| 1. |
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| 2. |
- Árnadóttir, Guðrún, et al.
(författare)
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Difference in impact of neurobehavioural dysfunction on Activities of Daily Living performance between right and left hemispheric stroke
- 2010
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Ingår i: Journal of Rehabilitation Medicine. - : Foundation of Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 42:10, s. 903-907
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore whether persons with right- and left-sided cerebrovascular accidents differ significantly in mean impact of neurobehavioural impairments on ability to perform activities of daily living. Design and subjects: Retrospective study of data from 215 persons (103 right-sided, 112 left-sided cerebrovascular accident). The Activities of daily living-focused Occupation-based Neurobehavioral Evaluation was used to evaluate ability on an activities of daily living scale and the impact of neurobehavioural impairment on ability on another scale. Methods: To control for possible differences in activities of daily living ability between groups, analysis of covariance, with activities of daily living ability as a covariate, was used to test for a significant difference in impact of neurobehavioural impairments on activities of daily living ability between groups. Results: Expected moderate correlation (r=-0.57) was obtained between activities of daily living ability and neurobehavioural impact measures, and there was no difference in mean neurobehavioural impact measures between groups (F [1, 212] = 2.910,p = 0.090). Conclusion: This study is the first: to explore directly the impact of neurobehavioural impairment on activities of daily living ability. While persons with right-sided and left-sided cerebrovascular accidents may differ in type of neurobehavioural impairments, direct evaluation of the impact of such impairments on activities of daily living ability reveals no difference between groups.
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| 3. |
- Arnadottir, Gudrun, 1955-, et al.
(författare)
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Dimensionality of nonmotor neurobehavioral impairments when observed in the natural contexts of ADL task performance
- 2009
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Ingår i: Neurorehabilitation and neural repair. - : SAGE Publications. - 1545-9683 .- 1552-6844. ; 23:6, s. 579-586
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To examine diverse nonmotor neurobehavioral impairments (NBIs) that impact activities of daily living (ADL) task performance and to verify if such impairments can be viewed as one dimension when evaluated in an ecologically-relevant context. Methods. Rasch analysis was performed on data from 206 individuals diagnosed with dementia or cerebral vascular accident (CVA) who had been scored on 50 standardized NBIs from the A-ONE Neurobehavioral Impairment scale, based on naturalistic observation of ADL task performance. Evaluation of mean square (MnSq) infit and outfit values and principal components analysis (PCA) of residuals were used to evaluate unidimensionality of the items. Two evaluations were implemented: (1) to evaluate if there is a single global dimension common for persons with either dementia or CVA, and (2) to evaluate if the 50 NBIs are unidimensional, but comprised of different diagnosis-specific global hierarchies (dementia, left CVA, and right CVA). Results. The PCA indicated that 56.8% of variance was explained by the global measure (Rasch factor) of NBIs, with 4.9% of the unexplained variance explained by the first contrast. Four items showed outfit misfit to the common hierarchy. Developing diagnosis-specific global hierarchies resulted in improved PCA results for all 3 diagnostic groups (Rasch factor = 79.2% to 85.5%; unexplained variance in first contrast = 1.7% to 3.4%) after removal of 2 to 3 misfitting items. Conclusions. Nonmotor NBIs, when evaluated based on naturalistic performance of ADL, can be considered unidimensional, but the hierarchical structure of the dimension likely varies across diagnostic groups. Further study is needed with larger samples to verify these results.
