| 1. |
- Alexander, MS, et al.
(författare)
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International spinal cord injury female sexual and reproductive function basic data set
- 2011
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 49:7, s. 787-90
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To create the International Spinal Cord Injury (SCI) Female Sexual and Reproductive Function Basic Data Set within the International SCI Data Sets. Setting: An international working group. Methods: The draft of the data set was developed by an international working group consisting of members appointed by the International Spinal Cord Society (ISCoS), the American Spinal Injury Association (ASIA), and a representative from the Executive Committee of the International SCI Standards and Data Sets. The data set was developed in an iterative process with review and comments by members of the Executive Committee of the International SCI Standards and Data Sets, ISCoS Scientific Committee, ASIA Board and the ISCoS Council, as well as all interested organizations and individuals. In addition, the data set was posted for 2 months at the ISCoS and ASIA websites for comments. ISCoS and ASIA approved the final version of the data set. To make the data set uniform, each variable and each response category within each variable have been specifically designed to promote the collection and reporting of comparable minimal data. Results: Variables included in the International SCI Female Sexual and Reproductive Function Basic Data Set are as follows: date of data collection, interest in discussing sexual issues, sexual issues unrelated to spinal cord lesion, sexual dysfunction related to spinal cord lesion, psychogenic genital arousal, reflex genital arousal, orgasmic function and menstruation. Complete instruction for data collection, data sheet and training cases are available at the websites of ISCoS (http://www.iscos.org.uk) and ASIA (http://www.asia-spinalinjury.org).
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| 2. |
- Alexander, MS, et al.
(författare)
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International Spinal Cord Injury Male Sexual Function Basic Data Set
- 2011
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Ingår i: Spinal Cord. - 1362-4393. ; 49:7, s. 795-8
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To create the International Spinal Cord Injury (SCI) Male Sexual Function Basic Data Set within the International SCI Data Sets. Setting: An international working group. Methods: The draft of the data set was developed by an international working group consisting of members appointed by the International Spinal Cord Society (ISCoS), the American Spinal Injury Association (ASIA) and a representative from the executive committee of the International SCI Standards and Data Sets. The data set was developed in an iterative process with review and comments by the members of the executive committee of the International SCI Standards and Data Sets, ISCoS scientific committee, ASIA Board and the ISCoS Council, as well as all the interested organizations and individuals. Next, the data set was posted for 2 months at the ISCoS and ASIA's websites for comments. ISCoS and ASIA approved the final version of the data set. To make the data set uniform, each variable and each response category within each variable have been specifically defined in a way that is designed to promote the collection and reporting of comparable minimal data. Results: Variables included in the International SCI Male Sexual Function Basic Data Set are as follows: date of data collection, interest in discussing sexual issues, sexual issues unrelated to spinal cord lesion, sexual dysfunction related to spinal cord lesion, psychogenic erection, reflex erection, ejaculation and orgasmic function. Complete instructions for data collection, data sheet and training cases are available at the website of ISCoS (http://www.iscos.org.uk) and ASIA (http://www.asia-spinalinjury.org).
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| 3. |
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| 4. |
- Bodin, Per, et al.
(författare)
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Breathing patterns during breathing exercises in persons with tetraplegia
- 2003
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Ingår i: Spinal Cord. ; 41:5
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Cross-sectional, observational, controlled study. OBJECTIVES: To survey breathing patterns during breathing at rest, ordinary deep breathing (DB), positive expiratory pressure (PEP) and inspiratory resistance-positive expiratory pressure (IR-PEP) among individuals with a cervical spinal cord lesion (SCL) compared with able-bodied controls. SETTING: Sahlgrenska University Hospital, Goteborg, Sweden. METHOD: Participants consisted of 20 persons with a complete SCL at the C5-C8 level (at least 1 year postinjury) and 20 matched, able-bodied controls. Breathing patterns and static lung volumes were measured using a body plethysmograph. RESULTS: Compared to the controls, breathing patterns at rest among the people with tetraplegia were characterised by a decreased tidal volume, stable respiratory rate and total cycle duration resulting in decreased mean inspiratory and expiratory flow, and alveolar ventilation. All volume and flow parameters increased except respiratory rate, which decreased during DB and PEP. During IR-PEP, tidal volume increased less compared to PEP, and combined with a decreased respiratory rate the alveolar ventilation was lower than during breathing at rest. The functional residual capacity increased during PEP and IR-PEP in people with tetraplegia. CONCLUSION: DB exercises with or without resistance during expiration or the whole breathing cycle affect the breathing pattern in persons with tetraplegia. DB was superior in increasing volumes and flow. PEP and IR-PEP increased FRC but IR-PEP decreased volumes and flows. However, large interindividual differences in the SCL group indicate the need for caution in generalising the results. SPONSORSHIP: This work was supported in part by grants from the Memorial Foundation of the Swedish Association of registered Physiotherapists and the Association of Cancer and Road Accident Victims.
