) exploring enhancements in time management skills, satisfaction with daily occupations, and aspects of executive functioning in people with time-management difficulties and mild ID, and ii) describing clinical experiences of using the LGO-S for people with mild ID.MATERIAL AND METHODS: Twenty-one adults with mild ID were included. Data were collected pre-/post-intervention and at 3- and 12-month follow-ups with: Swedish version of Assessment of Time Management Skills (ATMS-S), Satisfaction with Daily Occupation (SDO-13), and Weekly Calendar Planning Activity (WCPA-SE). There were few follow-up participants (n = 6-9).RESULTS: Significant change in time management skills that maintained at 12-months follow-ups. Significant increase in regulation of emotions at 12-month follow-up. Results at 12-months follow-up indicated sustainability in outcomes as measured by ATMS-S. A non-significant positive trend was observed in other outcomes between pre- and post-intervention.CONCLUSIONS AND SIGNIFICANCE: LGO-S seems applicable for improving skills in time management, organisation and planning also for people with mild ID.
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| 15. |
- Baric, Vedrana B., et al.
(författare)
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Partnering for change (P4C) in Sweden : a study protocol of a collaborative school-based service delivery model to create inclusive learning environments
- 2023
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Ingår i: BMC Public Health. - : Springer Nature. - 1471-2458. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Inclusive learning environments are considered as crucial for children's engagement with learning and participation in school. Partnering for change (P4C) is a collaborative school-based service delivery model where services are provided at three levels of intensity based on children's needs (class, group-, individual interventions). Interventions in P4C are provided universally to support all children with learning, not only children with special education needs (SEN), and as such are expected to be health-promoting.Aim: The aim of the study is to evaluate the effectiveness and cost-effectiveness of P4C as well as school staff members' and children's experiences after P4C.Methods: In a parallel, non-randomised controlled intervention design, 400 children, aged 6-12 years, and their teachers, will be recruited to either intervention classes, working according to the P4C, or to control classes (allocation ratio 1:1). Data will be collected at baseline, post-intervention (4 months), and 11 months follow-up post baseline. The primary outcome is children's engagement with learning in school. Secondary outcomes include for example children's health-related quality of life and wellbeing, occupational performance in school, attendance, and special educational needs. The difference-in-differences method using regression modelling will be applied to evaluate any potential changes following P4C. Focus group interviews focusing on children, and professionals' experiences will be performed after P4C. A health economic evaluation of P4C will be performed, both in the short term (post intervention) and the long term (11-month follow-up). This study will provide knowledge about the effectiveness of P4C on children's engagement with learning, mental health, and wellbeing, when creating inclusive learning environments using a combination of class-, group- and individual-level interventions.
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| 16. |
- Eldh, Ann Catrine, et al.
(författare)
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Assessing and reporting patient participation by means of patient preferences and experiences
- 2020
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Ingår i: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although patient participation is strongly associated with high quality of healthcare, valid means to measure and report a comprehensive notion of patient participation are scarce. The Patient Preferences for Patient Participation (4Ps) is a new healthcare practice and research tool, comprising patients' preferences as well as experiences. The 4Ps employs 12 items for the patient to conceptualise patient participation. The aim of this paper is to describe how the two perspectives of patient participation, namely preferences and experiences, can be combined to visualise and report preference-based patient participation.METHODS: With four response alternatives in each section, the 4Ps offers sixteen possible combinations of degree of match per item. Theoretical and clinical principles fostered a tentative order of six ranks and three levels of preference-based patient participation. To test the standard, statistical analyses for ordinal data were performed, using data from a randomised controlled trial evaluating an intervention aiming to improve patient participation. Further, structures for visualising the preference-based patient participation of individuals and groups were suggested.RESULTS: Data from the 4Ps demonstrated the individuals' preference-based patient participation, indicating either a match or a mismatch for each item. Mismatches represented either the experience of participation surpassing the patient's preferences, or the patient's preferences for patient participation not being established. At group level, the suggested approach for visualising and reporting the 4Ps demonstrated that the intervention group had a significantly higher proportion of sufficient preference-based patient participation for certain items than the control group. These results had not been identified earlier, when using the preferences and experiences of patient participation as separate measures.CONCLUSIONS: Ways to easily acquaint stakeholders with patients' preferences for patient participation are needed, in order for healthcare staff to better use resources to match the basic requirements of individuals and groups. While the 4Ps can guide professionals to patient participation as framed in legislations, concept analyses and by patients, a visualisation of the results is needed to capture preference-based patient participation. The proposed route to representing degree of match in preferences and experiences may also be relevant to other dimensions of quality of healthcare.
