| 1. |
- Persson, Hanna C, 1979, et al.
(author)
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Consequences and coping strategies six years after a subarachnoid hemorrhage - A qualitative study
- 2017
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In: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 12:8
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Journal article (peer-reviewed)abstract
- Background After a subarachnoid haemorrhage (SAH), continuing impairment is common and may impact the person's life. There is a lack of knowledge regarding long-term consequences experienced. To explore experiences of the care and rehabilitation as well as the consequences and strategies used to cope with everyday life six years post SAH. An explorative interview study with a qualitative design. Individual interviews, with open ended questions, using an interview guide were performed with sixteen participants (mean age 63, 8 men, 8 women) six years post SAH. Data was analyzed according to a descriptive thematic analysis, and themes were discovered inductively. Two major themes from the analysis, both including four sub-themes, were identified; these themes were consequences of the SAH and coping strategies. Participants were grateful to have survived the SAH and most were satisfied with their acute medical care. If discharged directly from the neurosurgical unit participants can feel abandoned. In contrast, participants who were referred to a rehabilitation clinic felt supported and informed. Cognitive problems, such as impaired memory and mental fatigue, were reported as still present six years post SAH. Coping strategies were; receiving support from family, society, employers, or technical equipment. At work, talking to colleagues and to taking breaks were common. Participants described hiding their symptoms from employers and friends, as well as trying to continue doing tasks in the same manner as prior to the SAH. If this was not possible, some refrained from doing these tasks. They went through a mourning process, fear, and worries. Participants reported several long-term consequences which impacted on their daily lives post SAH, and different coping strategies were used to cope with these problems. Participants reported lack of awareness regarding the consequences of SAH and stressed the importance of structured multidisciplinary follow-ups, which mostly is missing.
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| 2. |
- Törnbom, Karin, 1982, et al.
(author)
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Experiences of participation in a Swedish society among adults with cerebral palsy or spina bifida: involvement and challenges.
- 2013
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In: Journal of social work in disability & rehabilitation. - 1536-7118. ; 12:4, s. 256-71
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Journal article (peer-reviewed)abstract
- Participation in society is vital to mental health and is beneficial to individuals and society. The goal of this study was to provide insight into how people with cerebral palsy and spina bifida view their experiences of participation and to examine factors that might influence this issue. The results show that participants emphasized the importance of being accepted and treated equally. Living independently and being able to play an active and leading role in their lives was also essential. Participation was described as a process of interaction between a person and society, with mutual responsibility in respect to integration.
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| 3. |
- Törnbom, Karin, 1982, et al.
(author)
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Swedish Citizens with Cerebral Palsy or Spina Bifida – Perceived Experiences of Social Life and Employment
- 2017
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In: Review of disability studies: an international journal. - 1552-9215. ; 13:1, s. 47-63
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Journal article (peer-reviewed)abstract
- This article offers insight into the ways in which people with cerebral palsy and spina bifida reflect upon their experiences of participation in relation to social life and employment. The qualitative method was used to explore experiences of participation among adults with CP or SB, using semi structured interviews. Participants expressed a desire to make a contribution to the labor market, to have sustainable relationships and to be accepted by others.
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| 4. |
- Björkelund, Cecilia, 1948, et al.
(author)
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Rehabilitation cooperation and person-centred dialogue meeting for patients sick-listed for common mental disorders: 12 months follow-up of sick leave days, symptoms of depression, anxiety, stress and work ability - a pragmatic cluster randomised controlled trial from the CO-WORK-CARE project.
- 2023
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In: BMJ open. - 2044-6055. ; 13:6
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Journal article (peer-reviewed)abstract
- To study whether early and enhanced cooperation within the primary care centres (PCC) combined with workplace cooperation via a person-centred employer dialogue meeting can reduce days on sick leave compared with usual care manager contact for patients on sick leave because of common mental disorders (CMD). Secondary aim: to study lapse of CMD symptoms, perceived Work Ability Index (WAI) and quality of life (QoL) during 12 months.Pragmatic cluster randomised controlled trial, randomisation at PCC level.28 PCCs in Region Västra Götaland, Sweden, with care manager organisation.30 PCCs were invited, 28 (93%) accepted invitation (14 intervention, 14 control) and recruited 341 patients newly sick-listed because of CMD (n=185 at intervention, n=156 at control PCCs).Complex intervention consisting of (1) early cooperation among general practitioner (GP), care manager and a rehabilitation coordinator, plus (2) a person-centred dialogue meeting between patient and employer within 3 months.regular contact with care manager.12 months net and gross number of sick leave days at group level.12 months depression, anxiety, stress symptoms, perceived WAI and QoL (EuroQoL-5 Dimensional, EQ-5D).No significant differences were found between intervention and control groups concerning days of sick leave (intervention net days of sick leave mean 102.48 (SE 13.76) vs control 96.29 (SE 12.38) p=0.73), return to work (HR 0.881, 95%CI 0.688 to 1.128), or CMD symptoms, WAI or EQ-5D after 12 months.It is not possible to speed up CMD patients' return to work or to reduce sick leave time by early and enhanced coordination among GP, care manager and a rehabilitation coordinator, combined with early workplace contact over and above what 'usual' care manager contact during 3 months provides.NCT03250026.