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| 5. |
- Bodin, Per, et al.
(författare)
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Effects of abdominal binding on breathing patterns during breathing exercises in persons with tetraplegia
- 2005
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 43, s. 117-122
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Tidskriftsartikel (refereegranskat)abstract
- Study design: Cross-sectional, experimental. Objectives: To investigate and compare static lung volumes and breathing patterns in persons with a cervical spinal cord lesion during breathing at rest, ordinary deep breathing, positive expiratory pressure (PEP) and inspiratory resistance-positive expiratory pressure (IR-PEP) with and without an abdominal binder (AB). Setting: The outpatient clinic at the Spinal Unit at Sahlgrenska University Hospital, Göteborg, Sweden. Method: The study group consisted of 20 persons with complete cervical cord lesion at C5–C8 level. Breathing patterns and static lung volumes with and without an AB were measured using a body plethysmograph. Results: With an AB, static lung volumes decreased, vital capacity increased, breathing patterns changed only marginally and functional residual capacity remained unchanged during PEP and IR-PEP. Conclusion: Evidence supporting the general use of an AB to prevent respiratory complications by means of respiratory training is questionable. However, the interindividual variation in our results indicates that we cannot rule out that some patients may benefit from the treatment. Sponsorship: This work was supported by grants from the Memorial Foundation of the Swedish Association of registered Physiotherapists and the Association of Cancer and Road Accident Victims, Sweden.
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| 6. |
- Elfström, Magnus L., et al.
(författare)
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General and condition-specific measures of coping strategies in persons with spinal cord lesion.
- 2005
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Ingår i: Psychology, Health & Medicine. - : Informa UK Limited. - 1354-8506 .- 1465-3966. ; 10:3, s. 231-242
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Tidskriftsartikel (refereegranskat)abstract
- We examined psychometric properties and validity of a general (Ways of Coping Questionnaire; WCQ) and a condition-specific (Spinal Cord Lesion-related Coping Strategies Questionnaire; SCL CSQ) measure of coping strategies. The sample included 181 community-residing traumatically spinal cord lesioned persons aged 16-85 years. Multi-trait/multi-item analysis, confirmatory factor analysis and multiple regression were used. Reliability and validity estimates were acceptable in most instances for the SCL CSQ, whereas the validity of the WCQ was inadequate. The SCL CSQ showed a significant relationship with the overall quality of life outcome measure, whereas the WCQ did not. We recommend condition-specific measures of coping strategies, and that the combination with coping style measures be tested in medical populations.
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| 7. |
- Hammarén, Elisabet, et al.
(författare)
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Modified exercise test in screening for mitochondrial myopathies--adjustment of workload in relation to muscle strength.
- 2003
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Ingår i: European neurology. - : S. Karger AG. - 0014-3022 .- 1421-9913. ; 51:1, s. 38-41
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the usefulness of a modification of the bicycle ergometer test, the subanaerobic threshold exercise test (SATET), as a screening test for patients with mitochondrial myopathies. Since the original SATET is frequently found to be strenuous for weak patients, a new variable (relative muscle strength) was added to the workload formula. Plasma lactate levels were recorded at rest, then after 5 and 15 min of cycling on an ergometer, with constant workload. Nine patients with mitochondrial myopathy, 10 patients with other neuromuscular diseases and 9 healthy but sedentary volunteers undertook the test. An upper reference limit after exercise for plasma lactate was settled at 2.9 mmol/l. The modified SATET showed a sensitivity of 78% and a specificity compared to the healthy subjects of 100%. Compared to patients with other neuromuscular diseases, the specificity was lower (60%). All subjects completed the test without severe fatigue or pain.
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| 8. |
- Johansson, C, et al.
(författare)
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Validity and responsiveness of the spinal cord index of function: an instrument on activity level.
- 2009
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Ingår i: Spinal cord : the official journal of the International Medical Society of Paraplegia. - : Springer Science and Business Media LLC.