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| 17. |
- Eliasson, Ann-Christin, et al.
(författare)
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Longitudinal development of hand use in children with unilateral spastic cerebral palsy from 18 months to 18 years.
- 2023
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Ingår i: Developmental Medicine & Child Neurology. - : Mac Keith Press. - 0012-1622 .- 1469-8749. ; 65:3, s. 376-384
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe the development of the use of the affected hand in bimanual tasks in children with unilateral cerebral palsy (CP) from 18 months to 18 years. Specifically, whether early development can be confirmed in a larger cohort and how development progresses during adolescence.METHOD: In total, 171 participants (95 males, 76 females; mean age 3 years 1 month [SD 3 years 8 months], range 18 months-16 years at inclusion) were classified in Manual Ability Classification System (MACS) levels I (n = 41), II (n = 91), and III (n = 39). Children were assessed repeatedly (median 7, range 2-16 times) with the Assisting Hand Assessment: in total 1197 assessments. Developmental trajectories were estimated using a nonlinear mixed effects model. To further analyse the adolescent period, a linear mixed model was applied.RESULTS: The developmental trajectories were different between participants in MACS levels (MACS I-II, II-III) in both rate (0.019, 95% confidence interval [CI] 0.006-0.031, p = 0.034; 0.025, 95% CI 0.015-0.037, p < 0.001) and limit (19.9, 95% CI 16.6-23.3, p = 0.001; 7.2, 95% CI 3.3-11.2, p < 0.003). The individual variations were large within each level. The developmental trajectories were stable over time for all MACS levels between 7 and 18 years (p > 0.05).INTERPRETATION: Children and adolescents with unilateral CP have considerable development at an early age and a stable ability to use their affected hand in bimanual activities from 7 to 18 years in all MACS levels.
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| 18. |
- Eliasson, Ann-Christin, 1950-, et al.
(författare)
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The influence of early modified constraint-induced movement therapy training on the longitudinal development of hand function in children with unilateral cerebral palsy
- 2015
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Ingår i: Developmental Medicine & Child Neurology. - : John Wiley & Sons. - 0012-1622 .- 1469-8749. ; 57:1, s. 89-94
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Tidskriftsartikel (refereegranskat)abstract
- Aim: There is evidence that modified Constraint-Induced Movement Therapy (mCIMT) has a short-term positive effect on hand function in children with unilateral cerebral palsy (CP), but the long-term effect is unknown. The aim was to investigate whether or not a single block of mCIMT (2 hours/day during 2 months) at age 2-3 years influences the course of development of bimanual hand function at about 8 years of age.Methods: A convenience sample of 45 children (girls, n = 21) with unilateral CP and mean age 32 months was included (mCIMT group, n = 26; reference group, n = 19). Brain lesion characteristics were available for 32 children. The children were measured repeatedly with the Assisting Hand Assessment (AHA) for a mean period of 4 years and 6 months. Development curves were created and compared with a non-linear mixed effects model.Results: Children receiving mCIMT had an upper limit of development that was 8.5 AHA units higher than the reference group (p = 0.022). When controlling for brain lesion characteristics and baseline in a subgroup of 32 children, the difference was considerably smaller and no longer significant.Conclusion: mCIMT might have a positive impact on long-term development, but the results are inconclusive.
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| 19. |
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| 20. |
- Gustafsson, Margareta, 1952-, et al.