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| 5. |
- Danielsson, Anna, 1957, et al.
(author)
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Experience of treadmill walking and audio-visual feedback after brain injury
- 2016
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In: ACPIN-INPA International Neurophysiotherapy Conference, London UK, 17-18 March 2016.
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Conference paper (other academic/artistic)abstract
- Background People with stroke often have a low physical activity level and finding ways to motivate people to become more physically active is highly important. Using virtual reality in rehabilitation has shown positive effects, however knowledge about patients’ perceptions of this type of training is needed. Purpose To explore mental and physical experiences of treadmill walking and audio – visual (AV) feedback after brain injury. Method Three woman and seven men (median age 51) with stroke/other brain injury were interviewed after walking on a treadmill with and without AV- feedback mediated as follows: the speed of a realistic movie projecting a walking path, with nature sounds and step rhythm sounds, (through earphones) were directed by software connected to movement sensors donned to the legs. Semi structured interviews were audio recorded, transcribed and analysed using qualitative content analysis (QCA). Interviews were read by both authors and a coding scheme based on key concepts related to the research questions was developed. All codes were retrieved in the interviews and grouped into categories. To catch the latent meaning, categories were formulated into themes. Results Themes comprised positive and negative experiences. Participants experienced treadmill walking as enjoyable. The AV- feedback was mainly considered as pleasurable and exiting. Patients with mental weariness were ambivalent and found the AV-feedback more or less disturbing. Therefore, they considered the experience to be too exhausting in this early stage of rehabilitation. No fall incidents occurred but patients with balance problems using hand support reported tiredness in the hand. Conclusions In general, participants liked and found this inexpensive AV –feedback motivating and more enjoyable than ordinary treadmill walking. However, to avoid perceptional overload the amount of stimuli provided should be adjusted to the each individual. Further studies are needed to investigate if AV-feedback can be used to increase exercise intensity.
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| 6. |
- Danielsson, Anna, 1957, et al.
(author)
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Experiences of treadmill walking and audio-visual feedback after stroke – an interview study
- 2017
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In: Nordic Stroke 2017. 19th Nordic Congress on Cerebrovascular Diseases, August 23-25, Aarhus, DK.
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Conference paper (other academic/artistic)abstract
- Introduction: Walking training after stroke is highly important and a high intensity is recommended. As in-patients rarely reach the recommended physical activity level, finding ways to motivate exercise is therefore a key issue in rehabilitation. Offering a variety of training methods e.g by using virtual reality, could be one option to increase exercise intensity. The purpose of the study was to explore how patients’ with stroke experience treadmill walking with a prototype for audio – visual (AV) feedback. Methods: Three woman and five men, with a median age of 52, undergoing walking training, participated during inpatient rehabilitation 2-10 months after stroke. They walked for two sessions of up to 30 minutes on a treadmill at self-selected speed, with and without AV- feedback, respectively. The AV-feedback was mediated through a realistic movie of a walking path displayed on a TV-screen. Movement sensors donned to the legs connected to software, directed the speed of the movie. In addition, nature sounds and the individual’s step rhythm were mediated through headphones. After the walking session the participants took part in an individual interview regarding their experience walking with and without the AV-feedback. Semi structured interviews were audio recorded, transcribed and analysed using qualitative content analysis. Interviews were read by both authors and a coding scheme based on key concepts related to the research questions was developed. All codes were retrieved in the interviews, grouped into categories and finally formulated into themes. Results: Three main themes; positive, negative and ambivalent experiences, were expressed. The AV- feedback was mainly considered as enjoyable, engaging and made walking on the treadmill more interesting than without. Some participants experienced dizziness and those sensitive to mental overload found parts of the feedback more or less wearing. No fall incidences occurred but patients with more pronounced balance problems reported physical fatigue in their supporting hand. Conclusions: In general, participants liked and found this inexpensive AV –feedback motivating and enjoyable. Yet, the individual’s capacity has to be taken into account when adding perceptional stimuli during treadmill walking. The additional value of virtual feedback aiming to increase exercise intensity ought to be further explored.
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| 7. |
- Danielsson, Anna, 1957, et al.
(author)
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VIEWS AND EXPERIENCES OF PHYSICAL TRAINING IN PEOPLE WITH STROKE OR OTHER BRAIN INJURY
- 2016
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In: 20th European Congress of Physical and Rehabilitation Medicine, Estoril Portugal 23-28 April 2016.