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Tidskriftsartikel (refereegranskat)abstract
- Objectives:To evaluate the validity and responsiveness of the Spinal Cord Index of Function (SIF), a new instrument on activity level, measuring the ability to perform various transfers in non-walking patients with a spinal cord lesion.Settings:Spinal Injuries Unit, Sahlgrenska University Hospital, Gothenburg, Sweden.Methods:Twenty-nine patients with a spinal cord lesion classified as grade A, B or C according to the American Spinal Injury Association/International Medical Society of paraplegia classification were included. Each patient was evaluated from the acute phase until discharge, every second week, by their physiotherapist, according to SIF and the Swedish physiotherapy clinical outcome variables (S-COVS). To determine validity, Spearman's rho correlation coefficient was calculated between the total scores of SIF and S-COVS, and the determination coefficient was calculated. Responsiveness was determined by computing effect sizes.Results:Spearman's correlation between SIF and S-COVS was 0.933 and the determination coefficient was 0.87. The effect size for SIF was 9.1.Conclusion:The results of the study prove that SIF is a valid and sensitive instrument, which will be useful for physiotherapists in goal-planning programs and in evaluating progress during a patient's rehabilitation. SIF could also be used in research and in evaluating the patient's functional ability at follow-ups.Spinal Cord advance online publication, 16 June 2009; doi:10.1038/sc.2009.57.
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| 9. |
- Kreuter, Margareta, 1947, et al.
(författare)
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Health and quality of life of persons with spinal cord lesion in Australia and Sweden
- 2005
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 43, s. 1123-1129
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Tidskriftsartikel (refereegranskat)abstract
- A cross sectional questionnaire study of 89 Australian and 71 Swedish spinal cord injured persons. The demonstrated health related quality of life profiles in spinal cord injured persons showed that valid measures can provide new information of clinical value beyond the self-evident physical and practical restrictions due to the injury. Illustrative comparisons between Australia and Sweden may extend our knowledge about areas where the spinal cord injured persons themselves are the logical experts, for example, maintenance of personal roles, social interaction and emotional well-being.
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| 10. |
- Kreuter, Margareta, 1947, et al.
(författare)
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Sexuality and sexual life in women with spinal cord injury: a controlled study.
- 2008
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Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977. ; 40:1, s. 61-9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe sexual life in women with spinal cord injury. DESIGN: Controlled cross-sectional, questionnaire. PARTICIPANTS AND METHODS: Women, 18-65 years, treated at spinal cord centres in Sweden, Denmark, Norway, Finland and Iceland. 545 women (57%) completed the questionnaires. The age-matched control group consisted of 507 women. The 104-item Spinal Cord Injury Women Questionnaire, was designed to assess different dimensions of sexuality. RESULTS: 80% of the women with spinal cord injury had engaged in sex after the injury. Reasons for not wanting or not having the courage to be intimate and sexual were physical problems, low sexual desire, low self-esteem and feelings of being unattractive. The motivations of both the women with spinal cord injury and controls to engage in sexual activity were intimacy-based rather than primarily sexual. Being in the right mood both before and during sex to become receptive to sexual stimulation was important. CONCLUSION: For women who are able to overcome the physical restrictions and mental obstacles due to injury, it is possible to regain an active and positive sexual life together with a partner. Sexual information and counselling should be available both during initial rehabilitation and later when the women have returned to their homes.
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| 11. |
- Kreuter, Margareta, 1947, et al.
(författare)
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Women's sexual functioning and sex life after spinal cord injury.
- 2011
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Ingår i: Spinal cord : the official journal of the International Medical Society of Paraplegia. - : Springer Science and Business Media LLC. - 1476-5624. ; 49, s. 154-160
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Tidskriftsartikel (refereegranskat)abstract
- Study design:Cross-sectional, mail-back questionnaire study.Objectives:To describe women's experiences of sexual functioning and sex life after spinal cord injury (SCI).Setting:Sweden, Denmark, Norway, Finland, and Iceland.Methods:All community-living SCI women treated at spinal cord centres in Sweden, Denmark, Norway, Finland, and Iceland meeting inclusion criteria (n=963) were mailed the study-specific SCI Women Questionnaire. Out of the 532 respondents, 392 reported having had sex after injury and were thus included in the study. The included women had a mean age of 42 years (range 18-68) and a mean time since injury of 11 years (range 2-54).Results:The SCI women reported that the injury caused many changes in their sex life and affected many aspects of their sexuality negatively. Some changes were of a physical nature (for example, decreased, lost, or changed sensation; difficulties to achieve orgasm; bladder or bowel problems; and difficulties to move and position oneself) whereas other changes were of a psychological nature (for example, feeling unattractive or less attractive, having less self-confidence, and difficulties to meet or find a partner).Conclusion:Successful SCI rehabilitation requires a holistic approach, taking into account the patient's physical, psychological, and interpersonal circumstances. Given that many women with SCI remain sexually active but often experience less satisfaction after injury, it is important that rehabilitation efforts address this aspect of the patient's life. Our results elucidating strategies applied by women with SCI to compensate for loss of genital sensation and cope with physiological impairment during sexual activity may serve to help professionals in developing rehabilitation programmes for women with SCI.Spinal Cord advance online publication, 11 May 2010; doi:10.1038/sc.2010.51.