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| 4. |
- Árnadóttir, Guðrún, 1955-
(författare)
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Measuring the impact of body functions on occupational performance : validation of the ADL-focused occupation-based neurobehavioral evaluation (A-ONE)
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Among the instruments commonly used by occupational therapists working in the area of rehabilitation of persons with neurological disorders are evaluations of both occupation, such as activities of daily living (ADL), and body functions. While persons with neurological diagnoses typically have symptoms that represent diminished neurobehavioral functions, the resulting pattern of neurobehavioral impairments affecting ADL performance often differs among diagnostic groups. Usually, neurobehavioral impairments are evaluated in a context that is separate from and not natural for ADL task performance. The A-ONE is a unique instrument that can be used to evaluate both ADL performance (ADL scale) and, in the natural context of the ADL task performance, the underlying neurobehaviors that cause diminished ADL task performance among persons with neurological disorders (Neurobehavioral scale). The scales of the instrument are of ordinal type, and in their existing form, do not have measurement properties. Measurement properties are a requirement of evidence-based and quality assured rehabilitation services.The overall aim of this doctoral study was to further develop and validate the A-ONE. This included (a) internal validation to explore the potential for converting the ordinal scales of the instrument to interval scales, (b) examination of which of the neurobehavioral items would be most beneficial and clinically useful for constructing a new Neurobehavioral Impact (NBI) scale for evaluating persons with different neurological diagnoses, and (c) exploration of whether persons with right and left cerebrovascular accidents (RCVA, LCVA) differ in mean NBI measures. Methods: This thesis is comprised of four studies which all contribute in different ways to the validation of the scales of the A-ONE. In the first three studies, Rasch analyses, a widely accepted modern test theory methodology, was used to examine internal validity of the scales and the reliability of the A-ONE measures. In the fourth study, ANCOVA was used to explore between group differences, and Pearson correlation coefficients were used to explore relations between person measures from the different A-ONE scales.Results: The first study of 209 persons diagnosed with CVA and dementia provided support for converting the ordinal ADL scale to an interval scale that has potential to be used to measure change in ADL performance over time. The second and third studies, including 206 and 422 persons respectively, indicated that it is possible to construct several unidimensional versions of a new NBI scale from the neurobehavioral items of the instrument, each with different item content and hierarchical item structure. Further, some of these NBI scales could be used across different diagnostic groups. When exploring differences between 215 persons with RCVA and LCVA on the NBI scale developed for CVA, results of the ANCOVA (with ADL ability as a covariate) indicated that there is no significant difference between groups in their mean NBI measures, despite known differences in patterns of neurobehavioral impairments.Conclusions: The results of this thesis indicate that the A-ONE, although developed by traditional psychometric methods for the purpose of providing useful information for intervention planning, now also has the potential to be used to measure change and compare diagnostic groups. This additional feature will likely enhance both clinical and research potential of the instrument. In order to make the results of the study accessible for clinicians, conversion tables need to be developed.
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| 5. |
- Arnadottir, Gudrun, et al.
(författare)
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Neurobehavioral functions evaluated in naturalistic contexts : Rasch analysis of the A-ONE Neurobehavioral Impact Scale
- 2012
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Ingår i: Scandinavian Journal of Occupational Therapy. - London : Informa Healthcare. - 1103-8128 .- 1651-2014. ; 19:5, s. 439-449
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The fact that different neurobehavioral impairments affect daily life task performance of clients with different neurological diagnoses currently restricts between-group comparisons in rehabilitation. The purpose of this study was to determine whether a single neurobehavioral impact scale could be constructed for use with different diagnostic groups. Methods and results. Rasch analysis of 422 clients (diagnosed with CVA and dementia) demonstrated that 29 of 55 items from the A-ONE Neurobehavioral Scale could be used to construct a short-form, Common Scale. Conclusions: While the use of different and longer diagnostic-specific scales versions may be more useful clinically, the short-form, Common Scale has the potential to be used in research focusing on comparison of groups. Further research will be needed to validate the common, short version.
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| 6. |
- Elinge, Eva, et al.
(författare)
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A group learning programme for old people with hip fracture : a randomized study
- 2003
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 10:1, s. 27-33
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine whether a group learning programme would influence the participants' perceived activity performance and ability to participate in social life after a hip fracture. The study comprised 35 people aged 54-90 years with hip fracture who had completed ordinary care and rehabilitation after their hip fractures. They were randomized to an intervention group (n=21) or to a control group (n=14). The intervention group participated in the group learning programme, while the control group received no intervention. Directly after the intervention and at 12 months after the intervention, no significant change was seen in either group, regarding the ability to perform ADL activities measured by the Barthel ADL index, or the performance of activities that were identified as important to the individual. However, in the intervention group, the number of ADL items perceived to be performed with difficulties decreased, and the perceived ability to participate in social life increased. These changes were not found in the control group. When analysed between groups, however, the only significant difference was the ability to participate in social life after the intervention. Further research is needed to investigate whether an intensive or prolonged period of rehabilitation, at the hospital or in the patient's home, would increase the ability to resume meaningful participation in social life
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| 7. |
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| 8. |
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| 9. |
- Löfgren, Britta, et al.