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Conference paper (other academic/artistic)abstract
- Introduction Physical activity after stroke promotes neuroplasticity, physical functions, daily activities, health and well-being. People with stroke are shown to be less active than healthy controls which is a risk for decline in function as well as getting a new cardiovascular event. To improve guidance further knowledge regarding attitudes and factors significant for physical activity is needed. Purpose To explore participants’ experiences of physical activity after stroke or other brain injury. Method Ten semi structured interviews were analysed, using qualitative content analysis. Interviews were read several times by the authors and a coding scheme based on key concepts related to the research questions was developed. All codes retrieved from the interviews were grouped into categories. To catch the latent meaning, categories were formulated into themes. Three woman and seven men with a median age of 51 years undergoing rehabilitation after stroke (n=7) or other brain injury (n=3) were interviewed. Results Three themes were identified: 1.The participants had mixed experiences and views on the significance of physical activity prior to injury. 2. After injury they experienced a new situation and saw exercise as a duty. Physical activity after injury was limited to short walks a few times a week. 3.Factors of importance for executing physical activity: Advice and support from a physiotherapist or other professionals were highlighted as very important. Support from significant others, fellow patients and to see progression towards set goals contributed as motivating factors. Physical and mental factors, especially balance and walking impairments as well as fatigue and lack of motivation were perceived as hindering. Discussion and Conclusions After injury, physical activity was perceived as filled with demands, a necessary evil to achieve as good function as possible. Dependence on security in the training situation, support and push from professionals and relatives were evident.
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| 8. |
- Engwall, Marie, 1964, et al.
(author)
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Recovering from COVID-19 - A Process Characterised by Uncertainty: A Qualitative study.
- 2022
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In: Journal of rehabilitation medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 54
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Journal article (peer-reviewed)abstract
- To obtain a deeper understanding of the lived experiences of patients with COVID-19, the recovery process and consequences for everyday life 6 months after hospital discharge.An explorative qualitative study using individual interviews.A purposive sampling was applied to recruit persons who had received inpatient hospital care, were discharged approximately 6 months previously, were of working age and had persistent self-reported symptoms at a 3-month follow-up appointment.Semi-structured interviews were conducted with 15 participants (10 men, 5 women), which were then transcribed and analysed with inductive thematic analysis.Three themes were identified: "Status of recovery - two steps forward, one step back", "Remaining symptoms caused limitations in everyday life" and "Strategies for recovery". Participants indicated the recovery process through 6 months after discharge was a challenging road, often involving setbacks. A wide range of persistent, fluctuating, or new symptoms negatively impacted many areas of daily life, with fatigue and lack of energy being especially prominent. Participants used a variety of strategies to cope and recover.This study increases our knowledge of the lived experiences of COVID-19 based individual experiences. Unexpected symptoms in the recovery process were described and not always possible to forecast.
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| 9. |
- Larsson, Alexandra C, 1986, et al.
(author)
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Figuring Out Life After Covid-19 : a Qualitative Study From Sweden
- 2023
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In: Journal of Rehabilitation Medicine. - 1650-1977 .- 1651-2081. ; 55
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To obtain a deeper understanding of the daily life experiences of working aged people during the year following hospitalization due to SARS-CoV-2 (COVID-19), with a focus on function-ing in daily life and return to work.DESIGN: An explorative qualitative study using individual interviews.SUBJECTS: A purposive sample was selected of persons who had received inpatient hospital care, had been discharged approximately 1 year previously and were of working age.METHODS: Semi-structured interviews were conducted with 11 participants (9 men, 2 women). The interviews were transcribed and analysed with inductive thematic analysis.RESULTS: Four themes were identified. Navigating health, with or without support from healthcare, was described as challenging when managing consequences of COVID-19. Participants struggled with a lack of energy that interfered with daily life. It was a trial-and-error process trying to use familiar strategies in new ways to manage. The return to work process was facilitated by own strategies and support.CONCLUSION: This study contributes increased knowledge of everyday life experiences of people 1 year following hospitalization due to COVID-19. The lack of energy and a struggle to manage health while navigating the healthcare system emphasize the importance of strengthening personal and organizational health literacy to facilitate the recovery process after severe COVID-19.
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| 10. |
- Nejati, Shabnam, 1972, et al.
(author)
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How can care managers strengthen health literacy among patients with common mental disorders? A qualitative study
- 2023
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In: Scandinavian journal of caring sciences. - 1471-6712. ; 37:3
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Journal article (peer-reviewed)abstract
- In order for persons with mental illness to be able to promote and preserve their health, sufficient knowledge about health is required. An effective means to improve the health of the patients is to strengthen their health literacy. The aim of this study was to explore how care managers work with health literacy in patients with common mental disorders to help them to better understand and manage their illness.A qualitative study was conducted, using written reports from 25 care managers regarding meetings with patients with common mental disorders in the primary care in a Swedish region. The care managers' reports were coded based on Sörensen's four dimensions for the domain "health care" and analysed deductively through systematic text condensation according to Malterud.The care managers described how they worked strategically and continuously with follow-up and wanted to be responsive to the patients' stories. They confirmed the patients' feelings with the goal of creating increased interaction, thereby involving the patients in their own care. The care managers also worked actively to provide well-balanced care at an early stage. Using various tools such as self-assessment instruments, the care manager started from the patient's basic problem, gave support and discussed strategies based on the patient's condition and situation.The care managers used multifaceted health literacy interventions. They worked in a person-centred, strategic and encouraging manner based on the patient's unique conditions, where sensitivity and adapted information were important aspects. The aim of the interventions was for the patients to become knowledgeable, gain new insights and work independently with their own health.