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| 12. |
- Lansinger, Birgitta, 1948, et al.
(författare)
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Health-related quality of life in persons with long-term neck pain after treatment with qigong and exercise therapy respectively
- 2013
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Ingår i: European Journal of Physiotherapy. - : Informa UK Limited. - 2167-9169 .- 2167-9177. ; 15:3, s. 111-117
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Tidskriftsartikel (refereegranskat)abstract
- The aims of this study were to evaluate health-related quality of life (HRQoL) in individuals with long-term, non-specific neck pain before and after treatment with qigong versus exercise therapy and to compare their HRQoL with an age and sex-matched reference population. A total of 122 persons were randomly assigned to either qigong or exercise therapy. HRQoL was measured with the 36-item Short Form Health Survey (SF-36) and pain intensity was assessed with a visual analogue scale (VAS) before and immediately after treatment, and at 12-month follow-up. Both treatment groups improved on all subscales; however, no differences were observed between the treatment groups either before or after treatment. Those who experienced pain relief (at least 10 mm change on VAS; 53%) also significantly improved from baseline on all SF-36 subscales. Persons with chronic neck pain had significantly lower scores on all SF-36 subscales than normative reference values both before and after treatment. The results of this study indicate no differences between qigong and exercise therapy in HRQoL outcome; however, broad HRQoL improvements seem to be contingent on significant pain reduction. As pain reduction was achieved in roughly half of the study group, more work is needed to refine these therapies, to identify neck pain persons most likely to benefit from them and to develop other physiotherapy treatment strategies suitable to non-responders.
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| 13. |
- Larsson, Maria E H, 1969, et al.
(författare)
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Is patient responsibility for managing musculoskeletal disorders related to self-reported better outcome of physiotherapy treatment?
- 2010
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Ingår i: Physiotherapy theory and practice. - : Informa UK Limited. - 1532-5040 .- 0959-3985. ; 26:5, s. 308-17
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Tidskriftsartikel (refereegranskat)abstract
- Musculoskeletal disorders are prevalent and a major burden on individuals and society. Information on relationships of patient involvement and responsibility to outcome is limited. This study aimed to explore relationships between self-reported outcome of physiotherapy treatment and attitudes toward responsibility for musculoskeletal disorders. A cross-sectional postal survey design was used. Patients (n=615) from an outpatient physiotherapy clinic, who had finished their physiotherapy treatment within the last 6 months were sent a questionnaire that included the Attitudes regarding Responsibility for Musculoskeletal disorders instrument (ARM), self-reported outcome of treatment and sociodemographic data. A total of 279 (45%) completed forms were returned. Multiple logistic regression analysis was used. The patients' scores on the four dimensions of ARM ("responsibility self active," "responsibility out of my hands," "responsibility employer," and "responsibility medical professionals"), controlled for age, sex, education, and physical activity as well as for number of treatments, main treatment, and physiotherapist, were associated with the patients' self-reported treatment outcome. Patients who attributed responsibility more to themselves were more likely (OR 2.37 and over) to report considerable improvement as the outcome of physiotherapy treatment. Because this study was conducted at only one physiotherapy outpatient clinic and had a cross-sectional design, the results should be replicated in other settings. Because patients' attitudes regarding responsibility for musculoskeletal disorders can possibly affect the outcome of physiotherapy treatment, it might be useful to decide whether to systematically try to influence the person's attitude toward responsibility for the management of the disorder or to match treatment to attitude.
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| 14. |
- Lindberg, Jeanette, 1987, et al.
(författare)
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Family Members’ Perspectives on Patient Participation in Spinal Cord Injury Rehabilitation
- 2014
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Ingår i: International Journal of Physical Medicine & Rehabilitation. - 2329-9096. ; 2:5, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To examine the importance and experiences of patient participation in spinal cord injury (SCI) rehabilitation from the perspective of family members, and compared with patients’ views. Method: Family members (N=83) and discharged patients with SCI (N=141) completed the Patient Participation in Rehabilitation Questionnaire (PPRQ), assessing the importance and experiences of the domains Respect and integrity; Planning and decision-making; Information and knowledge; Motivation and encouragement; and Involvement of family. Importance ratings were compared between all family members and patients, and experience ratings were compared between patient-family dyads (N=74). Results: Both family members and patients rated all participation domains as very or extremely important (m ≥4.0 of max 5). Family members rated all domains as slightly more important than did patients; however, patients rated Planning and decision-making more important that the family members (Δ=0.20; p<0.01). No significant differences were found between patients and family members regarding experience ratings and agreement was substantial (ICC=0.63-0.80). Conclusions: Current guidelines recommend involvement of family members in SCI care and rehabilitation. This study shows that family members, and patients alike, also considered their involvement as very important and that they were often given opportunities to be involved. Moreover, patients and family members shared perceptions of conditions necessary for facilitating and promoting participation. Although considerable congruence was found between family members’ and patients’ assessments, agreement was not perfect. As incongruence between patients and family members regarding the quality and delivery of care may disturb the rehabilitation process and its outcomes, it is important that differences in perspectives be identified and successfully resolved. The PPRQ may be useful in assessing patients’ and family members’ views of patient participation and in detecting disparities between them.