(författare)
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Cross-validation of a model predicting discharge home after stroke rehabilitation : validating stroke discharge predictors
- 2000
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Ingår i: Cerebrovascular Diseases. - : S. Karger AG. - 1015-9770 .- 1421-9786. ; 10:2, s. 118-125
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Tidskriftsartikel (refereegranskat)abstract
- A new sample of 116 stroke patients was collected in order to validate a logistic regression model, predicting the chances of severely affected stroke patients being discharged home to independent living. The model was found to be accurate in the new sample, especially for those patients who had a high estimated probability of being discharged home. When the dividing line for the predicted probability for discharge home was set at a value of >/=0.5, the positive and negative predictive values were 74 and 73%, respectively. Further modelling resulted in a new extended model including the variables postural stability on admission, cohabiting, age and perceptual impairment on admission that formed the basis for an index predicting discharge home. This index was then validated in the sample of 93 patients that the first developed model was derived from and showed positive and negative predictive values of 85 and 77%, respectively
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| 10. |
- Löfgren, Britta, et al.
(författare)
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In-patient rehabilitation after stroke : outcome and factors associated with improvement
- 1998
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 20:2, s. 55-61
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Tidskriftsartikel (refereegranskat)abstract
- A study aimed at examining the outcome of activities of daily living (ADL) of patients undergoing geriatric stroke rehabilitation was performed. Background and admission data of 99 patients surviving the acute phase and needing further hospital rehabilitation were registered. Forty per cent of the patients improved their ADL ability. The logistic regression modelling with the dichotomous dependent variable improvement versus no improvement showed the following factors associated with improvement: a diagnosis of intracerebral haemorrhage, male sex, high postural stability score at the admission and cohabitation. In conclusion, the most severely affected stroke patients, especially patients with intracerebral haemorrhage, have a great potential for improving their ADL. The results of the logistic regression model can serve as a useful guide when it comes to identifying patients that stand a fair chance of improving during their rehabilitation stay. Equally important, patients with a poor rehabilitation prognosis who may need intensified rehabilitation efforts to achieve optimum improvement can now be identified.
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| 11. |
- Löfgren, Britta, et al.
(författare)
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Psychological well-being 3 years after severe stroke
- 1999
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Ingår i: Stroke. - 0039-2499 .- 1524-4628. ; 30:3, s. 567-572
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Stroke often has a very negative influence on the victims' perception of their life situation. The aim of this study was therefore to assess the subjects' long-term psychological well-being and to explore associations between subject characteristics, impairments, disabilities, and psychological well-being. METHODS: Of 100 subjects rehabilitated at a specialized geriatric stroke ward after the acute phase, 47 survivors were assessed in their homes 3 years after discharge and interviewed regarding their psychological well-being with the Philadelphia Geriatric Center Morale Scale (PGCMS). RESULTS: Sixty-four percent of the subjects were classified as having high scores for psychological well-being or fell within the middle range. In a cluster analysis, depression was shown to have the strongest association with the subjects' PGCMS scores. Variables including the subjects' social situation and functions as well as age, gender, ability to communicate, and need for help showed a much weaker association with the PGCMS. CONCLUSIONS: More than half of the stroke subjects were classified as having levels of psychological well-being that were good or fairly good. The strong association between PGCMS scores and depression indicates the importance of detecting and treating depression and of following up initiated therapy after stroke.
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| 12. |
- Löfgren, Britta, et al.
(författare)
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Rehabilitation of stroke patients who are older and severely affected: short- and long-term perspectives
- 2000
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Ingår i: Topics in Stroke Rehabilitation. - 1074-9357 .- 1945-5119. ; 6:4, s. 20-29
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Tidskriftsartikel (refereegranskat)abstract
- This review has focused on older and severely affected patients. The following aspects have been studied: the suffering of a stroke, experiences of stroke units, rehabilitation, long-term perspective, and psychological well-being. The conclusion is that older and severely affected patients can make substantial progress during rehabilitation. Most patients can maintain or even improve this progress in the long-term perspective. The review shows that many can stay in independent living with support from home help services and relatives, home adjustments, and assistive devices. In long-term follow-ups, some indications show that stroke patients assess their psychological well-being as good, or fairly good, but detection and treatment of depression are essential
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| 13. |
- Löfgren, Britta, et al.