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| 11. |
- Petersson, Eva-Lisa, et al.
(author)
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Process evaluation of the CO-WORK-CARE model : Collaboration and a person-centred dialogue meeting for patients with common mental disorder in primary health care
- 2024
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In: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712.
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Journal article (peer-reviewed)abstract
- Rationale: To ensure optimal patient care based on evidence, it is crucial to understand how to implement new methods in practice. However, intervention studies often overlook parts of the implementation process. A comprehensive process evaluation is necessary to understand why interventions succeed or fail in specific contexts and to integrate new knowledge into daily practice. This evaluation examines the full implementation of the Co-Work-Care model in Swedish primary healthcare to identify strengths and weaknesses. Aim: This study aimed to evaluate the process of implementing the CO-WORK-CARE model that focuses on close collaboration and the use of a person-centred dialogue meeting in primary healthcare for patients on sick leave due to common mental disorders. Method: The CO-WORK-CARE model emphasises collaboration among the GP, rehabilitation coordinator and care manager, along with person-centred dialogue meetings involving employers. Following UK Medical Research Council guidelines, we conducted a process evaluation. Data from previous studies were reanalysed. We also analysed field notes and meeting notes using Malterud's qualitative method. Results: The evaluation identified key facilitators for model implementation, including regular visits by facilitators and guidance from the research physician. Peer support meetings also bolstered implementation. However, challenges emerged due to conflicts with existing structures and limitations in person-centred dialogue meetings. Conclusion: Adapting the CO-WORK-CARE model to Swedish primary care is feasible and beneficial, with collaboration among the care manager, rehabilitation coordinator and GP and person-centred dialogue meetings. Thorough preparations, ongoing facilitator and peer support and integrated information enhanced implementation efficiency, despite challenges posed by existing structures.
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| 12. |
- Petersson, Eva-Lisa, et al.
(author)
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The experiences of care managers and rehabilitation coordinators of a primary care intervention to promote return to work for patients with common mental disorders: a qualitative study.
- 2020
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In: BMC family practice. - : Springer Science and Business Media LLC. - 1471-2296. ; 21:1
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Journal article (peer-reviewed)abstract
- In an earlier study, PRIM-CARE RCT, a care manager implementation at the primary care centre showed improved return to work and reduced sick leave for patients with CMD. To further improve return to work, the project Co-Work-Care added a person-centered dialogue meeting between the patient, the employer and the rehabilitation coordinator, preceded by an increased collaboration between care manager, rehabilitation coordinator and GP. In this first qualitative study of the Co-Work-Care project, we explored how care managers and rehabilitation coordinators experienced the Co-Work-Care model. The purpose of this study was to explore care managers' and rehabilitation coordinators' perceptions and experiences of a close collaboration and the use of the person-centred dialogue meeting.From an ongoing RCT with 20 primary care centres, care managers (CMs) (n=13) and rehabilitation coordinators (RCs) (n=12) participated in a qualitative study with focus groups. The study was conducted in the primary health care in a Swedish region. The data was analysed with Systematic Text Condensation by Malterud.Seven codes describing the participants' experiences of the Co-Work-Care model were identified: 1) The importance of collaboration at the primary care centre, 2) Collaboration and division of roles between the RC and the CM, 3) Collaboration with the General practitioner (GP), 4) The person-centred dialogue meeting, 5) Initiating the person-centred dialogue meeting, 6) The person-centred dialogue meeting to improve collaboration with the employer, and 7) The person-centred dialogue meeting to teach about the return to work process.The increased collaboration within the Co-Work-Care model created a common picture and understanding of the patient's situation. The person-centred dialogue meeting in the rehabilitation process became a bridge between the employer and the patient.NCT03250026 (registered August 15, 2017).
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| 13. |
- Saxvik, Ausra, et al.
(author)
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Experiences of patients with common mental disorders concerning team-based primary care and a person-centered dialogue meeting: An intervention to promote return to work.