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| 15. |
- Lindberg, Jeanette, 1987, et al.
(författare)
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Patient participation in care and rehabilitation from the perspective of patients with spinal cord injury
- 2013
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 51:11, s. 834-7
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Tidskriftsartikel (refereegranskat)abstract
- Study design:Qualitative method, semi-structured interviews.Objectives:The aim of the study was to explore the meaning of patient participation in care and rehabilitation from the perspective of patients with spinal cord injury (SCI).Setting:Post discharge community setting.Methods:Semi-structured interviews were performed with 10 persons with SCI representing different ages, gender and levels of injury. All interviews were conducted individually and lasted 40-120min. The interviews were verbally transcribed and the data were analyzed by means of content analysis.Results:All informants stressed the importance of patient participation as a necessary prerequisite for successful care and rehabilitation, but emphasized that participation must be tailored to each patient's own preferences, capacities and needs. They also underscored that the staff should be sensitive and responsive to the fact that desired levels and kinds of participation may vary from patient to patient, as well as for the same patient during the course of the rehabilitation. Five themes reflecting central aspects of participation emerged: respect and integrity, planning and decision-making, information and knowledge, motivation and encouragement, and involvement of family.Conclusions:Patient participation is a critical component of successful SCI rehabilitation and must be facilitated, promoted and tailored to each patient by the staff. Based on the finding from this study a questionnaire has been developed for assessing patient experiences of five domains of participation in rehabilitation to serve as a tool to help in evaluating provided care and in identifying patients' preferences for participation
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| 16. |
- Lindberg, Jeanette, 1987, et al.
(författare)
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Patient Participation in Rehabilitation Questionnaire (PPRQ)-development and psychometric evaluation
- 2013
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 51:11, s. 838-42
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Tidskriftsartikel (refereegranskat)abstract
- Study design:A cross-sectional postal questionnaire study.Objectives:The aim of the study was to evaluate selected psychometric properties of a draft version of the Patient Participation in Rehabilitation Questionnaire (PPRQ) measuring patients' experiences of participation in care and rehabilitation.Setting:Sweden.Methods:On the basis of previous qualitative analyses of patient interview data, a 32-item questionnaire covering five domains of participation was developed and sent to 268 persons with spinal cord injury, aged 18-80 years and injured 1-12 years previously. In total, 141 (51%) evaluable questionnaires were returned. Multi-trait analysis was used to assess scaling assumptions by testing item convergent and discriminant validity and internal consistency reliability (Cronbach's α) associated with the hypothesized item-scale structure of the questionnaire.Result:Nine items failed to meet scaling assumptions and were omitted. Scaling assumptions were thereafter substantiated for the scales: 'respect and integrity' (6 items); 'planning and decision-making' (4 items); 'information and knowledge' (4 items); 'motivation and encouragement' (5 items); and 'involvement of family' (4 items). Item-scale correlations ranged from 0.67 to 0.85 and most items correlated higher or significantly higher with their hypothesized scale than with other scales. Cronbach's α was 0.89 for all scales.Conclusion:The PPRQ appears to adequately assess central aspects of participation in care and rehabilitation from the perspective of patients with spinal cord injury. Further studies using larger samples will be undertaken to confirm the scale structure as well as the sensitivity and responsiveness of the questionnaire.
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| 17. |
- Lundgren Elfström, Magnus, 1971, et al.
(författare)
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Effects of coping on psychological outcome when controlling for background variables: a study of traumatically spinal cord lesioned persons.