(författare)
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Test-retest reliability of the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) scale
- 2015
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Ingår i: Nurse Education in Practice. - : Elsevier BV. - 1471-5953 .- 1873-5223. ; 15:4, s. 253-257
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Tidskriftsartikel (refereegranskat)abstract
- The Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) scale evaluates the student nurses' perception of the learning environment and supervision within the clinical placement. It has never been tested in a replication study. The aim of the present study was to evaluate the test-retest reliability of the CLES + T scale. The CLES + T scale was administered twice to a group of 42 student nurses, with a one-week interval. Test-retest reliability was determined by calculations of Intraclass Correlation Coefficients (ICCs) and weighted Kappa coefficients. Standard Error of Measurements (SEM) and Smallest Detectable Difference (SDD) determined the precision of individual scores. Bland-Altman plots were created for analyses of systematic differences between the test occasions. The results of the study showed that the stability over time was good to excellent (ICC 0.88 - 0.96) in the sub-dimensions “Supervisory relationship”, “Pedagogical atmosphere on the ward” and “Role of the nurse teacher”. Measurements of “Premises of nursing on the ward” and “Leadership style of the manager” had lower but still acceptable stability (ICC 0.70 - 0.75). No systematic differences occurred between the test occasions. This study supports the usefulness of the CLES + T scale as a reliable measure of the student nurses’ perception of the learning environment within the clinical placement at a hospital.
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| 21. |
- Hickisch, Annika, 1953-, et al.
(författare)
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Swedish Translation and Reliability of the Full Outline of Unresponsiveness Score
- 2016
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Ingår i: Journal of Neuroscience Nursing. - Philadelphia, USA : Lippincott Williams & Wilkins. - 0888-0395 .- 1945-2810. ; 48:4, s. 195-205
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is important for patient safety that the patient's level of consciousness is assessed and documented in a structured and reliable manner. The Full Outline of Unresponsiveness (FOUR) score measures the level of consciousness more comprehensively than the coma scales that are commonly used in Sweden. Therefore, there was a need to translate the FOUR score into Swedish and to evaluate its use in a Swedish healthcare context.Objectives: The aim of this study was to translate the FOUR score into Swedish and to evaluate the reliability of the Swedish version compared with the reliability of the Glasgow Coma Scale (GCS).Methods: The English version of the FOUR score was translated into Swedish and evaluated in terms of interrater reliability and internal consistency on fictitious patient cases with an advanced high-fidelity patient simulator. Two nurses rated 30 patient cases with the FOUR score and the GCS. Interrater reliability for items was determined by quadratic-weighted kappa and for the total score by intraclass correlation coefficient. Internal consistency was calculated with Cronbach's alpha.Results: The fourth version of the Swedish translation reached consensus in the expert panel. The back-translation was approved by the author of the original FOUR score. Interrater reliability of the Swedish version of the FOUR score was excellent; the weighted kappa was 0.94-1, and intraclass correlation coefficient = .99 (95% CI [0.97, 0.99]), and these were equal to the reliability of the GCS. Cronbach's alpha showed a high degree of internal consistency for the FOUR score (α = .92 for rater A and .91 for rater B), which was slightly higher than that for the GCS.Conclusions: The Swedish version of the FOUR score is equivalent to the original English version and has shown excellent reliability using fictitious patient cases with an advanced patient simulator.
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| 22. |
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| 23. |
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| 24. |
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| 25. |
- Holmefur, Marie, 1968-, et al.