(författare)
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Three years after in-patient stroke rehabilitation : A follow-up study
- 1999
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Ingår i: Cerebrovascular Diseases. - : S. Karger AG. - 1015-9770 .- 1421-9786. ; 9:3, s. 163-170
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Tidskriftsartikel (refereegranskat)abstract
- A 3-year follow-up study was performed aimed at describing the outcome for severely affected stroke survivors who had undergone geriatric in-patient rehabilitation. Living conditions, psychological well-being, and changes in functions were assessed in 55 survivors. Twenty-five people were living in the community, 15 in apartment hotels or homes for the aged and 15 in nursing homes. From discharge to follow-up 11 people had had to move to an accommodation offering more support. Living alone, recurrent strokes and functional decline were associated with moving. Many of those living in the community were supported by relatives or home help services. Home adjustments and assistive devices were common and in most cases were aimed at facilitating transfers and bathroom activities. Motor function had deteriorated from discharge to follow-up, otherwise no statistically significant changes were seen in the survivors' abilities and functions. Most survivors had in fact been able to maintain their functions or to make further improvements. Also, their psychological well-being seemed quite good. These results should encourage rehabilitation efforts for elderly people severely affected by stroke
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| 14. |
- Löfgren, Linus, et al.
(författare)
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Low-power humidity sensor
- 2008
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Ingår i: Proceedings of Eurosensors. ; , s. 231-234
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Konferensbidrag (refereegranskat)
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| 15. |
- Löfgren, Linus, et al.
(författare)
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Low-power humidity sensor for RFID applications
- 2008
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Ingår i: 4M2008 Conference, Cardiff, UK.
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Konferensbidrag (refereegranskat)abstract
- Wireless sensors incorporated in RFID systems are important in several industrial, consumer and logisticsapplications. By extending RFID tags to sensing applications, the products become smarter. Application areas forthese smart tags include; health care (verification of the environmental conditions during transport or in storage of e.g.diapers, bandages, etc.), food monitoring (food quality during transport, storage and sales) and construction industry(e.g. building material).In this paper, a small, very low power and low cost humidity sensor tailor made for passive RFID applications ispresented. The sensor consists of a glass chip substrate with a sub-micron interdigitated gold electrode structurecovered with a humidity sensitive polyimide layer. The humidity absorbed by the sensing layer is measuredcapacitively. Finite element modeling and analytic calculations were used to determine the design of the interdigitatedelectrodes and the optimal thickness of the polyimide layer. A read-out electronics circuit was designed and used toevaluate the sensor. Sensors were fabricated and calibrations have been made to verify their function. The sensorresponse was close to linear from below 20 to above 90 %RH and its response time was proven to be at least as shortas that of the climate chamber, namely 0.1 %RH/s. The concept can easily be adapted to measure a range of otherparameters such as temperature or the presence of certain substances.
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| 16. |
- Löfgren, Linus, et al.
(författare)
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Low-power humidity sensor for RFID applications
- 2008
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Ingår i: 4M 2008: Proceedings of the 4th International Conference on Multi-material Micro Manufacture. - 1904445764
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Konferensbidrag (refereegranskat)
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| 17. |
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| 18. |
- Munkholm, Michaela, 1967-, et al.
(författare)
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Cross-regional validation of the school version of the assessment of motor and process skills
- 2010
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Ingår i: American journal of occupational therapy. - Bethesda, MD : The American Occupational Therapy Association. - 0272-9490 .- 1943-7676. ; 64:5, s. 768-775
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE.: The objective was to determine whether the School Version of the Assessment of Motor and Process Skills (School AMPS) is valid when used to evaluate students in different world regions. METHOD.: Participants were 984 students, ages 3–13 yr, from North America, Australia and New Zealand, United Kingdom, and the Nordic countries, matched for age and diagnoses. We used FACETS many-faceted Rasch analyses to generate item difficulty calibrations by region and evaluate for significant differential item functioning (DIF) and differential test functioning (DTF). RESULTS.: Four School AMPS items demonstrated DIF but resulted in no DTF. CONCLUSION.: This study provided support for occupational therapists using the School AMPS to evaluate students' quality of schoolwork task performances across regions because the School AMPS measures are free of bias associated with world region.