- 2002
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Ingår i: Spinal cord : the official journal of the International Medical Society of Paraplegia. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 40:8, s. 408-15
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Cross-sectional. OBJECTIVES: In a previous study we found spinal cord lesion (SCL)-related coping factors to be distinctly related to levels of SCL-related psychological outcome. However, we did not control for other potentially confounding variables. In this study we investigated effects of coping strategies on psychological outcome reactions in traumatically spinal cord lesioned persons controlling for sociodemographic, disability-related and social support variables. SETTING: The Gothenburg Spinal Injuries Unit in Sweden. METHODS: The study sample comprised 255 persons and a subsample of 157 persons. A series of stepwise multiple regression analyses were performed. RESULTS: SCL-related coping factors clearly predicted psychological outcome even when background variables were controlled. Higher levels of acceptance coping predicted decreased psychological distress and increased positive morale. Elevated social reliance coping predicted heightened distress. Higher levels of social support predicted lower feelings of helplessness. Sociodemographic and disability-related variables were weak predictors of psychological outcome with one exception: higher education predicted less bitterness and brooding. CONCLUSION: SCL-related coping remained the most important predictor of psychological outcome even when a wide range of variables was controlled. Thus we conclude that psychosocial interventions aimed at helping individuals develop their coping strategies might be of substantial value in their adjustment to SCL.
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| 18. |
- Lundgren Elfström, Magnus, 1971, et al.
(författare)
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Linkages between coping and psychological outcome in the spinal cord lesioned: development of SCL-related measures.
- 2002
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Ingår i: Spinal cord : the official journal of the International Medical Society of Paraplegia. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 40:1, s. 23-9
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Cross-sectional. OBJECTIVES: To investigate relationships between coping and mental well-being with clinical relevance to spinal cord lesion (SCL). SETTING: The Gothenburg Spinal Injuries Unit in Sweden. METHODS: The study sample comprised 274 persons. From in-depth interviews, literature reviews, and the transactional theory of stress and coping, items reflecting coping and psychological outcome, respectively were generated. Principal components factor analysis, multi-trait analysis, and structural equation modelling were used. RESULTS: The coping scale comprised three factors: Acceptance (i.e. revaluation of life values); Fighting spirit (i.e. efforts to behave independently); Social reliance (i.e. a tendency towards dependent behaviour). The outcome scale included the factors: Helplessness (i.e. feeling perplexed, out of control and low self-esteem); Intrusion (i.e. bitterness and brooding); Personal growth (i.e. positive outcomes of life crisis). Acceptance showed a positive relation to Personal growth and was inversely related to both Helplessness and Intrusion. Fighting spirit had a weak negative association to Helplessness and a weak positive association to Personal growth. Social reliance was positively related to Helplessness and Intrusion. Only Social reliance showed any association to neurological status. Those lesioned 1-4 years reported more Helplessness, Intrusion, Social reliance, and less Acceptance than those lesioned >or=5 years. CONCLUSION: Coping is related to psychological outcome in SCL. Our situational coping measure may be a candidate to assess intervention effects.
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| 19. |
- Lundgren Elfström, Magnus, 1971, et al.
(författare)
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Relations between coping strategies and health-related quality of life in patients with spinal cord lesion.
- 2005
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Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 37:1, s. 9-16
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Although the use of appropriate coping strategies has been suggested to be a key factor in determining successful adjustment to severe physical illness/disability, little systematic support for this link has been found. We investigated relationships between spinal cord lesion-related coping strategies and health-related quality of life when studying for sociodemographic, disability-related and social support variables. DESIGN AND SUBJECTS: We studied 256 persons with traumatically acquired spinal cord lesion (=1 year) from a typical rural/urban Swedish area in a cross-sectional design. METHODS: Coping measure was the Spinal Cord Lesion-related Coping Strategies Questionnaire. Outcome measures were the Spinal Cord Injury Quality of Life Questionnaire, the Short-Form 36 Health Survey version 2.0, and a standardized global question of overall quality of life. Multiple regressions were performed. RESULTS: Coping strategies were clear correlates of health-related quality of life when sociodemographic, disability-related and social support variables were studied. The relationship between coping strategies and quality of life was: the more revaluation of life values (Acceptance) and the fewer tendencies towards dependent behaviour (Social reliance) the better the health-related quality of life. CONCLUSION: Our results suggest that greater focus needs to be directed to coping strategies and to ways of facilitating adaptive outcomes in rehabilitation.
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| 20. |
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| 21. |
- Lundgren Elfström, Magnus, 1971, et al.
(författare)
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Relationships between locus of control, coping strategies and emotional well-being in persons with spinal cord lesion
- 2006
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Ingår i: J Clin Psychol Med Settings. - : Springer Science and Business Media LLC. - 1068-9583 .- 1573-3572. ; 13:1, s. 93-104
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Tidskriftsartikel (refereegranskat)abstract
- Relations between locus of control, coping strategies and emotional well-being in persons with traumatically acquired spinal cord lesion were examined. The sample included 132 community-residing adults. Structural equation modelling, including confirmatory factor analysis, was used. A model was hypothesized based on the transactional theory of stress and coping where coping strategies mediated the relation between locus of control and emotional well-being. The model showed acceptable fit to the data and was compared with five alternative models. The alternative models fitted the data less well or were difficult to interpret. In the preferred model, persons indicating internal control reported more coping strategies (Acceptance, Fighting spirit) related to increased well-being, whereas persons indicating external control reported a coping strategy (Social reliance) related to poorer well-being. The findings support the stress and coping framework in medical rehabilitation and illustrate why some persons need coping effectiveness training to enhance emotional adjustment.
