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2.
  • Carnesten, Hillewi, et al. (författare)
  • Battling extraordinary situations and conflicting emotions : A qualitative study of being a newly graduated Registered Nurse in the emergency department during the COVID-19 pandemic
  • 2022
  • Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 9:5, s. 2370-2380
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To describe newly graduated registered nurses' (NGRNs') experiences of encountering stress in emergency departments (EDs) during the COVID-19 pandemic. Design: A qualitative descriptive study. Methods: Data from 14 in-depth interviews with NGRNs working in an ED for 3-36 months after graduation was analysed by the means of qualitative content analysis as described by Graneheim and Lundman. Interviews were conducted from March to November 2020 covering the first two waves of the pandemic. Results: Data revealed three categories and nine subcategories comprised in the theme Battling extraordinary situations and conflicting emotions. Empowered by acknowledging themselves as important caregivers during the pandemic NGRNs struggle against limitations and exert themselves beyond their known limit. External stressors due to work overload in combination with understaffing force NGRNs into the role of the experienced nurse prematurely and internal stressors derives from part taking in less qualitative care.
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3.
  • Carnesten, Hillewi, et al. (författare)
  • Caring through barriers—Newly graduated registered nurses' lived experiences in emergency departments during the COVID-19 pandemic
  • 2023
  • Ingår i: Journal of Advanced Nursing. - : John Wiley and Sons Inc. - 0309-2402 .- 1365-2648. ; 79:6, s. 2269-2279
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To illuminate the meaning of newly graduated registered nurses' experiences of caring for patients in emergency departments during the COVID-19 pandemic. Design: A phenomenological hermeneutical study guided by Lindseth and Norberg. Methods: In-depth one-on-one interviews with 14 nurses from five hospitals were conducted from March to November 2020 and analysed using thematic analysis. The consolidated criteria for reporting qualitative research (COREQ) were used as the reporting guideline. Results: The findings comprise one main theme Caring through barriers and three themes with sub-themes. In the first theme, having intention to care, participants revealed their dedication to care for patients during the pandemic despite extensive stress, little experience and skills. The second theme, with tied hands in human suffering, illuminates experiences of being disconnected from the patient, overwhelmed by responsibility and unable to relieve suffering. The third theme, feeling inadequate, reveals experiences of lack of support and doubts meaning less space to develop into the nurse one wants to be. Conclusion: Findings reveal a new understanding of new nurses' experiences during times of crisis. The essence of caring in the emergency department during the pandemic can be explained as mediated through spatial, temporal and emotional barriers preventing new nurses from providing holistic care. Impact: The results may be used as anticipatory guidance for new nurses and inform targeted support interventions to support new nurses entering the profession in crisis conditions. Public Contribution: This study involved new nurses in semi-structured interviews. 
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4.
  • Carnesten, Hillewi, 1969- (författare)
  • Nurses' caring struggle : Stress in caring within hospital emergency care during the COVID-19 pandemic
  • 2024
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Nurses took a frontline caregiving role during the COVID-19 pandemic in pervasively altered conditions in Swedish hospital emergency healthcare. Little is known about nurses’ experiences of the stress they were subjected to. In this thesis, findings from individual in-depth interviews with both newly graduated registered nurses (NGRNs) and experienced nurses (ERNs), as well as a web-based questionnaire, illuminate nurses’ lived experiences of stress in caring during the COVID-19 pandemic. Three studies employed qualitative methods (I, II, IV), and one a mixed methods approach (III). Study I aimed to describe NGRNs’ experiences of encountering stress in EDs during the COVID-19 pandemic. Findings illuminate how dedicated NGRNs struggle to develop into the nurse they want to be whilst battling extraordinary situations and conflicting emotions. Loss of control and experiences of shortcomings caused by work overload in combination with understaffing force NGRNs into an independent role at an early point in their career. Study II aimed to illuminate the meaning of NGRNs' experiences of caring for patients in EDs during the COVID-19 pandemic. Findings comprise caring being bestowed through spatial, emotional, and temporal barriers. NGRNs want to be present, relieve suffering yet describe caring during the pandemic as being a hidden activity, less acknowledged and left to the recognition of each nurse. Study III aimed to explore healthcare workers’ (HCWs’) experiences of the changed caring reality of the COVID-19 pandemic. Findings disclose traumatic experiences and having to sacrifice moral values and harbour dilemmas in isolation. Experiencing stress was significantly correlated to lower sense of coherence (SOC). Study IV aimed to explore nurses’ lived experiences of stress in the transformed caring reality during the COVID-19 pandemic. The interpreted meaning comprises the dilemma of enduring the unbearable, meaning having to silence one’s inner ethical, caring compass. In conclusion, stress in caring during the COVID-19 pandemic from a nurse perspective, can be understood as a caring struggle entailing bodily, knowledge, and ethical stress in a search for meaning that might be found in togetherness with patients, with colleagues, with dear ones and in nature.
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5.
  • Carnesten, Hillewi, 1969-, et al. (författare)
  • Struggling in the dehumanized world of COVID-An exploratory mixed-methods study of frontline healthcare workers' experiences
  • 2024
  • Ingår i: Journal of Advanced Nursing. - : WILEY. - 0309-2402 .- 1365-2648.
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To explore healthcare workers' experiences of the changed caring reality during the COVID-19 pandemic in Sweden. Design: An online fully mixed-methods design. Methods: A web-based self-reported questionnaire with fixed and open-ended answers collected data from March to April 2021, analysed in three steps. First, free-text questions were analysed by qualitative content analysis. Then quantitative linear regression analyses using models covering stress and coping mechanisms were conducted. Finally, a meta-inference of qualitative and quantitative data emerged a new comprehensive understanding. The COREQ guidelines were used for reporting. Results: Meta-inferenced results of quantitative and qualitative findings show the pandemic was a traumatic experience for healthcare workers. Main theme; When work became a frightening experience in a dehumanized reality, comprised four themes: Entering unprepared into a frightful, incomprehensible world; Sacrificing moral values and harbouring dilemmas in isolation; Lack of clear management; and Reorient in togetherness and find meaning in a changed reality. Qualitative results comprised four categories; Working in a dehumanized world; Living in betrayal of ones' own conscience; Lack of structure in a chaotic time and Regaining vitality together. Subdimensions comprehensibility and meaningfulness were associated significantly with post-traumatic stress disorder in multiple regression analysis. In multiple regression analysis, sense of coherence was the most prominent coping strategy. Conclusions: Forcing oneself to perform beyond one's limit, sacrificing moral values and lacking management was a traumatic experience to healthcare workers during the pandemic. Reorienting as a way of coping was possible in togetherness with colleagues. There is an urgency of interventions to meet the needs among healthcare workers who took on a frontline role during the COVID-19 pandemic and to prevent mental health illness in future crisis. Patient or Public Contribution: No patient or public contribution. Summary: The pandemic outbreak exposed frontline healthcare workers to unparallelled stress shown as negative for their mental health in several meta-analyses and systematic reviews. In-depth understanding on experiences and how symptoms of post-traumatic stress disorder relate to coping mechanisms have been scarcely explored. This study contributes to understanding on healthcare workers' experiences and the relation between lower sense of coherence and increased risk of developing symptoms of post-traumatic stress disorder. Implications for Practice/Policy: This study might guide how to prepare for resilience in future emergencies.