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| 19. |
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| 20. |
- Munkholm, Michaela, 1967-
(författare)
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Occupational performance in school settings : evaluation and intervention using the school AMPS
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: This thesis is was designed to evaluate aspects of reliability and validity of the School Version of the Assessment of Motor and Process Skills (School AMPS) (Fisher, Bryze, Hume, & Griswold, 2007), an observation-based evaluation of quality of occupational performance when children perform schoolwork tasks in school settings. The long term goal was to contribute to knowledge about children at risk or with mild disabilities who experience difficulties with occupational performance in school settings, and describe how the School AMPS can be used when a true top−down process of planning and implementing school-based occupational therapy services is implemented in a Swedish context. Methods: In Study I, two different split-half methods and were used to estimate reliability of the School AMPS measures. These were cross-validated using Rasch equivalent of Cronbach’s alpha. The standard error of measurement (m) was also calculated. In Studies II and III, many-facet Rasch analyses and/or relevant inferential statistics (e.g., ANOVA, tests) were used to examine for evidence of validity based on (1) internal structure related to differential item functioning (DIF), (2) relations to other variables (sensitivity) in terms of comparing groups (typically-developing children vs. children with mild disabilities), and (3) consequences of testing (benefits of testing) in terms of test fairness. In Study IV, ANOVA and tests were used to examine relations to other variables in terms of sensitivity of the School AMPS measures for detecting change based on repeated School AMPS evaluations pre- and post-interventions. Results: The three methods for estimating reliability of the School AMPS measures yielded high reliability coefficient estimates (≥0.73) and low ms. Minimal DIF was identified, and despite minimal DIF, the School AMPS measures were found to be free of differential test functioning. The School AMPS measures were sensitive enough to detect differences between groups as well as changes following consultative occupational therapy services provided in natural school settings. Conclusions: The results support the reliability and validity of the School AMPS scales and measures when used to evaluate quality of occupational performance in school settings. The results are also of clinical importance as they provide evidence that occupational therapists can have confidence in the School AMPS measures when they are used in the process of making decisions about individual students, planning interventions, and later perform follow-up evaluations to measure the outcomes. We also have objective evidence that children with mild disabilities demonstrate diminished quality of "doing" when performing schoolwork tasks. The potential long term benefits of such evidence may be to support or justify the need for children with mild disabilities to receive occupational therapy services within school settings in Sweden; and through collaboration with teachers, plan and implement better targeted and more effective interventions.
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| 21. |
- Munkholm, Michaela, 1967-, et al.
(författare)
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Reliability of the School AMPS measures
- 2012
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Ingår i: Scandinavian Journal of Occupational Therapy. - London, UK : Informa Healthcare. - 1103-8128 .- 1651-2014. ; 19:1, s. 2-8
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The purpose of this study was to use a variety of methods to evaluate and cross-validate the reliability estimates of the quality of schoolwork performance measures in the School Version of the Assessment of Motor and Process Skills (School AMPS)(1).Methods: Split-half reliability was estimated based on School AMPS data from 6 194 students who had performed at least two school AMPS tasks. Two different split-half methods were used: splitting the School AMPS items vertically and splitting them horizontally. The Rasch equivalent of Cronbach’s alpha for the full School AMPS evaluation and standard error of measurement (SEm) were also considered.Results: All three methods yielded high reliability coefficient estimates (r ≤ 0.70) and overall SEm was low.Conclusions: From a practice perspective, the results of this study are of clinical importance as they provide evidence that occupational therapists can have confidence in the consistency of the School AMPS measures when they are used in the process of making decisions about individual students, planning interventions, and later performing followup evaluations to measure the outcome.
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| 22. |
- Nilsson, Ingeborg, et al.
(författare)
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Focus on leisure repertoire in the oldest old : the Umeå 85+ study
- 2006
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Ingår i: Journal of Applied Gerontology. - : SAGE Publications. - 0733-4648 .- 1552-4523. ; 25:5, s. 391-405
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Tidskriftsartikel (refereegranskat)abstract
- This study elucidates the oldest olds’ leisure repertoire and how this repertoire varies due to gender, where they live, and cognitive status. A validated 20-item leisure interest checklist with four subscales was used to measure leisure participation and investigate the leisure repertoire among participants. The oldest old were most likely to be interested in, perform, be motivated for, and perceive well-being from social activities, cultural activities, and TV/video/movies. The respondents were least likely to be interested in, perform, be motivated for, and perceive well-being from equipment sports and ball games. Some gender, geographic differences, and differences in cognitive status were found. The oldest old were more likely to endorse the same activities across all subscales of the checklist, but the linear magnitude varied across sub-scales. The relationships between performance and the other subscales suggested that a sense of engagement or participation is related to actual performance.