(författare)
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Evaluation of the "Let's Get Organized" group intervention to improve time management : protocol for a multi-centre randomised controlled trial
- 2021
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Ingår i: Trials. - : BioMed Central. - 1745-6215. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Time management skills are essential for living in modern society. People with mental or neurodevelopmental disorders typically have cognitive limitations, including affected time management, which might lead to poor occupational balance, low self-efficacy, and poor parental sense of competence. "Let's Get Organized" (LGO) is a recently developed manual-based group intervention to train time management skills. The aim of this trial is to evaluate the efficiency of the Swedish version of LGO (LGO-S) compared to treatment as usual (individual occupational therapy) to improve time management for adults with impaired time management skills due to mental or neurodevelopmental disorders. Furthermore, to evaluate if the intervention is a cost-effective way to improve the quality of life and time management skills of these individuals, we will conduct a health economic evaluation.METHODS: The trial will have a multi-centre, open, parallel randomised controlled design. A total of 104 adults with cognitive limitations due to mental or neurodevelopmental disorders will be recruited from open psychiatric or habilitation care units. Outcomes will be measured before and after a 10-week intervention, with a follow-up 3 months after completing the intervention. The primary outcome will be self-assessed time management skills. Secondary outcomes will be e.g. self-assessed skills in organisation and planning, regulation of emotions, satisfaction with daily occupations, occupational balance, self-efficacy, and quality-adjusted life years.DISCUSSION: A recent feasibility study has shown promising results for LGO-S, and a randomised trial will provide robust evidence for the possible efficacy of LGO-S in comparison to treatment as usual.TRIAL REGISTRATION: ClinicalTrials.gov NCT03654248 . Registered on 20 August 2018.
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| 26. |
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| 27. |
- Holmefur, Marie, 1968-, et al.
(författare)
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Factors that predict and correlate with development of hand function in children with unilateral cerebral palsy
- 2012
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Ingår i: 9th COTEC Congress of Occupational Therapy.
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Konferensbidrag (refereegranskat)abstract
- Earlier studies of development of hand function showed large variation between individuals in course of development.Aim: To identify factors that predict or correlate with development of hand function in children with unilateral cerebral palsy (CP).Methods: Forty-five children with unilateral CP (inclusion age 18-64 months) were measured repeatedly with the Assisting Hand Assessment over on average 4,5 years. Data was collected on brain lesion (n=27), learning ability, sensibility in affected hand etc. A non-linear mixed models analysis was used.Results: Type, extent and location of brain lesion could predict development of hand function. Decreased learning ability was a predictor of slower development of hand function. Poor sensibility in the affected hand correlated with slower development and a lower ability level compared to children with good sensibility.Conclusion: Development of hand function can be predicted by brain lesion and is correlated to learning ability and sensibility in the affected hand.
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| 28. |
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| 29. |
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| 30. |
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| 31. |
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| 32. |
- Holmefur, Marie, 1968-, et al.
(författare)
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Let’s Get Organized : pilot study of an occupational therapy group intervention aimed to improve time management skills
- 2018
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Konferensbidrag (refereegranskat)abstract
- Introduction: Managing daily life activities requires time management and organizing skills. Individuals with cognitive disabilities commonly have poor ability to manage time, which often results in decreased ability to properly manage daily life activities. An intervention aimed to increase time management skills is "Let’s get organized" (LGO).Objective: The current pilot study was designed to explore the outcome of the LGO with regards to time management skills, executive functions and satisfaction with daily occupations among individuals with cognitive disabilities.Method: Persons with mental and neurodevelopmental disorder with decreased ability to manage time in daily life according to self-rated measures, were recruited by their local Occupational Therapist. All participants took part in LGO, which is a 10-week manual based group intervention with weekly meetings. Each session has a separate theme, with a common structure and goal to improve time management skills and to implement the use of a calendar in daily life. Measured outcomes were time management skills (Assessment of Time Management Skills), executive functioning (Weekly Calendar Planning Activity) and overall satisfaction with daily activities (Satisfaction with Daily Occupations).Results: In all 55 persons participated in the study. Preliminary results from a subgroup indicate significant improvements in time management skills, in aspects of executive functioning and in overall satisfaction with daily occupations.Conclusion: The LGO seems to be a promising intervention to improve time management skills and satisfaction with daily occupations in the short term. The used instruments appear to be sensitive to capture change from LGO.
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| 33. |
- Holmefur, Marie, 1968-, et al.