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6.
  • Carnesten, Hillewi, 1969-, et al. (författare)
  • Struggling with frightening experiences in a transformed reality : A mixed methods study of healthcare workers’ experiences during the pandemic.
  • 2023
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Background: The COVID-19 pandemic continues to impact health care workers’ (HCWs’) mental health. Research show that psychological distress and hard challenges abide with strong commitment to contribute. Yet, in-depth understanding of HCWs’ experiences of the changed caring reality during the pandemic is missing. Mixed methods research (MMR) accommodates several features apart from employing either quantitative or qualitative methods. This presentation focuses on examples from the 13-step mixed method by Leech and Onwuegbuzie.Methods: 97 HCWs in one hard-hit region in Sweden answered a web-based questionnaire measuring symptoms of stress (using DSM-5 criteria for post-traumatic stress syndrome, PTSD) in relation to perceived sense of coherence (SOC-scale) and self-compassion (SCS) as well as HCWs’ experiences. First, qualitative data (experiences of the pandemic) was analyzed by qualitative content analysis, then quantitative data (associations between PTSD and SOC/SCS) were analyzed with linear regression adjusted for covariates. Thirdly, a synthesis, the meta-inference of qualitative and quantitative data, explained a new comprehensive understanding. Results: By analyzing the categories and subcategories from the qualitative analysis in relation to symtoms of stress and SOC/SCS, a synthesis emerged. This was undertaken by merging and comparing the findings and discussing the new comprehensive understanding. Finally, to fully outline the mixed methods approach, qualitative and quantitative data were synthesized into a new comprehensive whole, a meta inference. Conclusion: This study moves away from dichotomic traditions between qualitative or quantitative approaches. By broadening the methodological departure this study may provide a new comprehensive understanding and contribute to enhance quality in MMR. 
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7.
  • Cederbom, Sara, et al. (författare)
  • A behavioral medicine intervention for older women living alone with chronic pain - a feasibility study
  • 2014
  • Ingår i: Clinical Interventions in Aging. - 1176-9092 .- 1178-1998. ; 9, s. 1383-1397
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: To be an older woman, live alone, have chronic pain, and be dependent on support are all factors that may have an impact on daily life. One way to promote ability in everyday activities in people with pain-related conditions is to use individualized, integrated behavioral medicine in physical therapy interventions. How this kind of intervention works for older women living alone at home, with chronic pain, and dependent on formal care to manage their everyday lives has not been studied. The aim was to explore the feasibility of a study and to evaluate an individually tailored integrated behavioral medicine in physical therapy intervention for the target group of women. Materials and methods: The study was a 12-week randomized trial with two-group design. Primary effect outcomes were pain-related disability and morale. Secondary effect outcomes focused on pain-related beliefs, self-efficacy for exercise, concerns of falling, physical activity, and physical performance. Results: In total, 23 women agreed to participate in the study and 16 women completed the intervention. The results showed that the behavioral medicine in physical therapy intervention was feasible. No effects were seen on the primary effect outcomes. The experimental intervention seemed to improve the level of physical activity and self-efficacy for exercise. Some of the participants in both groups perceived that they could manage their everyday life in a better way after participation in the study. Conclusion: Results from this study are encouraging, but the study procedure and interventions have to be refined and tested in a larger feasibility study to be able to evaluate the effects of these kinds of interventions on pain-related disability, pain-related beliefs, self-efficacy in everyday activities, and morale in the target group. Further research is also needed to refine and evaluate effects from individualized reminder routines, support to collect self-report data, safety procedures for balance training, and training of personnel to enhance self-efficacy.
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8.
  • Cederbom, Sara, et al. (författare)
  • Chronic pain among older women living alone. A study focusing on disability and morale.
  • 2014
  • Ingår i: European Journal of Physiotherapy. - 2167-9169 .- 2167-9177. ; 16:3, s. 139-150
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To investigate 1)how older women who are living alone perceive chronic musculoskeletal pain,Activities of Daily Living (ADL), physical activity, affective distress,pain-related beliefs, pain management, and rate pain-related disability andmorale,  2) the relationships betweendemographic variables, ADL, physical activity, affective distress, pain-relatedbeliefs, and pain management with pain-related disability and morale.Method: The study had across-sectional and correlational design. Sixty women, living alone with chronicpain and community support aged ≥65 years were included.Results: The women were on average 81 years old and had lived with pain forabout 21.5 years. They reported low scores of affective distress,catastrophizing thoughts and self-efficacy, high scores of fear of movement,low degrees of pain-related disability, and low levels of  morale. The multiple regression analysisshowed that only catastrophizing thoughts significantlyexplained the variation in pain-related disability, and both affective distress and catastrophizing thoughtssignificantly explained the variation in morale. Conclusion: These older women livingalone with chronic pain reported similar prevalence ofchronic pain and pain-related disability but lower morale when comparingthe results with similar studies about older people in the same age group orolder people who are in need of help to manage their daily life. The only variable that was independely associated to bothpain-related disability and morale was catastrophizing. Further researchshould focus on identifying catastrophizing thougts,and also on developing a rehabilitation program based on a biopsychosocialperspective with the goal to decrease catastrophizing, pain-relateddisability, and increase morale for this target group
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9.
  • Cederbom, Sara, et al. (författare)
  • Home Help Service Staffs' Descriptions of Their Role in Promoting Everyday Activities Among Older People in Sweden Who Are Dependent on Formal Care.
  • 2017
  • Ingår i: Journal of Applied Gerontology. - : SAGE Publications. - 0733-4648 .- 1552-4523. ; 36:8, s. 971-992
  • Tidskriftsartikel (refereegranskat)abstract
    • The study aimed to explore how home help service staff described their role in improving the abilities of older people, in particular, older women with chronic pain who are dependent on formal care, to perform everyday activities. Three focus group interviews were conducted, and a qualitative inductive thematic content analysis was used. The analysis resulted in one theme: struggling to improve the care recipients' opportunities for independence but being inhibited by complex environmental factors. By encouraging the care recipients to perform everyday activities, the staff perceived themselves to both maintain and improve their care recipients' independence and quality of life. An important goal for society and health care professionals is to improve older people's abilities to "age in place" and to enable them to age independently while maintaining their quality of life. A key resource is home help service staff, and this resource should be utilized in the best possible way.
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12.
  • Cederbom, Sara, et al. (författare)
  • The importance of a daily rhythm in a supportive environment-  promoting ability in daily activities among older women livingalone with chronic pain
  • 2014
  • Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 36:24, s. 2050-2058
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: The aim of this study was to explore how older women living alone with chronic musculoskeletal pain, describe their ability in performing activities in everyday life and what could promote their ability in activities in everyday life as well as their perceived meaning of a changed ability to perform activities in everyday life. Method: Qualitative interviews were conducted with 12 women, and an inductive content analysis was used. Results: The results showed the importance of a daily rhythm of activities. Activities included in the daily rhythm were socializing with family and friends, physical activities, doing own activities as well as activities supported by relatives and the community. The activities described by the women also promoted their ability in activities in everyday life. Other findings were the women's perceived meaning of being independent and maintaining that independency, along with the meaning of accepting and adapting to a changed life situation. Conclusion: This paper concludes that it is important to be sensitive of individual needs regarding the daily rhythm of activities when health-care professionals intervene in the activities in everyday life of older women living alone, promote the women's independency, and enable them to participate in the community. 