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| 23. |
- Nilsson, Ingeborg, 1969-
(författare)
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Occupational Engagement among Older People : Evaluation, Repertoire and Relation to Life satisfaction
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Occupational engagement among older people is important to investigate as older people are the fastest growing segment in our society, and because occupational engagement is viewed within occupational therapy as one of the basic premises for health. Three perspectives of engagement are highlighted in this thesis: evaluation of occupational engagement, the repertoire of occupational engagement, and finally, the relation between occupational engagement and life satisfaction. The overall aim of this thesis was to study aspects of occupational engagement among older people, with a special focus on evaluation of the experiences of an occupation-based group programme, evaluation of leisure, the leisure repertoire, and the relation between occupational engagement and life satisfaction. The thesis is comprised of four studies which all contribute in different ways to an increasing understanding of occupational engagement among older people. In the first study (Study I), three older persons participated in a group activity programme and were interviewed about their experiences of occupational engagement. The qualitative interviews were done with each participant after each group session, in total 15 interviews. The other three studies (Studies II-IV) were based on a subgroup of a population studied in a cross-sectional population-based study, the Umeå 85+ study. Very old people with an MMSE score of 20 or more were included in Studies II, III, and IV (n=156). During home visits, they were interviewed about their occupational engagement (ADL and leisure) and their life satisfaction. The qualitative interviews analysed using a Grounded theory approach, revealed two different dimensions of experiences while engaged in a group programme. The participants described experiences of activation, with a creative force and a place for learning, but also experiences of transformation with reflection, adaptation, and finally, a personal synthesis. Evaluation of occupational engagement through measurement using the modified NPS Interest Checklist (MNPS) was made possible using Rasch analysis. The results revealed preliminary evidence for internal scale validity and person response validity. Scale and person reliability were Rasch equivalents of Cronbach alpha of .98 for items and .66 to .75 for persons, respectively. In their leisure repertoire, very old people were more likely to endorse Social and Cultural activities and least likely to endorse Ballgames and Equipment sport. Traditional gender differences and some differences between older persons in rural versus urban areas and between persons with different cognitive levels were also found. Finally, significant correlations were found between life satisfaction and both engagement in ADL (r =.31) and engagement in leisure (r =.34) among very old people. A forced entry regression revealed that both variables together explained slightly more (12.4%) than leisure alone (11.2%). As a conclusion and in relation to evaluation of occupational engagement during therapy, the experiences of engagement are described by the respondents from both a perspective of action and a perspective of inner reflection, and together they might support the developmental process among older people. Through using Rasch analysis, it was possible to convert ordinal data into linear measures and also to organize leisure occupations into a hierarchical repertoire of engagement. This repertoire gives further understanding for specific tasks and about the general relation between leisure dimensions. Finally, the contribution of occupational engagement to life satisfaction is likely essential, but explains only about 12% of total life satisfaction among very old people.
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| 24. |
- Nilsson, Ingeborg, et al.
(författare)
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Occupational engagement and life satisfaction in the oldest old : the Umeå 85+ study
- 2007
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Ingår i: OTJR (Thorofare, N.J.). - 1539-4492 .- 1938-2383. ; 27:4, s. 131-139
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Tidskriftsartikel (refereegranskat)abstract
- This study was designed to evaluate whether the level of occupational engagement is relatedto life satisfaction among the oldest-old. The study was performed as part of a cross-sectionalstudy of individuals 85 years and older in northern Sweden. The results revealed significantcorrelations between life satisfaction and engagement in both leisure and activities of daily living,and the effect sizes were interpreted as medium. This study adds some support to earlierfindings that a higher level of task performance is related to a higher level of life satisfaction.The results also give some clinical evidence to support a client-centered approach that includesconsideration of leisure tasks a person is motivated to perform.
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| 25. |
- Norberg, Eva-Britt, et al.