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| 22. |
- Melin, Jeanette, et al.
(författare)
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Patient participation from the perspective of staff members working in spinal cord injury rehabilitation
- 2018
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 56:6, s. 614-620
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Tidskriftsartikel (refereegranskat)abstract
- Study design Qualitative method, semi-structured interviews. Objectives The aims of this study were to explore the meaning of patient participation from the perspective of staff members working with spinal cord injury (SCI) rehabilitation, and what they saw as requisites for and constraints to patient participation. Methods Interviews with 13 staff members at a spinal unit were conducted individually and analyzed by means of content analysis. Results One category describing patient participation emerged from the interviews: Patient - a team member. Four categories were extracted as requisites: Communication; information and knowledge; routines; respecting the patient as a unique person; and an open climate. Three categories of constraints were identified: Understaffing and new staff members; patients' inability to grasp information; and structures and fragmented responsibilities. Conclusions The informants were unanimous in stating that the patient is an integral and natural member of the rehabilitation team. Recognizing the person with SCI as a team member acknowledges and endorses the patient as a person with capabilities to participate in his or her rehabilitation. The patient as a person also means that he or she has unique needs and preferences, which the staff members must accommodate. This is also fundamental in a person-centered approach. Therefore, the viewpoints of the informants may be useful for other settings to enhance person centeredness and patient participation.
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| 23. |
- Rosen, Eva, et al.
(författare)
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Fear of falling, balance, and gait velocity in patients with stroke
- 2005
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Ingår i: Physiother Theory Pract. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 21:2, s. 113-20
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Tidskriftsartikel (refereegranskat)abstract
- After a stroke balance can be impaired, that may influence the physical activities which can be undertaken. A person's confidence in performing activities without falling could be as important as the real balance ability in situations of daily living. The aims of the study were to evaluate the relationship between perceived self-confidence in task performance without falling, using the Falls Efficacy Scale, Swedish version, (FES(S)) and observer-assessed balance, measured by the BDL Balance Scale (BDL BS) and also between the FES(S) and gait velocity. Thirty-one subjects with stroke, 32-62 years of age, time since onset between 3 and 104 months, participated The FES(S) was significantly correlated with the BDL BS (r = 0.49, p = 0.008). Furthermore there were significant correlations between the FES(S) and self-selected (r = 0.53, p = 0.003) as well as for maximum (r = 0.55, p = 0.002) gait velocity. The results indicate that the use of the FES(S) can be recommended in subjects with stroke and balance deficit in order to map out the dimension of self-confidence in balance problems. However, in more highly functioning subjects with stroke other fall-efficacy assessments with major demands on balance performance may be preferable due to partly ceiling effect in the study population.
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| 24. |
- Sand, Åsa, et al.
(författare)
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Spinal cord injured persons' conceptions of hospital care, rehabilitation, and a new life situation.
- 2006
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Ingår i: Scandinavian journal of occupational therapy. - 1103-8128. ; 13:3, s. 183-92
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The basic aim of spinal cord injury (SCI) rehabilitation is to help patients return to a life worth living. It is therefore important that the staff at spinal units and rehabilitation centres understand how the patients experience their rehabilitation and their adjustment process to the new situation. AIM: To describe SCI persons' experiences of their rehabilitation process. METHOD: Nineteen SCI persons were interviewed. Data from the tape-recorded interviews were analysed according to a modified descriptive version of the phenomenographic analysis process. RESULTS: Six categories that describe the informants' conceptions of their rehabilitation process emerged: access to information, participation in planning rehabilitation, emotional support, feelings of vulnerability, adjustment to a new life situation, and emotional consequences of the injury. CONCLUSION: Straightforward information, participation in the planning of the rehabilitation programme and emotional support were important factors influencing the rehabilitation process after the SCI. Professionals working with SCI rehabilitation should make use of patients' experiences in order to develop better rehabilitation programmes that focus on the individual needs of the patient. People are individuals and failure to take this into account can impact negatively on quality of life and the effectiveness of the rehabilitation.
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| 25. |
- Siösteen, Agneta, 1942, et al.
