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  • Norin, Lizette, et al. (författare)
  • Housing adaptations and housing accessibility problems among older adults with long-standing spinal cord injury
  • 2020
  • Ingår i: British Journal of Occupational Therapy. - : SAGE Publications. - 0308-0226 .- 1477-6006. ; , s. 1-10
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Adults with spinal cord injuries are living longer than previously, and a majority are living in ordinary housing in the community. Housing accessibility is important for maintaining independent occupational performance for this population, but knowledge in this area is insufficient. We investigated housing adaptations and current accessibility problems among older adults with long-standing (>10 years) spinal cord injuries. Method: Data from home visits among 122 older adults with spinal cord injuries in Sweden were used. Housing adaptations and environmental barriers were descriptively analysed. Findings: Kitchens, entrances, and hygiene areas were common locations for housing adaptations and environmental barriers that generated accessibility problems. The most common adaptations were ramps, wheelchair-accessible stovetops, and ceiling-lifts. Wall-mounted cupboards and high shelves (kitchen), inaccessible storage areas (outside the dwelling), and a lack of grabbars (hygiene area) generated the most accessibility problems. Conclusion: Despite housing adaptations, there are considerable accessibility problems in the dwellings of older adults with long-standing spinal cord injuries in Sweden, indicating that long-term follow-up of the housing situation of this population is necessary. Focusing on accessible housing as a prerequisite for occupational performance is at the core of occupational therapy, deserving attention on the individual as well as the societal level.
  • Andersson, Nilla, et al. (författare)
  • Environmental barriers and housing accessibility problems for people with Parkinson’s disease : A three-year perspective
  • 2022
  • Ingår i: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis. - 1103-8128.
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Although housing accessibility is associated with important health outcomes in other populations, few studies have addressed this in a Parkinson’s disease population. Aim: To determine the most severe environmental barriers in terms of housing accessibility problems and how these evolved over 3 years among people with Parkinson’s disease. Material and Methods: 138 participants were included (men = 67%; mean age = 68 years). The most severe environmental barrier were identified by the Housing Enabler instrument and ranked in descending order. The paired t-test was used to analyse changes in accessibility problems over time. Results: The top 10 barriers remained largely unchanged over 3 years, but with notable changes in order and magnitude. ‘No grab bar in hygiene area’ and ‘Stairs only route’ were top-ranked in generating accessibility problems at baseline but decreased significantly (p = 0.041; p = 0.002) at follow-up. ‘Difficulties to reach refuse bin’ was top-ranked at follow-up, with a significant increase (p < 0.001) of related accessibility problems. Conclusions and Significance: The new knowledge about how accessibility problems evolve over time could be used by occupational therapists to recommend more effective housing adaptations taking the progressive nature of Parkinson’s disease into account. On societal level, the results could be used to address accessibility problems systematically.
  • Andersson, Nilla, et al. (författare)
  • Psychometric properties of the external Housing-Related Control Belief Questionnaire among people with Parkinson’s disease
  • 2020
  • Ingår i: Aging clinical and experimental research. - : Kurtis. - 1594-0667. ; 32:12, s. 2639-2647
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Housing-related control beliefs are associated with aspects of health among older people in general. Research on Parkinson’s disease (PD) focusing on perceptions of the home are rare and instruments capturing perceived aspects of home have seldom been used. Aims: To evaluate psychometric properties of the external Housing-related Control Beliefs Questionnaire (HCQ) among people with PD. Methods: The external HCQ were administrated to 245 participants with PD, (mean age = 69.9 years; mean PD duration = 9.7 years). External HCQ has 16-items, with five response options. The psychometric properties evaluated were data quality, structural validity (factor analysis), floor and ceiling effects, corrected item total correlations, internal consistency and construct validity (testing correlations with relevant constructs according to pre-defined hypotheses). Results: Data quality was high. Structural validity showed a unidimensional construct with removal of two items. Homogeneity was questionable, but strengthened after the removal of the two items. For the 14-item version internal consistency was α = 0.78 and SEM 4.47. Corrected item total correlation ranged between 0.31 and 0.54 and no floor or ceiling effects. Significant correlations with relevant constructs supported the construct validity. Conclusions: Taken together, the psychometric results suggest a 14-item version of the external HCQ to be sufficiently reliable and valid for use in the PD population. The results pave the way for further studies, using the HCQ to analyse how perceptions of control of the home may be associated with health among people ageing with PD.