(författare)
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A client-centred programme focusing energy conservation for people with heart failure
- 2017
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 24:6, s. 455-467
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The purpose of this study was to describe clients and occupational therapists (OTs) experiences of a home-based programme focusing energy conservation strategies (ECS) for clients with chronic heart failure (CHF).METHODS: The programme, based on occupational therapy intervention process model (OTIPM), was led by two OTs in primary health care. Five clients' self-reported activities of daily living (ADL), fatigue, depression, goal achievements and use of ECS. Furthermore, both clients and OTs were individually interviewed.RESULTS: The clients reported mild depression, severe fatigue and both increased and decreased independence in ADL. Most goals were achieved, and multiple ECS were used. Clients perceived that they worked collaboratively with the OTs and gained professional support to enhance daily activities. The OTs experienced knowledge and structure and found benefits from the programme, but doubted the possibility of using it in clinical practice.CONCLUSIONS: This study, despite having few participants, indicates that both the OTs and the clients experienced that the specialized programme gave structure to the OTs work, provided knowledge about CHF and valuable energy conservation strategies. The programme supported the OTs in working in a more comprehensive client-centred way. However, its feasibility needs to be further evaluated.
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| 26. |
- Norberg, Eva-Britt, et al.
(författare)
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Activities of daily living for old persons in primary health care with chronic heart failure
- 2008
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 22:2, s. 203-210
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Tidskriftsartikel (refereegranskat)abstract
- Chronic heart failure (CHF) is a common condition among Europe's aging population. Findings indicate that CHF patients must make significant changes in many aspects of daily life. Previous studies of older primary health-care participants and their activities of daily living (ADL)-ability are rare. The aim of this study was to describe ADL-ability in older people with CHF syndrome. The factors considered were dependence on others, perceived strain, quality of performance, and the association between The New York Heart Association classification (NYHA) and ADL-ability. The participants, recruited from a primary health-care centre, had symptoms indicating CHF and were diagnosed by a cardiologist. Forty persons over 65 years (mean age 81), participated in the study and self-reported co-morbidity was frequent. The Assessment of Motor and Process Skills (AMPS) and the Staircase of ADL were used to describe ADL-ability. Most participants were independent with respect to personal activities of daily living (PADL), and 75% were dependent in one or more instrumental activities of daily living (IADL), usually shopping. Most participants perceived strain, and only three could perform all ADL without strain. Age had a significant impact on ADL performance (motor measures: OR 7.11, CI 1.19-42.32, p = 0.031 and process measures: OR 8.49, CI 1.86-38.79, p = 0.006). However, participants showed lower ADL motor and process ability in AMPS compared with well persons of the same age. Participants in NYHA III/IV (adjusted for age), had significantly increased effort (under motor cut-off) when performing ADL-tasks (OR: 15.5, CI 2.40-100.1, p = 0.004) compared to those in NYHA I/II. Older persons in primary health care with CHF exhibit a high amount of dependence, perceived strain and increased effort during performance of ADL. There is an association between NYHA class III/IV and a decreased ADL-ability (AMPS motor ability) even when adjusted for age.
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| 27. |
- Norberg, Eva-Britt, 1956-
(författare)
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Dagliga aktiviteter bland äldre personer med kronisk hjärtsvikt : begränsningar och möjligheter
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Chronic Heart Failure (CHF) is known to have a substantial impact on activities of daily living (ADL) and symptoms such as breathlessness and fatigue are characteristic. Despite this, research in occupational therapy concerning people with CHF is rare. The overall aim of this thesis was to increase the knowledge of ADL ability and fatigue among those with CHF, to describe experiences of limitations in occupational performance and the strategies that these elderly people use to manage their daily activities and also to describe a programme including energy conservation for clients with CHF in primary healthcare.Method Three groups of older people with a verified diagnosis of CHF and one group of occupational therapists (OTs), all recruited from primary healthcare, were analyzed. The ADL ability of 40 participants was described, with reference to dependence on others, perceived strain and quality of occupational performance. The association between ADL ability and the New York Heart Association Classification (NYHA), a functional classification for people with CHF, was analyzed. Fatigue and its association to ADL ability, use of assistive devices and community support were also analyzed. Ten respondents were then interviewed and asked to describe the strategies they used to manage ADL. The interview results were combined with the current body of research and CHF guidelines to form a base for the development of an intervention programme, including energy conservation, for people with CHF. The programme, based on the Occupational Therapy Intervention Process Model (OTIPM), was used by OTs in primary healthcare, and the clients’ ADL, goal achievements and use of energy conservation