- 2022
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In: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 17:7
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Journal article (peer-reviewed)abstract
- Common mental disorders in combination with work-related stress are widespread in the western world, not least in Sweden. Various interactive factors, primarily work-related, have impact on the return to work process, for example; a supportive communicative function between the person on sick leave and the employer may facilitate this process. The aim was to investigate experiences of being part of a collaborative care model including a person-centered dialogue meeting with the employer and with a rehabilitation coordinator as the moderator.A qualitative design based on individual interviews with 13 persons diagnosed with common mental disorders who participated in an extensive collaborative care model, called the Co-Work-Care model. Persons were recruited as a heterogeneous sample with respect to age, gender, work background, and time since the intervention. All interviews were analyzed with Systematic Text Condensation.Five codes synthesized the results: 1) A feeling of being taken care of, 2) Collaboration within the team was perceived as supportive, 3) An active and sensitive listener, 4) Structure and planning in the dialogue meeting, 5) The person-centered dialogue meeting was supportive and provided increased understanding.Participants experienced the close collaborative contact with the care manager and the rehabilitation coordinator as highly valuable for their rehabilitation process. Participants valued a well-structured dialogue meeting that included initial planning and a thorough communication involving the patient, the employer, and coordinator. Further, participants appreciated having an active role during the meeting, also empowering the return to work process.
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| 14. |
- Saxvik, Ausra, et al.
(author)
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"Gaining control through close collaboration" - GPs' experiences of a Collaborative Care Model for patients with Common Mental Disorders who need sick leave certification.
- 2022
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In: BJGP open. - 2398-3795. ; 6:4
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Journal article (peer-reviewed)abstract
- General Practitioners (GPs) are an important part of collaboration around patients with common mental disorders in primary care. To further improve collaboration, the model Co-Work-Care was implemented, which emphasised working more closely with patients through active dialogues among care managers, rehabilitation coordinators and GPs. This enhanced collaborative model also included a person-centred dialogue meeting with patients' employers.To explore GPs' experiences of the Co-Work-Care model - a collaborative care organisation at the primary care centre including a person-centred dialogue meeting in the care of patients with common mental disorders who need sick leave certification.Qualitative individual and group interviews among Swedish GPs with experience of the Co-Work-Care trial where the primary care centre (PCC) was an intervention PCC with the enhanced collaboration model.GPs were sampled purposefully from different Co-Work-Care intervention PCCs in Sweden. Focus group and individual in-depth semi-structured interviews were conducted. All interviews were analysed by Systematic Text Condensation according to Malterud.Three codes describing the GPs' experiences of working in the Co-Work-Care model were identified: 1) A structured work approach, 2) Competency of the care manager and the rehabilitation coordinator, and 3) Gaining control through close collaboration.Overall, GPs experienced that the enhanced collaboration reduced their workload and enabled them to focus on the medical care. Patient care was perceived as safer and more effective. These advantages may result in higher quality in medical and rehabilitation decisions, as well as a more sustainable and less stressful work situation for GPs.
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| 15. |
- Törnbom, Karin, 1982, et al.
(author)
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Back to life: Is it possible to be myself again? A qualitative study with persons initially hospitalised due to COVID-19.
- 2022
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In: Journal of rehabilitation medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 54
-
Journal article (peer-reviewed)abstract
- To gain a deeper understanding of the lived experiences of patients with COVID-19, regarding rehabilitation, work and social life 6 months after hospital discharge.An explorative qualitative study with individual interviews.Patients of working age with persistent self-reported symptoms at a 3-month follow-up who had received inpatient hospital care with discharge approximately 6 months previously were purposively sampled.Semi-structured interviews were performed with 10 men and 5 women. The interviews were transcribed verbatim and analysed with inductive thematic analysis.Four themes were identified: "Social support - crucial, but decreased over time", "Varying needs of, and access to, rehabilitation", "Returning to work after COVID-19 - crucial for future prospects" and "An overwhelming experience that essentially changed one's personality".Rehabilitation provided participants with the valuable tools for recovery, giving them hope for future recovery. Support from next of kin was highly valued, creating stronger family bonds. A new meaning and greater appreciation of life was expressed.
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| 16. |
- Törnbom, Karin, 1982, et al.
(author)
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Defining the undefined: understanding an ongoing project aimed at formalizing the assignment and use of theory and methods of health social workers
- 2024
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In: NASSW/FORSA 2024 Research Conference; Social Work as Emancipatory Practice: Creating Pathways towards Social Justice.
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Conference paper (other academic/artistic)abstract
- This research project focuses on health social workers´ (HSWs) work-methods, theoretical inspiration, and epistemic contribution. The empirical material consists of four focus group interviews with HSWs, and two group interviews with a manager and two HSWs with a specialist function, at a hospital in Sweden. The interviews were held at two occasions, in December 2022 and in April 2023. During this time, the HSWs were active in a project emanating from the managers experience of finding it difficult to answer questions about how the HSWs knew that their work had the desired outcomes. Additionally, there was uncertainty about how to know when work-methods used were supported by research. The analytical focus of this research was directed at gaining a deeper understanding of HSWs' work-methods and theoretical inspirations, as well as to analyze the HSWs' understanding of the project in relation to the theoretical concepts of discretion and epistemic hierarchies. The presentation directs attention to overarching questions of how the HSWs discuss differences and similarities among themselves and explores how they articulate understandings of their work, with an overall focus on the professionalization of this subgroup in social work. This is particularly interesting as HSWs, as the first group of social workers in Sweden, have been granted a professional license requiring a one-year Masters´ level specialist education.