(författare)
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Longitudinal development of hand function in children with unilateral cerebral palsy
- 2009
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Ingår i: Developmental Medicine & Child Neurology. - West Sussex, UK : Wiley-Blackwell. - 0012-1622 .- 1469-8749. ; 51:s5
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Tidskriftsartikel (refereegranskat)abstract
- Background/Objectives: Studies of longitudinal development of hand function in children with unilateral cerebral palsy (CP) are sparse. For children with unilateral CP the ability to use the affected hand as an effective assist to the dominant hand in bimanual tasks may be the most important aspect of hand function in daily life. This ability can be assessed with the assisting hand assessment (AHA). The aim of this study was to describe how the usefulness of the hemiplegic hand develops in children with unilateral CP between 18 months and 8 years of age.Design: This was a study of prognosis with a prospective longitudinal cohort design. Participants and Setting: Forty-three children with unilateral cerebral palsy participated (22 male, 21 female). They were recruited at local rehabilitation centres and constituted a convenience sample. Inclusion age was 18 months–5 years 4 months (mean 2 years 8 months). Manual ability classification system (MACS) levels: I [n=7], II [n=25], III [n=11].Materials/Methods: The children were assessed with the AHA over a period of at least 3 years (mean 4.5 years), with 3–11 assessments per child. Children entered the study at different ages allowing evaluation of development from ages 18 months to 8 years. Estimated average motor development curves were fitted with a non-linear mixed effects model.Results: Individual differences in development were considerable. Children with a high AHA score at 18 months (over 40 raw scores) reached a significantly higher ability level and at a higher progression rate than the children with a low 18-month AHA score. The children with high 18-month AHA score reached 90% of their limit at average age 3 years whereas the children with a low 18-month AHA score reached 90% of their maximum level at a mean age of 7. Similarly, the maximum level of development differed between children in MACS level I–III. The rate of change was similar in levels I and II and significantly slower, in level III.Conclusions/Significance: This study shows that children with different ability levels all develop their way of using their hemiplegic hand during the preschool years. The AHA can be used to follow development over time and the AHA score at 18 months can be used for approximate prediction of development of assisting hand use.
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- Holmefur, Marie, 1968-, et al.
(författare)
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Measurement properties of the 13-item sense of coherence scale using Rasch analysis
- 2015
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Ingår i: Quality of Life Research. - : Springer Netherlands. - 0962-9343 .- 1573-2649. ; 24:6, s. 1455-1463
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The sense of coherence (SOC) scale is widely used and has an extensive history in research. The psychometric properties of the SOC scale have been investigated using classic test theory, but modern test theory enables a more multifaceted investigation of the properties of the SOC scale. The aim of this study was to explore the measurement properties of the SOC scale using the Rasch measurement model.Methods: SOC questionnaires from a sample of 623 healthy adults were analysed using Rasch analysis. Aspects analysed were rating scale functioning, item fit, unidimensionality, differential item functioning (DIF), targeting, and reliability.Results: Rating scale analysis showed that the seven scale steps were not utilized in the intended manner and that a shortening to five categories would be beneficial. Twelve out of the 13 items showed acceptable goodness-of-fit and 43 % of the variance was explained by the SOC dimension in the principal components analysis. There was no DIF between subgroups in the sample. The items were well targeted to the sample SOC level with no ceiling or floor effects. Item and person reliability were good and the person separation index was 2.05 indicating that the scale can separate three different levels of SOC, which corresponds well to its theoretical base.Conclusions: The SOC scale is generally well functioning; however, the three components of SOC seem to influence the PCA results. The scale would benefit from a reduction from seven to five scale steps, which would need to be investigated further.
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- Holmefur, Marie, 1968-, et al.