strategies were described, as well as the five clients’ and two OTs’ experiences of the program.Results Most participants were independent in personal ADL activities (PADL). A majority was dependent in one or more instrumental ADL activities (IADL) and perceived strain when performing the activities independently. The Assessment of Motor and Process Skills (AMPS) showed a reduced quality of occupational performance compared with healthy people of the same age. Age had a significant impact on ADL performance. Despite this, participants in NYHA III/IV showed significantly increased effort (under motor cutoff) when performing ADL tasks compared with those in NYHA I/II. Fatigue was common and greater fatigue was associated significant with increased dependence and decreased quality of occupational performance, with the exception of shopping. Participants who used assistive devices and home care estimated higher physical fatigue, but no correlation was found with community mobility services. Comorbidities, which can affect occupational performance, were common in all the studies.The participants experiences of limitations in occupational performance and the strategies that they used to manage their daily activities were described as redefining an active life, aware of one’s impaired body and planning activities and balancing the degree of effort.During the interventions according to the programme the clients’ increased their participation and independence in daily activities, consciously gave up what were less meaningful activities for them and deteriorated because of the progression of the CHF. Most goals were achieved and many energy conservation strategies were used by the clients. The clients’ experiences were described as working in collaboration to manage daily activities and using professional support from OTs to enhance their activities. The OTs’ experiences of the programme were described as being supported with specific knowledge and a structured way of working and finding clinical benefits from working according to the program, but doubt the possibilitiy of using it, due to constraints in clinical practice.Discussion The participants' physical fatigue and breathlessness had a negative impact on their ADL-ability. Age affected ADL performance, but the impact of a more severe CHF remained adjusted for age. An ongoing process of occupational adaptation due to periodical physical decline and fluctuating day-to-day ability was described. Many of the strategies used by the participants to handle daily activities could be described as energy conservation strategies, an indication that occupational therapy interventions including energy conservation management would be beneficial for clients with CHF. Both the OTs and the clients described that the specialized programme provided structure for the OTs’ work, knowledge about CHF and about valuable energy conservation strategies. The programme seemed to support the OTs to work in a more comprehensive client-centered way.Conclusion The work with this thesis has increased the limited existing knowledge about elderly people with CHF and their ADL ability, fatigue and the adaptation of occupational performance that they use to manage their daily activities. The experiences indicated that a specialized programme including energy conservation for occupational therapy in primary healthcare seemed to support the OTs work in a more comprehensive client-centered way. The programme needs to be further evaluated.
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| 28. |
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| 29. |
- Norberg, Eva-Britt, et al.
(författare)
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Impact of fatigue on everyday life among older people with chronic heart failure
- 2010
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Ingår i: Australian Occupational Therapy Journal. - : Wiley. - 0045-0766 .- 1440-1630. ; 57:1, s. 34-41
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Tidskriftsartikel (refereegranskat)abstract
- Fatigue had a negative impact on ADL mainly from physical rather than from mental causes. Improved energy conservation strategies to reduce the consequences of fatigue are needed.
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| 30. |
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| 31. |
- Norberg, Eva-Britt, et al.
(författare)
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Occupational performance and strategies for managing daily life among the elderly with heart failure
- 2014
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 21:5, s. 392-399
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Tidskriftsartikel (refereegranskat)abstract
- Aim:The aim of this study was to describe experiences of limitations in occupational performance and strategies for managing daily activities among the elderly with chronic heart failure (CHF).Methods:Ten participants from primary healthcare with a confirmed diagnosis of CHF were interviewed. The interviews were analysed using qualitative content analysis.Results: The first theme, "Redefining an active life, aware of one's impaired body", was based on four sub-themes: realizing one's limited activity ability; striving to preserve an active life; focusing on meaningful activities; and changing vs. not changing habits and roles. The second theme, "Planning activities and balancing the degree of effort", was based on three sub-themes: limiting, organizing, and rationalizing activities; adjusting activities to today's ability; and using technology and adapting the environment.Conclusions:Elderly people with CHF are struggling with an ongoing process of occupational adaptation due to periodical physical decline and fluctuating day-to-day ability. This highlights a need for information on strategies from a holistic perspective and client-centred occupational therapy interventions.
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| 32. |
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