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13.
  • Dahlén, Micael, et al. (författare)
  • Changes in Physical Activity Are Associated with Corresponding Changes in Psychological Well-Being : A Pandemic Case Study
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601 .- 1661-7827. ; 20, s. 1-9
  • Tidskriftsartikel (refereegranskat)abstract
    • Societal crises and personal challenges are often followed by substantial changes in physicalactivity. Is there a link between such changes and psychological well-being? Seeking to answerthis question, we conducted a correlational study on a representative sample in Sweden during thefirst year of the COVID-19 pandemic (N = 1035). About 49% of the sample had decreased theirphysical activity compared to their self-reported activity level prior to the pandemic, whereas 32%had increased it. The results showed a positive and robust association between changes in dailyactivity level and corresponding changes in psychological well-being. Specifically, individuals whohad reduced their physical activity over the last year reported lower life satisfaction than before, andindividuals who had increased their physical activity reported higher life satisfaction than before.The amount of complete physical inactivity (sitting) showed a similar pattern as the exercise data,meaning that individuals who reported increasing inactivity per day also reported a greater declinein life satisfaction. Additional analyses showed that the association between daily activity level andlife satisfaction was somewhat stronger for men than for women, but there was no difference whencomparing individual versus organized activities. The current study was based on a cross-sectionaldesign, measuring self-reported change over time. Recent work from other research teams have usedlongitudinal data and experience-sampling in different settings, finding similar results. We concludethat there is good reason to recommend physical exercise as a coping strategy in difficult times.
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14.
  • Dahlén, Micael, et al. (författare)
  • The comeback effect : How happy are people who have recovered from a COVID-19 infection?
  • 2022
  • Ingår i: International Journal of Wellbeing. - : International Journal of Wellbeing. - 1179-8602. ; 12:2, s. 114-133
  • Tidskriftsartikel (refereegranskat)abstract
    • There is already a large body of research on the dramatic negative effects of COVID-19 on peoples’ mental and physical health. Millions of people have died, and the pandemic has negatively influenced the lives of billions of people. Luckily however, the vast majority of people infected with the virus, recovers. The happiness and wellbeing of these people have not been extensively studied. In the current paper, we ask the question: Are people who have recovered from a COVID-19 infection happier than those who have not been infected at all? Building on previous research on hedonic adaptation and counterfactual thinking, we hypothesize, and find, that those who have had an infection appear slightly happier than others.  The study relies on two surveys conducted in Sweden during the pandemic in 2020 (n=1029) and 2021 (n=1788).
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15.
  • Eklund, Caroline, 1983-, et al. (författare)
  • The Meaning of Sedentary Behavior as Experienced by People in the Transition From Working Life to Retirement : An Empirical Phenomenological Study
  • 2021
  • Ingår i: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 101:8
  • Tidskriftsartikel (refereegranskat)abstract
    • ObjectiveSedentary behavior (SB) is defined as a mean of >6 hours of daytime sitting or lying down. SB has been shown to increase with older age and is a risk factor for disease. During the transition from working life to retirement, changes in daily life activities occur, risking increased SB. The aim of the present study was to gain a deeper understanding of SB in relation to the transition from working life to retirement as experienced by persons in retirement.MethodsThe study was grounded in a phenomenological life-world perspective. Fourteen semi-structured interviews were conducted with participants aged 64–75. Data were analyzed using the empirical phenomenological psychological method.ResultsThe participants described that voluntary sedentary time was positively related to general health and well-being, while involuntary sedentary time was negatively related to health. Increased sedentary time was described as natural when aging. Retirement was expressed as a time for rest after hard work and the ability to choose a slower pace in life. Internal and external demands and daily routines interrupted SB, whereas loneliness was perceived to increase SB. Participants strived to find a balance between physical activity and sedentary time. The variations in the participants’ descriptions formed three typologies: in light of meaningful sedentary behavior, in the shadow of involuntary sedentary behavior, and a dual process – postponing sedentary behavior with physical activity.ConclusionsIncreased SB was perceived as natural when aging, but something that may be postponed by conscious choices. SB was perceived as associated with health, rest and recovery but also with the risk of deteriorating health.ImpactThis knowledge of the experienced meaning of SB could guide the design of health promotion interventions and may be helpful in targeting those in need of support and individualizing interventions to decrease SB in retirement.Lay SummaryThis study reveals how persons in retirement describe sedentary behavior as something healthy but also as unhealthy and that sedentary behavior is natural in aging and can be postponed by physical activity.
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17.
  • Elvén, Maria, 1973-, et al. (författare)
  • Changes in Physical Activity and Sedentary Behavior before and during the COVID-19 Pandemic : A Swedish Population Study
  • 2022
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Governments have enforced measures to limit the spread of COVID-19 with varying degrees of success, which could affect people’s physical activity (PA) and sedentary behavior. This study aimed to examine changes in PA levels, types of PA, and sedentary behavior in the Swedish population before and during the COVID-19 pandemic. Associations between changed PA levels and demographical and behavioral determinants were also investigated. In December 2020, 1035 individuals (18–79 years old) completed a survey about their PA and sedentary behavior before and during the pandemic. Factors influencing their PA were also explored. Fifty-one percent of the sample reported reduced total PA, 18% had no change, and 31% increased their PA. Overall, organized PA decreased the most and sedentary behavior increased. The youngest and oldest age groups reported the greatest reduction in PA, while middle-aged groups reported the most increased PA. Men reported a larger increase in sedentary behavior than women. Mental and physical capability was associated with change in PA. In conclusion, this study indicates that, during the COVID-19 pandemic, the majority of the Swedish population have decreased PA levels with a concurrent increase in sedentary behavior, which may have negative health consequences. Interventions are recommended to address both PA and sedentary behavior, specifically to strengthen people’s ability to perform PA and focusing on the youngest and oldest age groups. 
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18.