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| 17. |
- Törnbom, Karin, 1982, et al.
(author)
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Experiences of treadmill walking with non-immersive virtual reality after stroke or acquired brain injury - A qualitative study.
- 2018
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In: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 13:12
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Journal article (peer-reviewed)abstract
- It is well known that physical activity levels for persons after stroke or acquired brain injuries do not reach existing recommendations. Walking training is highly important since the ability to walk is considered to be a meaningful occupation for most people, and is often reduced after a brain injury. This suggests a need to innovate stroke rehabilitation, so that forms of walking training that are user-friendly and enjoyable can be provided.An interview study was carried out with persons after stroke (n = 8), or acquired brain injury (n = 2) at a rehabilitation unit at Sahlgrenska University Hospital. We used a semi-structured interview guide to investigate experiences and thoughts about walking on a treadmill with non-immersive virtual reality feedback. The contents were analyzed through an inductive approach, using qualitative content analysis.The virtual reality experience was perceived as enjoyable, exciting, and challenging. Participants stressed that the visual and auditory feedback increased their motivation to walk on a treadmill. However, for some participants, the virtual reality experience was too challenging, and extreme tiredness or fatigue were reported after the walking session.Participants' thoughts and experiences indicated that the Virtual Reality walking system could serve as a complement to more traditional forms of walking training. Early after a brain injury, virtual reality could be a way to train the ability to handle individually adapted multisensory input while walking. Obvious benefits were that participants perceived it as engaging and exciting.
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| 18. |
- Törnbom, Karin, 1982, et al.
(author)
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Long-term participation 7-8 years after stroke: Experiences of people in working-age.
- 2019
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In: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 14:3
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Journal article (peer-reviewed)abstract
- To enhance the understanding of long-term participation in working-aged people 7-8 years after stroke.This study had a qualitative design, using a thematic analysis methodology. Eleven individuals took part in an in depth interview 7-8 years after a first time stroke. They had received care at the Sahlgrenska University Hospital in Gothenburg, and were recruited as a heterogenic sample with respect to age, gender, stroke severity and subtype.From the participants' experiences four themes emerged: "Returning to work after stroke"; "Working life 7-8 years after stroke"; "Social life 7-8 years after stroke"; and "A state of reorientation in life". Quotes about experienced participation in everyday life were summarized and presented as "Participation after stroke narratives". Participants chose to emphasize on work- and social life when describing situations of successful participation. Being included in the wider community and having a sense of purpose, when interacting with others, were factors that these narratives had in common. Participants had gradually become accustomed to a somewhat altered life situation. Some consequences after stroke were still considered frustrating in social or work situations. However, the importance of these issues had reduced and were no longer problematized.Participants felt content with their everyday life in general, which was a principal and positive result of this study. Reaching a stage of acceptance seemed to be a complex and continuous struggle, and an individual approach in long-term rehabilitation would be valuable to support this personal process. More knowledge about what factors that facilitate participation in people of working-age many years after stroke is needed, so that more people can reach a state of positive identity and participation.
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| 19. |
- Törnbom, Karin, 1982, et al.
(author)
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”My life after stroke through a camera lens” – A Photovoice study on participation in Sweden
- 2019
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In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:9
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Journal article (peer-reviewed)abstract
- Background An increasing number of people with stroke live in their communities, yet the understanding of how their reintegration into society can best be facilitated is incomplete. If needs are not sufficiently met and difficulties overcome, it may result in limited participation and decreased life satisfaction for this group. We aimed to understand life after stroke through the lens of participants’ cameras, and hence their views and experiences guided this study. Methods By the means of photovoice, an action research method, this study was conducted in a collaborative format with six women and five men after stroke. Participants photographed in everyday life for up to four weeks and then met to discuss all images in a focus group setting. Subsequently, participants gave feedback on the method and discussed the upcoming photography exhibition. All photos and the three focus group discussions were analyzed using a thematic analysis with an inductive approach. Results In the focus group discussions, life after stroke were conceptualized through five main themes: a driving force to participate in society; managing everyday life through inventiveness and persistent training; insufficient healthcare and rehabilitation in the long-term perspective; finding meaningful relationships and activities in daily life. Participants’ voices are made clear through selected photos, which aim to present each theme and make results easier to understand. Conclusions Participants found new ways to approach everyday life situations and had thereby regained a sense of control in life. However, it was evident that psychological processes towards adaptation were hindered by depression and that some individuals felt alone in an ongoing struggle. Additionally, available interventions a long time after stroke were not flexible enough to address all participants’ needs.