(författare)
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Neuroradiology can predict the development of hand function in children with unilateral cerebral palsy
- 2013
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Ingår i: Neurorehabilitation and Neural Repair. - : Sage Publications. - 1545-9683 .- 1552-6844. ; 27:1, s. 72-78
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Much variation is found in the development of hand function in children with unilateral cerebral palsy (CP).OBJECTIVE: To explore how anatomic brain abnormalities can be used to predict the development of hand function.METHODS: A total of 32 children with unilateral CP (16 boys and 16 girls) were evaluated at least once a year by the Assisting Hand Assessment (AHA). The data collection covered an age range from 18 months to 8 years (mean time in study, 4 years and 6 months). Computerized tomography or magnetic resonance imaging of the brain were assessed for patterns of brain damage, including the location of gray and extent of white-matter damage. The children were divided into groups according to lesion characteristics, and a series of univariate models were analyzed with a nonlinear mixed-effects model. The rate and maximum limit of development were calculated.RESULTS: The highest predictive power of better development of hand function was the absence of a concurrent lesion to the basal ganglia and thalamus, independent of the basic type of brain lesion. This model predicted both the rate of increasing ability and hand function at age 8 years. Hand function was also predicted by the basic pattern of damage and by the extent of white-matter damage. The presence of unilateral or bilateral damage had no predictive value.CONCLUSIONS: Neuroradiological findings can be used to make a crude prediction of the future development of the use of the affected hand in young children with unilateral CP.
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- Holmefur, Marie, 1968-, et al.
(författare)
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Pilot Study of Let's Get Organized : A Group Intervention for Improving Time Management
- 2019
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Ingår i: American Journal of Occupational Therapy. - : American Occupational Therapy Association, Inc.. - 0272-9490 .- 1943-7676. ; 73:5
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE: There is a need for evidence-based occupational therapy interventions to enhance time management in people with time management difficulties.OBJECTIVE: To pilot test the first part of the Let's Get Organized (LGO) occupational therapy intervention in a Swedish context by exploring enhancements of time management skills, aspects of executive functioning, and satisfaction with daily occupations in people with time management difficulties because of neurodevelopmental or mental disorders.DESIGN: One-group pretest-posttest design with 3-mo follow-up.SETTING: Outpatient psychiatric and habilitation settings.PARTICIPANTS: Fifty-five people with confirmed or suspected mental or neurodevelopmental disorder and self-reported difficulties with time management in daily life.INTERVENTION: Swedish version of Let's Get Organized (LGO-S) Part 1, with structured training in the use of cognitive assistive techniques and strategies using trial-and-error learning strategies in 10 weekly group sessions of 1.5 hr.OUTCOMES AND MEASURES: Time management, organization and planning, and emotional regulation were measured with the Swedish version of the Assessment of Time Management Skills (ATMS-S). Executive functioning was measured with the Swedish version of the Weekly Calendar Planning Activity, and satisfaction with daily occupations was assessed with the Satisfaction With Daily Occupations measure.RESULTS: Participants displayed significantly improved time management, organization and planning skills, and emotional regulation, as well as satisfaction with daily occupations. Aspects of executive functioning were partly improved. ATMS-S results were sustained at 3-mo follow-up.CONCLUSION AND RELEVANCE: LGO-S Part 1 is a promising intervention for improving time management skills and satisfaction with daily occupations and should be investigated further.WHAT THIS ARTICLE ADDS: This study shows that LGO-S Part 1 is feasible for use in psychiatric and habilitation outpatient services. The results are promising for improved time management skills, organization and planning skills, and satisfaction with daily occupations and need to be confirmed in further studies.
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| 39. |
- Holmefur, Marie, 1968-, et al.