  • Elvén, Maria, 1973-, et al. (författare)
  • The impact of the COVID-19 pandemic on Swedes’ physical activity and sedentary behaviour
  • 2022
  • Konferensbidrag (refereegranskat)abstract
    • Background: Despite the proven health benefits of physical activity (PA), more than a quarter of the world’s adult population is insufficiently physically active, which increases the risk of diseases and premature death. During the COVID-19 pandemic governments have implemented enforced measures to limit the spread of the virus, which could affect people’s PA.  Aim: This study aimed to examine changes in PA levels, types of PA, and sedentary behavior in the Swedish population before and during the COVID-19 pandemic. Associations between demographical and behavioral determinants, and changes in PA were also investigated. Method: In December 2020, 1.035 individuals (18-79 y) completed a survey about PA and sedentary behavior, at present and before the pandemic. Factors influencing their PA were also explored.  Results: Fifty-one percent of the sample reduced total PA, 18% had no change and 31% increased PA. Overall, organized PA, for example at fitness centers and sport training, decreased the most, and sedentary behavior increased. The youngest and the oldest age groups reported the greatest reduction of PA, while the middle age groups reported the most increased PA. Mental and physical capability was associated with PA change. Conclusion: During the pandemic, most of the Swedish population have decreased PA levels with a concurrent increase in sedentary behavior. This may have both a short-and long-term negative health impact on individuals’ and populations’ health.  Implications for caring in a changing world: As physical inactivity already is a global public health problem during non-pandemic circumstances this study’s findings call for further actions during and after the pandemic to support people in maintaining or increasing daily PA and decreasing sedentary behavior. Interventions in health care are recommended to strengthen peoples’ ability to perform PA, focus on the youngest and oldest age groups, and be applied on an individual basis as well as in organizational contexts.
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19.
  • Fritz, Johanna, et al. (författare)
  • CHRONIC PAIN AND SEDENTARY BEHAVIOR - WHAT TO DO?
  • 2023
  • Ingår i: International Journal of Behavioral Medicine. - : SPRINGER. - 1070-5503 .- 1532-7558. ; 30, s. S147-S148
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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20.
  • Fritz, Johanna, et al. (författare)
  • Determinants of Implementing an Information and Communication Technology Tool for Social Interaction Among Older People : Qualitative Content Analysis of Social Services Personnel Perspectives
  • 2024
  • Ingår i: JMIR Aging. - : JMIR Publications Inc.. - 2561-7605. ; 7:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Older people are particularly vulnerable to social isolation and loneliness, which can lead to ill-health, both mentally and physically. Information and communication technology (ICT) can supplement health and social care and improve health among the vulnerable, older adult population. When ICT is used specifically for communication with others, it is associated with reduced loneliness in older populations. Research is sparse on how the implementation of ICT, used specifically for communication among older people in social services, can be performed. It is recommended to consider the determinants of implementation, that is, barriers to and facilitators of implementation. Determinants related to older people using ICT tools are reported in several studies. To the best of our knowledge, studies investigating the determinants related to the social services perspective are lacking. Objective: This study aims to explore the determinants of implementing the Fik@ room, a new, co-designed, and research-based ICT tool for social interaction among older people, from a social services personnel perspective. Methods: This study used an exploratory, qualitative design. An ICT tool called the Fik@ room was tested in an intervention study conducted in 2021 in 2 medium-sized municipalities in Sweden. Informants in this study were municipal social services personnel with experience of implementing this specific ICT tool in social services. We conducted a participatory workshop consisting of 2 parts, with 9 informants divided into 2 groups. We analyzed the data using qualitative content analysis with an inductive approach. Results: The results included 7 categories of determinants for implementing the ICT tool. Being able to introduce the ICT tool in an appropriate manner concerns the personnel’s options for introducing and supporting the ICT tool, including their competencies in using digital equipment. Organizational structure concerns a structure for communication within the organization. Leadership concerns engagement and enthusiasm as driving forces for implementation. The digital maturity of the social services personnel concerns the personnel’s skills and attitudes toward using digital equipment. Resources concern time and money. IT support concerns accessibility, and legal liability concerns possibilities to fulfill legal responsibilities. Conclusions: The results show that implementation involves an entire organization at varying degrees. Regardless of how much each level within the organization comes into direct contact with the ICT tool, all levels need to be involved to create the necessary conditions for successful implementation. The prerequisites for the implementation of an ICT tool will probably change depending on the digital maturity of future generations. As this study only included 9 informants, the results should be handled with care. The study was performed during the COVID-19 pandemic, which has probably affected the results.
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21.
  • Gusdal, Annelie K, 1963-, et al. (författare)
  • Older Adults’ Use of a Research-Based Web Platform for Social Interaction
  • 2023
  • Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 11:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Loneliness and social isolation are triggers for unfavorable changes in older adults’ health and well-being. Information and communication technology (ICT) can be used by older adults to mitigate the negative effects of loneliness and social isolation. However, ICT needs to be customized to the specific needs and conditions of older adults. The aim of this study was to explore older adults’ use of a new, co-designed and research-based web platform for social interaction from the perspectives of older adults, researchers, and social services personnel. The study is an intervention study with a multimethod approach in which 20 older adults used the web platform for social interaction “the Fik@ room” for eight weeks. Quantitative and qualitative data were collected pretest, during the test, and posttest. The Fik@ room met the expectations of those older adults who completed the study. It enabled them to expand their social network and develop new friendships, but their experiences of loneliness were not reduced. The involvement of social services personnel in recruitment and support was important in facilitating older adults’ use of the Fik@ room. Our study contributes knowledge about a new, co-designed and research-based web platform, customized specifically for older adults, which is valuable in guiding the design and delivery of future web platforms for social interaction among older adults.
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22.
  • Gusdal, Annelie K, 1963-, et al. (författare)
  • Prerequisites for a healthy and independent life among older people : a Delphi study
  • 2021
  • Ingår i: Ageing & Society. - : Cambridge University Press. - 0144-686X .- 1469-1779. ; 41:9, s. 2171-2187
  • Tidskriftsartikel (refereegranskat)abstract
    • The number of older people (aged 65+) will more than double by 2050 in Sweden. The ageing population is an increasing concern due to rising health-care costs and a shortage of health professionals. Older people generally prefer ageing in place, as long as they feel confident and comfortable. However, preventive and supportive measures are needed to maintain older people's independence and active participation in society. The aim of this study is to explore the prerequisites for a healthy and independent life among older people in Sweden. A Delphi study was conducted in three rounds. In round 1, seven focus group interviews were performed with older persons aged 65-79, older persons aged >= 80, next of kin of older persons, health professionals in primary and home health care, assistant nurses in home care, care managers and local politicians. The data were analysed using thematic analysis, resulting in 35 statements of the prerequisites needed for a healthy and independent life. These statements were sent to the participants from round 1, who were asked to evaluate the degree to which they agreed with each statement in round 2, and again in round 3. There was an agreement of at least 80 per cent for 31 of the 35 statements. When asked to identify the three prerequisites of most importance for a healthy and independent life, most participants stated: to have a social life, to have freedom of choice and power over one's own situation, and to have the possibility to choose independently one's type of housing. There was an overall high group agreement on the prerequisites needed for a healthy and independent life among older people. The main areas of importance were to have a social life, several dimensions of feeling safe and to retain one's personal control.
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23.
  • Hellström, Charlotta, et al. (författare)
  • Vad har hänt med den fysiska aktiviteten bland befolkningen under pandemin?
  • 2022
  • Ingår i: Socialmedicinsk Tidskrift. - 0037-833X. ; 99:2, s. 213-219
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Coronapandemin har lett till förändrade möjligheter till en hälsosam livsstil och individers utförande av fysisk aktivitet har påverkats, särskilt inom vissa grupper inom befolkningen. Artikeln nedan har ett folkhälsovetenskapligt perspektiv och utgår från resultaten ur en undersökning som genomfördes av Novus under december 2021 samt från aktuella debattartiklar relaterade till studien. Data analyserades av forskare som representerar forskningsområdena; Hållbart arbetsliv, Livsstil och hälsa, Hälsa och välfärd för människor i utsatta och sårbara livssituationer samt Hälso- och välfärdsteknik ur ett användarperspek-tiv, vid Mälardalens universitet.