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| 20. |
- Törnbom, Karin, 1982
(author)
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Participation after stroke in a short- and long-term perspective
- 2019
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Doctoral thesis (other academic/artistic)abstract
- The main scope of this thesis was to study and describe perceived participation among persons with stroke. In doing so, different timepoints were chosen to make a more complete picture of participation after stroke. The two first studies were performed using quantitative methods. The results of study I demonstrated that emotional health, communication skills, and the ability to remember were perceived as quite good one month after stroke. The findings of study II showed that participation scores were widely distributed during the first year after stroke. Associations between perceived physical capacity and participation were found at 1, 6, and 12 months. Findings of study I and II indicate that physical functioning was important for perceived participation during all timepoints that were investigated in the first year after stroke. A continuous focus on physical functioning in rehabilitation should therefore also be beneficial for perceived participation. Study III and IV had qualitative designs and aimed to exemplify, describe and to deepen our understanding of how participation, and life in general, may be experienced in a long term perspective after stroke. Results of study III showed that participants most often emphasized work and social life when describing their participation. They had adapted to a somewhat altered way of living and the importance of consequences after stroke in everyday life had decreased. This result was partly confirmed by the results of study IV, which showed that participants had found new ways to approach difficult situations in everyday life. However, the more multi-dimensional result of study IV showed that several participants still felt depressed many years after onset, and were not content with how life had turned out at all. Findings of both qualitative studies showed a need for more knowledge about how participation can be promoted many years after stroke, so that more persons after stroke may achieve a positive identity and a life which they consider meaningful.
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| 21. |
- Törnbom, Karin, 1982, et al.
(author)
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Perceptions of physical activity and walking in an early stage after stroke or acquired brain injury.
- 2017
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In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 12:3
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Journal article (peer-reviewed)abstract
- Physical activity has been established as being highly beneficial for health after stroke. There are considerable global efforts to find rehabilitation programs that encourage increased physical activity for persons with stroke. However, many persons with stroke or acquired brain injury do not reach recommended levels of physical activity and increased knowledge about why is needed. We aimed to explore views and experiences of physical activity and walking among persons with stroke or acquired brain injury.A qualitative study was conducted, among persons with stroke (n = 8) or acquired brain injury (n = 2) from a rehabilitation unit at Sahlgrenska University Hospital in Sweden. Semi-structured in-depth interviews were held about perceptions and experiences of walking and physical activity in general. Data were analyzed using qualitative content analysis, with categories that were determined inductively.Physical activity in general and walking ability more specifically were considered very important by the participants. However, physical activity was, regardless of exercising habits pre-injury, associated with different kinds of negative feelings and experiences. Commonly reported internal barriers in the current study were; fatigue, fear of falling or getting hurt in traffic, lack of motivation and depression. Reported external barriers were mostly related to walking, for example; bad weather, uneven ground, lack of company or noisy or too busy surroundings.Persons with stroke or acquired brain injury found it difficult to engage in and sustain an eligible level of physical activity. Understanding individual concerns about motivators and barriers surrounding physical activity may facilitate the work of forming tailor-made rehabilitation for these groups, so that the levels of physical activity and walking can increase.
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| 22. |
- Törnbom, Karin, 1982, et al.
(author)
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Self-Assessed Physical, Cognitive, and Emotional Impact of Stroke at 1 Month: The Importance of Stroke Severity and Participation
- 2017
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In: Journal of Stroke & Cerebrovascular Diseases. - : Elsevier BV. - 1052-3057. ; 26:1, s. 57-63
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Journal article (peer-reviewed)abstract
- Objectives The aims of this study were to describe the self-assessed physical, emotional, and cognitive impact of stroke and to investigate associations with participation and stroke severity in early stage (1 month) poststroke. Methods Participants (n=104, mean age=68) with reduced upper extremity function assessed at day 3 were included from a Swedish stroke unit. Participants were evaluated with The National Institutes of Health Stroke Scale at arrival, median 7.9 (0-24). The cohort was assessed for their perceived impact of stroke with the Stroke Impact Scale at 1 month poststroke. Results The perceptions of emotional health, communication skills, and ability to remember were perceived as quite good, with a mean score of 83-86. However, nearly 60% reported limitations in participation. This group also evaluated their physical function to be significantly lower compared to participants who did not report limitations in participation. Conclusions One month poststroke, a lower score on self-assessed physical function was associated with both a perceived restriction in participation and a more severe stroke. The association of physical function and perceived participation at 1 month poststroke needs to be taken into account when planning the early rehabilitation.
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| 23. |
- Törnbom, Karin, 1982, et al.