(författare)
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Psychometric properties of a revised version of the Assisting Hand Assessment (Kids-AHA 5.0)
- 2016
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Ingår i: Developmental Medicine & Child Neurology. - : Wiley-Blackwell. - 0012-1622 .- 1469-8749. ; 58:6, s. 618-624
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to scrutinize the Assisting Hand Assessment (AHA) version 4.4 for possible improvements and to evaluate the psychometric properties regarding internal scale validity and aspects of reliability of a revised version of the AHA.Method: In collaboration with experts, scoring criteria were changed for four items, and one fully new item was constructed. Twenty-two original, one new, and four revised items were scored for 164 assessments of children with unilateral cerebral palsy aged 18 months to 12 years. Rasch measurement analysis was used to evaluate internal scale validity by exploring rating-scale functioning, item and person goodness-of-fit, and principal component analysis. Targeting and scale reliability were also evaluated.Results: After removal of misfitting items, a 20-item scale showed satisfactory goodnessof- fit. Unidimensionality was confirmed by principal component analysis. The rating scale functioned well for the 20 items, and the item difficulty was well suited to the ability level of the sample. The person reliability coefficient was 0.98, indicating high separation ability of the scale. A conversion table of AHA scores between the previous version (4.4) and the new version (5.0) was constructed.Interpretation: The new, 20-item version of the Kids-AHA (version 5.0), demonstrated excellent internal scale validity, suggesting improved responsiveness to changes and shortened scoring time. For comparison of scores from version 4.4 to 5.0, a transformation table is presented.
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| 47. |
- Holmefur, Marie, 1968-, et al.
(författare)
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The assisting hand assessment for children and youth with brachial plexus birth injury : a study of validity and item hierarchy of AHA-Plex
- 2023
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Ingår i: Journal of Rehabilitation Medicine. - : Foundation for Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 55
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Functional assessments that focus on activity performance and that produce valid outcome measures for people with brachial plexus birth injury are lacking. The primary aim of this study was to re-evaluate the internal scale validity of the Assisting Hand Assessment specifically for children and adolescents with brachial plexus birth injury. Two further aims were investigating whether the scale could be shortened for this group while maintaining psychometric quality, and exploring and presenting its item difficulty hierarchy.DESIGN: A cross-sectional psychometric study.SUBJECTS: A convenience sample of 105 children and adolescents (aged 18 months to 18 years, mean 6 years, 7 months, standard deviation (SD) 4 years, 4 months) from Sweden, Norway, and the Netherlands with brachial plexus birth injury.METHODS: Participants were assessed with the Assisting Hand Assessment. Data were analysed with Rasch measurement analysis. RESULTS: The 20 Assisting Hand Assessment items together measured a unidimensional construct with high reliability (0.97) and the 4-level rating scale functioned well. Item reduction resulted in 15 items with good item fit, unidimensionality, reliability and acceptable targeting.CONCLUSION: Assisting Hand Assessment for people with brachial plexus birth injury, called AHA-Plex, has 15 items and good internal scale validity. A unique item hierarchy for people with brachial plexus birth injury is presented.
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- Holmefur, Marie, 1968-, et al.
(författare)
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The influence of early CIMT training on longitudinal development of hand function in children with unilateral cerebral palsy
- 2013
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Ingår i: Developmental Medicine & Child Neurology. - West Sussex, UK : Wiley-Blackwell. - 0012-1622 .- 1469-8749. ; 55:s2, s. 18-18
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: There is evidence that Constraint-Induced Movement Therapy (CIMT) has a short-term positive effect on hand function in children with unilateral cerebral palsy (CP). Secondary analysis from previous study of development of hand function was performed with the aim to investigate whether one period of CIMT (at age 2–3y) influences the course of development or not.Participants and Methods: A convenience sample of 45 children with unilateral CP was included at mean age 32 months (CIMT-group, n=24, non-CIMT group n=21) and mean age at start of intervention was 28.2 months. The children were measured repeatedly, at least once a year with the Assisting Hand Assessment (AHA) for a mean period of 4 years and 6 months. A non-linear mixed effects model was used to create and compare development curves for the CIMT and non-CIMT groups.Results: Children who had CIMT had an upper limit of development that was 8,1 AHA-units higher than the children who had not have CIMT (p=0.028). Also when controlling for brain lesion characteristics there was a difference in limit of development in favour of the CIMTgroup, although not significant. Children with lower AHA-score at 18 months had seemed to gain more from CIMT than children with a higher AHA-score.Conclusion: This study shows that one period of CIMT at age 2–3 years in children with unilateral CP is associated with better development of hand function regardless of brain lesion characteristics. This is the first study describing long-term effects of CIMT.
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