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24.
  • Henriksson, Anna, 1983-, et al. (författare)
  • Exploring lived experience of sedentary behavior during cancer treatment : - a phenomenological study
  • 2021
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Background Sedentary behavior (SB) increases during cancer treatment, which may have deteriorating effects on long-term health. Few studies exploring patients' experience of SB during neo- or adjuvant cancer treatment have been conducted, and this information may be crucial in developing effective support for patients to reduce SB.Purpose To explore the lived experiences of SB in patients undergoing neo- or adjuvant cancer treatment and to explore the impact of the COVID-19 pandemic.MethodsIndividual interviews were conducted with patients undergoing treatment for breast, prostate and colorectal cancer recruited from the oncological department of a university hospital in Sweden. Interviews were analyzed phenomenologically and results presented as descriptions of the phenomenon SB. Results Preliminary results are that patients describe SB by depicting physical activity and awareness of its health benefits. Also, being inactive or sedentary is stigmatized. The type and phase of treatment, life circumstances (COVID-19 pandemic, sick leave) as well as motivation, social support, and self-image can impact SB during treatment.Conclusions The results indicate that SB is difficult for patients to discern. This suggests that SB is an unimplemented concept in the cancer context and needs to be addressed in a way that does not stigmatize patients. The coronavirus pandemic had both negative and positive impacts on SB for these patients. Furthermore, developing support that targets periods with more side-effects and helping patients reduce SB throughout changed life circumstances may be helpful. 
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25.
  • Henriksson, Anna, et al. (författare)
  • Exploring sedentary behavior during neo- or adjuvant treatment in patients with cancer : A phenomenological study
  • 2024
  • Ingår i: European Journal of Oncology Nursing. - : ELSEVIER SCI LTD. - 1462-3889 .- 1532-2122. ; 70
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Increased sedentary behavior during cancer treatment is common, which may have negative long-term health effects. Understanding patients' experience of sedentary behavior during neo- or adjuvant cancer treatment may be crucial in developing effective support for patients to reduce sedentary behavior. Therefore, the present study aimed to explore sedentary behavior in patients undergoing neo- or adjuvant cancer treatment. Methods: Eleven interviews were conducted with patients undergoing treatment for breast, prostate, and colorectal cancer. Participants were recruited from a university hospital in Sweden. Interviews were analyzed phenomenologically, and the results were presented as descriptions of the phenomenon sedentary behavior. Results: The overarching theme of sedentary behavior during cancer treatment was that sedentary behavior is experienced through being physically active or not. Furthermore, experiences of sedentary behavior increased with side effects and varied depending on the type and phase of cancer treatment, meaning that sedentary behavior is an adjustment to side effects. Additionally, sedentary behavior was influenced by life circumstances and social interaction, such as work status and having social support. Finally, sedentary behavior is influenced by strategies and motivations, such as the perceived benefits of physical activity and self-image. Conclusions: Sedentary behavior is difficult for patients to discern, which is why health care personnel may need to help patients by increasing awareness of the negative impact of sedentary behavior in a way that does not stigmatize patients. Furthermore, developing support that targets periods with more side effects and helping patients reduce sedentary behavior throughout changing life circumstances may be helpful.
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26.
  • Höglander, Jessica, et al. (författare)
  • Implementing A person-centred CommunicaTION (ACTION) educational intervention for in-home nursing assistants – a study protocol
  • 2023
  • Ingår i: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 23:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: In this study, the focus is on how to support the competence development needed for nursing assistants in home care. Home care services for older persons can be challenging concerning the nature of the interpersonal interaction and communication needed to care for and respond to the diverse needs of older people who seek to live well in our communities. This implies a need to offer more person-centred care (PCC) to older persons. However, there is a lack of knowledge on how to develop such competence. We, therefore, developed A Person-centred CommunicaTION (ACTION) programme, which is a web-based educational intervention aimed at supporting competence development for nursing assistants. The research objective is to evaluate the ACTION programme with respect to participants’ responses to and the effect of the intervention. Methods: A multicentre case–control study with pre- and post-assessments was designed. The ACTION programme will be implemented at home care units, in two different geographic areas in Sweden. A total of 300 nursing assistants will be recruited: 150 for the intervention group and 150 for the control group. We will evaluate the impact measures and the process. Pre- and post-assessments will be performed with data collected via a) audio recordings of communication, b) a questionnaire on self-efficacy communication skills, PCC, empathy and job satisfaction, c) user data, evaluation forms, field notes and observations, and d) interviews. The data will be analysed with descriptive and analytic statistics and/or qualitative methods for meanings. Discussion: This study has the potential to contribute to the evidence supporting competence development required to offer person-centred and quality home care to older persons and to meet upcoming needs for flexible and easily accessible competence development. Trial registration: ISRCTN64890826. Registered 10 January 2022, https://www.isrctn.com/ISRCTN64890826 
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27.
  • Johansson-Pajala, Rose-Marie, et al. (författare)
  • A codesigned web platform for reducing social isolation and loneliness in older people : a feasibility study
  • 2024
  • Ingår i: Informatics for Health and Social Care. - : Informa UK Limited. - 1753-8157 .- 1753-8165.
  • Tidskriftsartikel (refereegranskat)abstract
    • Social isolation and loneliness are associated with negative health outcomes, physical as well as cognitive. Information and communication technology (ICT) can be effective tools for preventing and tackling social isolation and loneliness among older people. Our objective was to evaluate the feasibility of the Fik@ room, a web platform for social interaction designed for older people. A mixed methods design was applied, where both quantitative and qualitative data were collected during a 12-week period (n = 28, Md age 74). Experiences of loneliness were reduced using the Fik@ room. The results highlight the feasibility issues surrounding the recruitment process, adoption, pattern of use, usability, support service, and technical infrastructure. In particular, the importance of offering ICT solutions with few technical issues, and to provide easily accessible and appropriate support. The Fik@ room is a feasible tool for older people to develop new friendships, reduce loneliness, and grow their social networks. However, it is not a communication option that fits all. The results offer a compilation of feasibility issues that can serve as an inspirational guide in the design and implementation of similar technologies. 
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28.