  • Andersson, Nilla, et al. (författare)
  • The meaning of home questionnaire revisited : Psychometric analyses among people with Parkinson's disease reveals new dimensions
  • 2020
  • Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 15:12
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Research addressing perceptions of housing in people with Parkinson's disease (PD) is rare, and existing instruments capturing perceived aspects of housing are rarely used. Perceived housing comprises of several domains and is associated with health in general older populations. One such domain is meaning of home, captured by the Meaning of Home Questionnaire (MOH). The aim of this study was to evaluate psychometric properties of the MOH among people with PD. MATERIALS AND METHODS: The MOH was administrated to 245 participants with PD (mean age = 69.9 years; mean PD duration = 9.7 years). The instrument consisted of four sub-scales with 28 items, each with 11 response options (strongly disagree = 0; strongly agree = 10). We evaluated data quality, structural validity (factor analysis), construct validity (i.e., testing correlations with relevant constructs according to pre-defined hypotheses), corrected item total correlations, floor and ceiling effects and internal consistency. RESULTS: The data quality was high (0-1.2% missing data). The exploratory factor analysis suggested removal of five items and revealed three new factors; "My home is my castle", "My home is my prison" and "My home is my social hub". The 23-item MOH showed statistically significant correlations with life satisfaction, usability and ADL dependence, while not correlated with number of environmental barriers. These findings were largely as hypothesised, thus supporting construct validity (both convergent and discriminant). The corrected item total correlations were >0.3 for all items and the internal consistency was >0.70 for all sub-scales. No floor or ceiling effects were reported except for the sub-scale "My home is my castle" (ceiling effect = 15.6%). CONCLUSIONS: The 23-item MOH version with three new sub-scales is sufficiently reliable and valid for use in PD populations. This paves the way for further research of meaning of home among people with PD, using the 23-item MOH version.
  • Axmon, Anna, et al. (författare)
  • Detecting longitudinal changes in activities of daily living (ADL) dependence : Optimizing ADL staircase response choices
  • 2019
  • Ingår i: British Journal of Occupational Therapy. - : SAGE Publications. - 0308-0226. ; 82:10, s. 646-652
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Using a sum score based on a three-graded response scale for the activities of daily living staircase has previously been found to increase the statistical power compared to dichotomized responses when assessing longitudinal changes in activities of daily living. We aimed to investigate if the statistical power could be further increased by using a four-graded scale. Methods: We used data from two previous studies on community-living people to calculate sum scores based on a dichotomized (independent/dependent), a three-graded (independent/partly dependent/dependent), and a four-graded (independent without difficulty/independent with difficulty/partly dependent/dependent) response scale for the activities of daily living staircase. In total, 1818 paired observations (baseline to follow-up) from 482 people were included. Statistical power was estimated for the entire material as well as stratified by follow-up time and baseline activities of daily living using simulations. Results: The four-graded scale provided the highest statistical power, particularly for shorter follow-up times and low and high baseline activities of daily living, but had similar statistical power to the three-graded scale for longer follow-up times and medium baseline activities of daily living. Conclusion: Adding a second level to “independent” in the activities of daily living staircase improved the detection of changes over time.
  • Bukvic, Olivera, et al. (författare)
  • A review on the role of functional limitations on evacuation performance using the International Classification of Functioning, Disability and Health
  • 2021
  • Ingår i: Fire Technology. - : Springer. - 0015-2684. ; 57:2, s. 507-528
  • Forskningsöversikt (refereegranskat)abstract
    • This scoping review addresses the role of functional limitations on evacuation performance of adults in public buildings. Although this topic has been addressed in evacuation research, no linkage is currently available between functional limitations, the predominant activities affected by them and evacuation performance. This review strives to open a debate on the need to classify the impact of disability in terms of functional limitations on evacuation performance according to methods adopted in health science. This paper reviews literature concerning evacuation from public buildings with adults aged ≥ 60 years and/or adults aged ≥ 18 years with functional limitations. The International Classification of Functioning, Disability and Health has been used to identify predominant activities during an evacuation and to perform a structured classification at different levels of resolution to address self-evacuation possibilities. Results of the review are presented in a tabular form linking predominant activities in terms of the International Classification of Functioning, Disability and Health and six categories of functional limitations with the engineering evacuation time-line. The suggested classification can facilitate the assessment of the evacuation-related issues in buildings in relation to the population under consideration. The main research gaps identified include the lack of studies concerning the impact of cognitive limitations on egress, and the need to add the temporal dimension to the methods adopted in accessibility research to allow for their use in the egress field.
  • Carlsson, Gunilla, et al. (författare)
  • Assessing environmental barriers by means of the swedish craig hospital inventory of environmental factors among people post-stroke
  • 2021
  • Ingår i: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis. - 1103-8128. ; 28:5, s. 366-374
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: When occupational therapists address environmental barriers to occupational engagement, some barriers might not be possible to reduce for single individuals, because decisions have to be taken at community or societal level, for example changes in public transport. Investigating environmental barriers by means of the Swedish Craig Hospital Inventory of Environmental Factors (CHIEF-S) may increase our understanding of the environmental impact on occupation engagement and the methodological challenges to assess environmental barriers. Aims: To investigate and describe the magnitude of encountered environmental barriers in a group of people post-stroke and to assess psychometric properties of the CHIEF-S. Material and methods: In total, 34 participants, who had sustained a stroke in Sweden were recruited. Results: The participants reported in average 2,7 barriers and the total frequency-magnitude score of barriers (CHIEF-S score) was 0.45. The Cronbach’s α for the total CHIEF-S was 0.80 and the analysis of test-retest reliability revealed ICC = 0.86. The entire instrument demonstrated better psychometric properties than the single sub-scales. Conclusion: In this study, the frequency-magnitude of environmental barriers encountered by people post-stroke are reported at a group level and adds information to the cumulative knowledge generation on perceived environmental barriers in the society. However, to inform which interventions are needed at a more detailed level, other data collection methods have to be added.
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