(författare)
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Patient-staff agreement in the perception of spinal cord lesioned patient´s problems, emotional well-being and coping pattern
- 2005
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Ingår i: Spinal Cord. ; 43, s. 179-186
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Tidskriftsartikel (refereegranskat)abstract
- A matched patient/staff study. 29 persons with spinal cord injury and 24 staff participated. Relatively high agreement between patients and staff concerning patients´problems and states is possible to obtain in a caring setting. This may be more related to the quality of caring in the studied unit than to the study methodology used. Small units with high staff density and a long stay and/or prolonged contact with the patients probably facilitate communication with and knowledge about the patients. Interventions aimed at increasing staff awareness of patients´coping efforts may further improve staff ability to understand and support patients in their adaptation process.
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| 26. |
- Ström, Helena, 1985, et al.
(författare)
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Quality of Life in Parents/Caretakers of Children with Cerebral Palsy in Kampong Cham, Cambodia.
- 2012
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Ingår i: Journal of tropical pediatrics. - : Oxford University Press (OUP). - 1465-3664 .- 0142-6338. ; 58:4, s. 303-306
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to investigate QOL in parents/caretakers of children with cerebral palsy in the province of Kampong Cham, Cambodia. Forty parents/caretakers of children with cerebral palsy aged 1-13 years (F19/M21) participated in this study. The study was carried out using the Comprehensive Quality of life Scale A5 (ComQOL-A5) questionnaire. Results point out three major domains where quality of life is unsatisfactory: health, material well-being and emotional well-being. Of these areas, QOL in the health domain demonstrates the lowest scores. Results support a further commitment in providing comprehensive rehabilitation for parents and their children with CP in Kampong Cham. This study identifies the need for further research on QOL in parents/caretakers of children with CP in Cambodia and the need for development of valid and reliable QOL instruments targeting the developing world.
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| 27. |
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| 28. |
- Zidén, Lena, 1954, et al.
(författare)
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Home rehabilitation after hip fracture. A randomized controlled study on balance confidence, physical function and everyday activities.
- 2008
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Ingår i: Clinical rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 22:12, s. 1019-33
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate whether home rehabilitation can improve balance confidence, physical function and daily activity level compared to conventional care in the early phase after hip fracture. DESIGN: A randomized controlled study. SETTING: Geriatric rehabilitation clinic. SUBJECTS: One hundred and two community-dwelling elderly people. INTERVENTIONS: A geriatric, multiprofessional home rehabilitation programme focused on supported discharge, independence in daily activities, and enhancing physical activity and confidence in performing daily activities was compared with conventional care in which no structured rehabilitation after discharge was included. MAIN MEASURES: Falls efficacy, degree of dependency and frequency in daily activities, habitual physical activity and basic functional performance. RESULTS: When comparing status one month after discharge with baseline, the home rehabilitation group showed a higher degree of recovery in self-care (P<0.0001), mobility (P = 0.002), locomotion (P = 0.0036) and domestic activities (P = 0.0098), as well as larger increase in balance confidence on stairs (P = 0.0018) and instrumental activities (mean increase home rehabilitation 19.7 and conventional care 7.1, P<0.0001) compared with the conventional care group. At one month, a majority of the home rehabilitation participants (88%) took outdoor walks, compared with less than half (46%) of the conventional care group (P<0.001) and were also more independent in outdoor activities (P = 0.0014). CONCLUSIONS: This study indicates that home rehabilitation, focused on supported discharge and enhancing self-efficacy, improves balance confidence, independence and physical activity in community-dwelling older adults in the early phase after hip fracture.
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| 29. |
- Zidén, Lena, 1954, et al.
(författare)
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Long-term effects of home rehabilitation after hip fracture - 1-year follow-up of functioning, balance confidence, and health-related quality of life in elderly people.
- 2009
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Ingår i: Disability and rehabilitation. - : Informa UK Limited. - 0963-8288. ; 32:1, s. 18-32
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. To investigate the long-term effects of home rehabilitation (HR) after hip fracture in elderly people. Method. A randomized, controlled longitudinal study on geriatric hospital-based HR was compared with conventional care (CC) in 102 patients. Independence in activities of daily living (ADL), frequency of activity, basic physical performance, balance confidence, health-related quality of life, mood and perceived recovery were measured 6 and 12 months after discharge. Results. One year post-discharge the HR participants reported significantly higher degree of independence in self-care and locomotion, as well as of balance confidence in stairs and instrumental activities and perceived physical function, than the CC group. One year after discharge 14 persons (29%) in the HR group and five persons (9%) in the CC group considered themselves fully recovered. Conclusions. The positive long-term effects were more pronounced among the participants in the HR group than among those who received CC, possibly due to the early start of the HR programme in hospital and its focus on self-efficacy and training of daily activities. However, one year after discharge a mojority of participants in both groups did not consider themselves to be fully recovered when they compared to their situation before the fracture.
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