  • Johansson-Pajala, Rose-Marie, et al. (författare)
  • Anxiety and loneliness among older people living in residential care facilities or receiving home care services in Sweden during the COVID-19 pandemic : a national cross-sectional study
  • 2022
  • Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Older people were subjected to significant restrictions on physical contacts with others during the COVID-19 pandemic. Social distancing impacts older people’s experiences of anxiety and loneliness. Despite a large body of research on the pandemic, there is little research on its effects on older people in residential care facilities (RCF) and in home care services (HCS), who are the frailest of the older population. We aimed to investigate the effect of the first wave of the COVID-19 pandemic in March-May 2020 on experiences of anxiety and loneliness among older people living in RCF or receiving HCS and the impact of the progression of the pandemic on these experiences.Methods: A retrospective cross-sectional design using data from the national user satisfaction survey (March − May 2020) by the Swedish National Board of Health and Welfare. Survey responses were retrieved from 27,872 older people in RCF (mean age 87 years) and 82,834 older people receiving HCS (mean age 84 years). Proportional-odds (cumulative logit) model was used to estimate the degree of association between dependent and independent variables.Results: Loneliness and anxiety were more prevalent among the older persons living in RCF (loneliness: 69%, anxiety: 63%) than those receiving HCS (53% and 47%, respectively). Proportional odds models revealed that among the RCF and HCS respondents, the cumulative odds ratio of experiencing higher degree of anxiety increased by 1.06% and 1.04%, respectively, and loneliness by 1.13% and 1.16%, respectively, for 1% increase in the COVID-19 infection rate. Poor self-rated health was the most influential factor for anxiety in both RCF and HCS. Living alone (with HCS) was the most influential factor affecting loneliness. Experiences of disrespect from staff were more strongly associated with anxiety and loneliness in RCF than in HCS.Conclusion: Older people in RCF or receiving HCS experienced increasing levels of anxiety and loneliness as the first wave of the pandemic progressed. Older people’ mental and social wellbeing should be recognized to a greater extent, such as by providing opportunities for social activities. Better preparedness for future similar events is needed, where restrictions on social interaction are balanced against the public health directives.
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29.
  • Kerstis, Birgitta, 1963-, et al. (författare)
  • Changes in Mental Health and Views on Communication and Activities of Public Institutions among Swedes during the COVID-19 Pandemic—A Cross-Sectional Repeated Measures Design
  • 2021
  • Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 9:11
  • Tidskriftsartikel (refereegranskat)abstract
    • Although many studies have been conducted on the effects of COVID-19 on individual lives, only a few focus on the changes in mental health and views of public institutions during the pandemic. This study aimed to investigate how mental health, i.e., life satisfaction, worries, and psychological distress, and views on public institutions’ communication and activities have changed among Swedes during the COVID-19 pandemic, and whether this was moderated by age and sex. In April–May 2020 (survey 1) and in January–February 2021 (survey 2), 2554 adults and 1904 newly recruited adults, respectively, anonymously completed online surveys. We found that life satisfaction and psychological distress did not change from survey 1 to survey 2. However, the level of worries increased, and the positive views of the public institutions decreased. Moreover, worries and psychological distress increased more in young adults than older adults. Finally, the change in the views of the public institutions was not related to the change in worries. Our results highlight the COVID-19 long-term impacts on individual mental health and call for the need for future research concerning the consequences for the population, especially among young adults. The results also indicate that the views on activities of public authorities decreased over time, especially among men. Given that loss of this trust can have vastly negative effects, for instance, on the vaccine campaign, it is important to monitor this trend, to increase awareness among Swedish authorities. The results also stress for institutions to provide adequate support both during the COVID-19 pandemic and in a future crisis.
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30.
  • Kraiwong, Ratchanok, et al. (författare)
  • Effect of Sensory Impairment on Balance Performance and Lower Limb Muscle Strength in Older Adults With Tune 2 Diabetes
  • 2019
  • Ingår i: ANNALS OF REHABILITATION MEDICINE-ARM. - : KOREAN ACAD REHABILITATION MEDICINE. - 2234-0645 .- 2234-0653. ; 43:4, s. 497-508
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective To compare balance performance and lower limb muscle strength between older adults with type 2 diabetes mellitus (DM), with and without sensory impairments and non-DM groups. Influence of a number of sensory impairments, and muscle strength on balance performance were explored. Methods Ninety-two older adults with and without type 2 DM, were examined relative to visual function with the Snellen chart, Melbourne Edge test, and Howard-Dolman test, vestibular function with the modified Romberg test, proprioception of the big toe, and diabetic peripheral neuropathy with the Michigan Neuropathy Screening Instrument. Balance performances were evaluated with the Romberg test, Functional Reach Test (FRT), and Timed Up and Go test (TUG). Strength of knee and ankle muscles was measured. Results FRT of type 2 DM groups with at least two sensory impairments, was lower than the non-DM group (p<0.05). TUG of all DM groups, was worse than the non-DM group (p<0.01). Lower limb muscle strength of type 2 DM groups with two and three sensory impairments, was weaker than non-DM group (p<0.05). Regression analysis showed that type 2 DM with three sensory impairments, ankle dorsiflexors strength, and age were influential predictors of TUG. Conclusion There were significant differences, of muscle strength and balance performance among groups. Poorer balance and reduced lower limb strength were marked in older adults with type 2 DM, even ones without sensory impairment. Muscle weakness seemed to progress, from the distal part of lower limbs. A greater number of sensory impairments, weaker dorsiflexors, and advanced age influenced balance performance.
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31.
  • Lindberg, Daniel, 1976-, et al. (författare)
  • How Have Physical Activity and Sedentary Behavior, Changed during the COVID-19 Pandemic? A Swedish Repeated Cross-Sectional Design Study
  • 2023
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 20:4, s. 3642-3642
  • Tidskriftsartikel (refereegranskat)abstract
    • Physical activity (PA) and sedentary behavior (SB) affect people’s physical and mental health. The aim was to examine changes in PA and SB in a Swedish population: at three time points: 2019, 2020, and 2022, i.e., before and during the COVID-19 pandemic. Pre-pandemic PA and SB, i.e., 2019, were assessed retrospectively in 2020. Associations between PA and SB with sex, age, occupation, COVID-19 history, weight change, health, and life satisfaction were also examined. The design was repeated cross-sectionally. The main findings demonstrate the PA levels decreased between 2019 and 2020, and between 2019 and 2022, but not between 2020 and 2022. The SB increase was most evident between 2019 and 2020. Between 2020 and 2022, results showed a decrease in SB, but SB did not reach pre-pandemic levels. Both sexes decreased their PA over time. Although men reported more PA sex, they did not have any association with PA changes. Two age groups, 19–29 years and 65–79 years, decreased their PA over time. Both PA and SB were associated with COVID-19, occupation, age, life satisfaction, health, and weight change. This study underlines the importance of monitoring changes in PA and SB as they have relevance for health and well-being. There is a risk that the levels of PA and SB do not return to pre-pandemic levels in the population.
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32.
  • Nordgren, Lena, Docent, 1963-, et al. (författare)
  • The Mediating Role of Healthy Lifestyle Behaviours on the Association between Perceived Stress and Self-Rated Health in People with Non-Communicable Disease
  • 2022
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:19
  • Tidskriftsartikel (refereegranskat)abstract
    • Perceived stress can affect people's lifestyle behaviours and self-rated health. A balanced, healthy lifestyle can alleviate experiences of stress. For clinicians to use evidence-based and theory-based knowledge in health dialogues with people with non-communicable diseases, and in order to develop more effective behavioural counselling, more knowledge is needed. Hence, this study aimed to examine the mediating role of sedentary behaviour, daily physical activity, physical exercise, and dietary habits on the association between perceived stress and self-rated health in people with or without one to four self-reported non-communicable diseases (myocardial infarction, stroke, hypertension, diabetes). The study used a cross-sectional design. Responses from in total 10,583 individuals were collected in 2016 and 2019 by a self-report questionnaire. A series of simple and multiple regression analyses were conducted to examine the mediating effects of healthy lifestyle behaviours on the association between perceived stress and self-rated health. The results show that the investigated healthy lifestyle behaviours partly mediated the association between perceived stress and self-rated health in people with no diagnosis, and in people with one or two diagnoses. It can be concluded that healthy lifestyle behaviours could probably be targeted in relation to the number of noncommunicable diseases that the individuals have.