(author)
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Self-Perceived Participation and Autonomy at 1-Year Post Stroke: A Part of the Stroke Arm Longitudinal Study at the University of Gothenburg (SALGOT Study)
- 2018
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In: Journal of Stroke & Cerebrovascular Diseases. - : Elsevier BV. - 1052-3057. ; 27:4, s. 1115-1122
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Journal article (peer-reviewed)abstract
- Background: Identifying factors predicting the long-term outcome of participation and autonomy after stroke is essential for developing individualized rehabilitation interventions. The aim was to describe self-assessed participation and autonomy and to explore factors associated with the same at 1 year post stroke. Methods: Participants consisted of 79 persons (mean age = 67) with a first-time stroke at the 1-year follow-up. To investigate perceived participation and autonomy at 1 year, a self-assessment questionnaire, the Impact on Participation and Autonomy—English version (IPA-E) was used. Multivariate logistic regression models were performed using age, gender, stroke severity, and functional dependency at discharge as potential contributors to the perceived level of participation and autonomy. Results: A high percentage (70%-88%) evaluated their functions as fair to very good within all domains of the IPA-E at 1 year post stroke. However, around a fifth experienced their Family role as poor to very poor. Participants' functional dependency at discharge significantly influenced the outcome for the domains of Family role (odds ratio [OR] = 5.66, P <.01), Social relations (OR = 3.23, P <.03), and Autonomy indoors (OR = 3.44, P <.04) at 1 year post stroke. Conclusion and Implications: Aspects of the Family role domain deserve further attention in interventions aimed at improving participation and autonomy at 1 year post stroke. The results also indicate that supporting indoor autonomy and social relations of persons with stroke during the acute rehabilitation is important to enhance participation and autonomy at 1 year post stroke.
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| 24. |
- Törnbom, Karin, 1982, et al.
(author)
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The impact of physical functioning on participation in the first year post-stroke
- 2017
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In: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314. ; 135:6, s. 649-655
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Journal article (peer-reviewed)abstract
- Studies have investigated predictors of participation and showed that fewer depressive symptoms, physical independence, and age could predict the level of participation after stroke. Association between self-assessed functions and perceived levels of participation over time is not yet known. The aim of this study was to investigate perceptions of participation and how this related to background characteristics and self-assessed rehabilitation outcomes, at 1, 6, and 12 months post-stroke.
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| 25. |
- Törnbom, Karin, 1982, et al.
(author)
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Understanding concerns after severe COVID-19: A self-imposed lockdown guarded by anxiety?
- 2023
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In: PloS one. - : NLM (Medline). - 1932-6203. ; 18:7
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Journal article (peer-reviewed)abstract
- Many people are struggling to get back to their lives after severe COVID-19. To facilitate their reintegration into everyday life, we need to understand how the process is experienced. We aimed to gain deeper knowledge about this process by interviewing persons one year after hospitalisation due to COVID-19.The study is based on a qualitative design, with eleven in-depth interviews conducted one year after discharge for COVID-19. Participants were recruited to form a heterogeneous sample with respect to age, gender and socioeconomic background. All interviews were analysed utilising inductive thematic analysis.From the participants' narratives four themes were identified: 'Concerns and worries in everyday life', 'Supportive and concerned relatives', 'A new way of life-sorrows and advantages' and 'Seize the day-a greater awareness of one´s mortality'. Participants described how they tried to create a functioning everyday life. They were generally afraid of getting COVID-19 again and concerned about future life, where their lack of energy played a major role. Narratives were diverse regarding to what extent the struggle to cope was experienced as emotionally challenging or not.Participants described an unpredictable recovery after COVID-19, characterised by ups and downs, which created worries concerning their future. In some cases, the worry of getting COVID-19 again was strong enough to keep participants in their homes, as a self-imposed lockdown guarded by anxiety. However, the narratives also revealed gratitude towards being alive and having coped so well. This led to a more positive outlook on life with a greater focus on intrinsic values, close social relations and the deeper meaning of life.
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| 26. |
- Westerlind, Emma, 1992, et al.
(author)
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Return to work predicts perceived participation and autonomy by individuals with stroke.
- 2020
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In: Disability and rehabilitation. - : Informa UK Limited. - 1464-5165 .- 0963-8288. ; 42:25, s. 3673-3678
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Journal article (peer-reviewed)abstract
- Participation in activities of everyday life is seen as main goal of rehabilitation after a stroke and return to work is an important factor to consider for the substantial number of persons having a stroke at working age. The current study aims to investigate whether returning to work would predict self-perceived participation and autonomy in everyday life after a stroke, from a long-term perspective.Persons with first-ever stroke at age 18-63years in 2009-2010, Gothenburg, were included. As 5-year follow-up, the Impact on Participation and Autonomy questionnaire was sent out, investigating self-perceived participation/autonomy in five levels, and work status was investigated from national sick-absence registers. Prediction of work on participation/autonomy was investigated with logistic regression.A total of 109 participants (49%) responded to the questionnaire. The majority (69-94%) perceived very good participation/autonomy in all domains and 59% were working 5years after stroke. Working was a significant predictor of high participation/autonomy in all domains of the questionnaire.Being able to return to work after a stroke seems to be important for self-perceived participation/autonomy. This emphasizes the importance of work-oriented information and rehabilitation after a stroke at working age. Implications for rehabilitation The current study shows that the majority report high self-perceived participation and autonomy in everyday life and 59% are working 5 years after a stroke in working age. To work 5 years after a stroke was a significant predictor for self-perceived participation and autonomy in everyday life. Since stroke is becoming more common among working age persons and work seem important for perceived participation and autonomy, to optimize the return to work by for instance work-oriented information and vocational rehabilitation is important.
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