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33.
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34.
  • Sandborgh, Maria, 1955-, et al. (författare)
  • Integration of Behavioral Medicine Competencies into Physical Therapy Curriculum in an Exemplary Swedish Program : Rationale, Process and Ten-year Review
  • 2020
  • Ingår i: Physiotherapy Theory and Practice. - Philadelphia : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 36:3, s. 365-377
  • Forskningsöversikt (refereegranskat)abstract
    • In 2004, Mälardalen University, Sweden, introduced a new undergraduate entry-level physiotherapy program. Program developers constructed the curriculum with behavioral medicine content that reflected the contemporary definition and values of the physiotherapy profession aligning it with current best practices, evidence, and the International Classification of Functioning, Disability, and Health (ICF). The new curriculum conceptualized movement and function as modifiable behaviors in that they reflect behavioral contingencies, perceptions, beliefs, and lifestyle factors as well as pathophysiology and environmental factors. The purpose of this article is to describe how one university accordingly structured its new curriculum and its review. We describe the rationale for the curriculum's behavioral medicinecontent and competencies, its development and implementation, challenges, long-term outcomes, and its related research enterprise. We conclude that physiotherapy practiced by our graduates augments that taught in other programs based on accreditation reviews. With their expanded practice scope, graduates are systematically practicing within the constructs of health and function conceptualized within the ICF. Our intent in sharing our experience is to exemplify one university's initiative to best prepare students with respect to maximizing physiotherapy outcomes as well as establish a dialogue regarding minimum standards of behavioral medicine competencies in physiotherapy education and practice.
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35.
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36.
  • Söderlund, Anne, 1957-, et al. (författare)
  • Adherence to and the Maintenance of Self-Management Behaviour in Older People with Musculoskeletal Pain-A Scoping Review and Theoretical Models
  • 2021
  • Ingår i: Journal of Clinical Medicine. - : MDPI. - 2077-0383. ; 10:2, s. 1-25
  • Forskningsöversikt (refereegranskat)abstract
    • (1) Background: Adherence to and the maintenance of treatment regimens are fundamental for pain self-management and sustainable behavioural changes. The first aim was to study older adults' (>65 years) levels of adherence to and maintenance of musculoskeletal pain self-management programmes in randomized controlled trials. The second aim was to suggest theoretical models of adherence to and maintenance of a behaviour. (2) Methods: The study was conducted in accordance with the recommendations for a scoping review and the PRISMA-ScR checklist. Capability, motivation and opportunity were used to categorize the behavioural change components in the theoretical models. (3) Results: Among the four studies included, components targeting adherence were reported in one study, and maintenance was reported in two studies. Adherence was assessed by the treatment attendance rates, and maintenance was assessed by the follow-up data of outcome measures. For adherence, the capability components were mostly about education and the supervision, grading and mastery of exercise to increase self-efficacy. The motivation components included the readiness to change, self-monitoring and goal setting; and the opportunity components included booster sessions, feedback and social support. For maintenance, the capability components consisted of identifying high-risk situations for relapse and problem-solving skills. The motivation components included self-regulation and self-efficacy for problem solving, and the opportunity components included environmental triggers and problem solving by using social support. (4) Conclusion: There are several behavioural change components that should be used to increase older adults' levels of adherence to and maintenance of a pain self-management behaviour.
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37.
  • Thunborg, Charlotta, 1965-, et al. (författare)
  • Development of a new assessment scale for measuring interaction during staff-assisted transfer of residents in dementia special care units
  • 2015
  • Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 15:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundMobility problems and cognitive deficits related to transferring or moving persons suffering from dementia are associated with dependency. Physical assistance provided by staff is an important component of residents’ maintenance of mobility in dementia care facilities. Unfortunately, hands-on assistance during transfers is also a source of confusion in persons with dementia, as well as a source of strain in the caregiver. The bidirectional effect of actions in a dementia care dyad involved in transfer is complicated to evaluate. This study aimed to develop an assessment scale for measuring actions related to transferring persons with dementia by dementia care dyads.MethodsThis study was performed in four phases and guided by the framework of the biopsychosocial model and the approach presented by Social Cognitive Theory. These frameworks provided a starting point for understanding reciprocal effects in dyadic interaction. The four phases were 1) a literature review identifying existing assessment scales; 2) analyses of video-recorded transfer of persons with dementia for further generation of items, 3) computing the item content validity index of the 93 proposed items by 15 experts; and 4) expert opinion on the response scale and feasibility testing of the new assessment scale by video observation of the transfer situations.ResultsThe development process resulted in a 17-item scale with a seven-point response scale. The scale consists of two sections. One section is related to transfer-related actions (e.g., capability of communication, motor skills performance, and cognitive functioning) of the person with dementia. The other section addresses the caregivers’ facilitative actions (e.g., preparedness of transfer aids, interactional skills, and means of communication and interaction). The literature review and video recordings provided ideas for the item pool. Expert opinion decreased the number of items by relevance ratings and qualitative feedback. No further development of items was performed after feasibility testing of the scale.ConclusionsTo enable assessment of transfer-related actions in dementia care dyads, our new scale shows potential for bridging the gap in this area. Results from this study could provide health care professionals working in dementia care facilities with a useful tool for assessing transfer-related actions.
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38.
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39.
  • Thunborg, Charlotta, 1965- (författare)
  • Exploring dementia care dyads' person transfer situations from a behavioral medicine perspective in physiotherapy : development of an assessment scale
  • 2015
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Individuals who suffer from severe dementia require assistance when performing activities of daily living. The highly important person transfer situation is influenced by complex, intertwined biopsychosocial factors that are related to the expression of personal, environmental and behavioral variables, which can interfere with the performance of dementia-care dyads' transfer situations.The overall aim of this study was to leverage a behavioral medicine perspective in physiotherapy to explore, intervene in, and develop an assessment scale for problematic person transfer situations including persons with dementia and the interaction with the caregiver in these transfer situations.Interviews were performed with ten caregivers who were recruited to two focus groups and worked in a special care unit for persons with dementia; interviewees described their experiences pursuant to assisting persons with dementia in transfer situations (I).Literature review and video recordings elicited 93 possible items for the new scale. Expert opinions and item-content validity index reduced the number of items to 17 that spanned two areas. Eight items related to the actions of persons with dementias, whereas nine related to caregiver actions. The feasibility testing of the scale in eight person transfer situations showed that the scale was ready for inter- and intra-rated reliability testing (II). Inter- and intra- rater reliability was good (III). In two single-case experimental design studies, the new scale was shown to contribute to a substantial gathering of data on behaviors in care dyads' person transfer situations (IV). In summary, the results of the thesis show that person transfer situations in dementia special care units are influenced by different biopsychosocial factors and that the new assessment scale can support decision-making about treatment strategies. These findings are important in promoting evidence-based behavior change strategies that can facilitate both sets of individuals—i.e., both persons with dementia and caregivers—in transfer situations. The results highlight important research issues that merit attention in future studies.
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40.
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41.
  • Thunborg, Charlotta, 1965-, et al. (författare)
  • Functional behaviour analysis guided interventions might improve transferrelated behaviour in dementia care dyads: a single case study
  • 2020
  • Ingår i: European Journal of Physiotherapy. - Abingdon : TAYLOR & FRANCIS LTD. - 2167-9169 .- 2167-9177. ; 22:1, s. 20-28
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Impaired mobility in people with severe dementia is well known. Physical therapists play a key role in guiding professional caregivers on how to handle mobility and transfer-related problems; however, it is unknown how to handle the complexity of dementia-related impaired endurance, joint dysfunction, balance, and gait dysfunction and at the same time, take into consideration the person's decreased cognition, communication deficits, and behaviour problems.Aims and methods: The aim was to explore the effectiveness and efficiency of functional behaviour analysis (FBA) guided interventions of dyadic transfer-related behaviour in dementia care dyads. An experimental single-case research design was used. Two care dyads participated. Different methods of assessment were performed to gather the dyadic transfer-related behavioural problems. Transfers were recorded by video uptakes and to generate a hypothesis about dyadic transfer-related behavioural problems, the Dyadic Interaction in Dementia Transfer Assessment Scale (DIDTAS) was used.Results: The problematic transfer-related behaviour in care dyad 1 changed positively, as reflected by a decrease in discomfort verbally expressed by the person with dementia. A trend towards increased cooperation was observed among caregivers assisting in the transfer situation. In care dyad 2, a trend towards increased caregiver self-efficacy (SE) was observed between the baseline and completed intervention phases. The decreased resistiveness to care (RTC) exhibited by the person with dementia paralleled the increase in caregiver SE.Conclusion: Considering the findings of this explorative study, physical therapists could consider the development of tailored interventions guided by an FBA for complex dyadic transfer-related behavioural problems in dementia care dyads.
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42.
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43.
  • Thunborg, Charlotta, et al. (författare)
  • Reciprocal struggling in person transfer tasks : Caregivers’ experiences in dementia care
  • 2012
  • Ingår i: Advances in Physiotherapy. - : Informa Healthcare. - 1403-8196 .- 1651-1948. ; 14:4, s. 175-182
  • Tidskriftsartikel (refereegranskat)abstract
    • This study describes caregivers’ experiences of person transfer situations involving people with dementia. Method: Qualitative focus group interviews were conducted with a total of 10 caregivers; two groups with five persons each, including two men and eight women. The resulting data were extracted and condensed into meaning units and codes using content analysis. Findings: One main theme was formulated that represents the caregivers’ experiences of person transfer situations involving people with dementia: “Reciprocal struggle in person transfer tasks”. Five categories were formulated: “Becoming familiar and making contact”, “Risking one's own body to protect the resident from injury”, “Focused yet aware of the surroundings”, “Identifying needs to facilitate the person transfer” and “Struggling to be understood”. Conclusion: Person transfer situations involving people with dementia are subject to sudden changes. The ongoing challenge is to ensure a dynamic approach that can be adapted to the needs of the person with dementia at any given time. There is a need for more studies within the field about care and rehabilitation among people with dementia. We suggest that assessment of person transfer situations involving people with dementia and their caregivers is an important issue for further investigation and physiotherapeutic interventions.
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44.
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45.
  • von Heideken Wågert, Petra, 1977- (författare)
  • Editorial
  • 2014
  • Ingår i: European Journal of Physiotherapy. - : Informa Healthcare. - 2167-9169 .- 2167-9177. ; 16:4, s. 193-193
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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46.
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47.
  • von Heideken Wågert, Petra, Docent, 1977-, et al. (författare)
  • Everyday life in older men living alone - a complex view needing a biopsychosocial perspective
  • 2020
  • Ingår i: Disability and Rehabilitation. - ABINGDON : TAYLOR & FRANCIS LTD. - 0963-8288 .- 1464-5165. ; 42:1, s. 44-52
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To explore how older men living alone, describe their everyday activities and their abilities as well as how they could be helped in everyday life.MATERIALS AND METHODS: Qualitative semi-structured interviews were analysed with inductive content analysis. Eight men aged 65+ years were included. They were all living alone, albeit with home help services. They were able to walk and had sufficient cognitive ability.RESULTS: The analysis resulted in one theme "A driving force of managing activities and overcome hindering factors requires a broad spectrum of prerequisites for participating in everyday life" with the following four categories: Importance of everyday activities; individual prerequisites enabling everyday activities; body and mind inhibit, and react to the decreased, abilities; and importance of the environment.CONCLUSIONS: The results generate a complex view of older men's everyday life. It is important for older men's independence that health care and rehabilitation staff adopt a comprehensive view and work from a biopsychosocial (BPS) perspective. Implications for rehabilitation To be an older man living alone might mean a decreased health and good health is a strong predictor for increased abilities in everyday activities. The living situation of older men living alone is not well studied and needs to be explored to a greater extend, especially from their own perspective. An interaction of biological, psychological, and social factors was expressed as important for older men's everyday life, in accordance with the biopsychosocial (BPS) model. The expressed importance of participation as well as performing both physical and social activities reflects the need of individualised goals in rehabilitation according to the behavioural medicine approach. It is of outmost importance that health care and rehabilitation staff in contact with this group has a comprehensive view and works from a biopsychosocial (BPS) perspective, for maintenance of the older men's independence in everyday life.
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48.
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49.
  • von Heideken Wågert, Petra, et al. (författare)
  • Falls in very old people : the population-based Umeå 85+ Study
  • 2009
  • Ingår i: Archives of gerontology and geriatrics (Print). - Clare : Elsevier. - 0167-4943 .- 1872-6976. ; 49, s. 390-396
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to describe incidences of falls and fall-related injuries, and to identify predisposing factors for falls in very old people in a prospective population-based follow-up study for falls. The study is part of the Umeå 85+ Study which includes half of the population aged 85, and the total population aged 90 and ≥95 (−103), in Umeå, Sweden. Of the 253 people interviewed, 220 (87%) were followed up for falls for 6 months, of whom 109 lived in ordinary and 111 in institutional housing. A comprehensive geriatric baseline assessment was made through interviews and testing during home visits. Forty percent of the participants did fall a total 304 times, corresponding to 2.17 falls per Person Year (PY). It occurred 0.83 injuries per PY, including 0.14 fractures per PY. In a Cox regression analysis, the independent explanatory risk factors for time to first fall were dependency in activities of daily living (ADL), thyroid disorders, treatment with selective serotonin reuptake inhibitors (SSRIs) and occurrence of falls in the preceding year. It could be predicted that every seventh participant and every third of the people who did fall would suffer a fracture within 1 year. ADL, thyroid disorders and treatment with SSRIs should be considered in fall prevention programmes.
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50.
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