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- Carlsson, Gunilla, et al.
(author)
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Self-reported versus professionally assessed functional limitations in community-dwelling very old individuals.
- 2012
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In: International Journal of Rehabilitation Research. - 1473-5660. ; 35:4, s. 299-304
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Journal article (peer-reviewed)abstract
- The objective of this study was to examine the relationship between self-reported and professionally assessed functional limitations in community-dwelling very old individuals. In total, 306 single-living adults aged 81-90 years were included in this cross-sectional study. The main outcome measure was the presence and absence of self-reported and professionally assessed functional limitations. A significant correlation was found between the total number of self-reported and professionally assessed functional limitations in the total sample (intraclass correlation=0.65) as well as in subgroups with respect to sex, age, and depression. When item-wise differences in the two assessments were assessed, the results showed significant differences for nine of the 15 functional limitations. In general, the participants reported more functional limitations as present than the professional did. In conclusion, research on self-reported and professionally assessed functional limitations contributes toward the understanding of how different modes of data collection influence the results. In this study, functional limitations were examined on a broad basis, including physical as well as cognitive and perceptual limitations. Once the assessments of self-reporting have been refined, we will have a more nuanced picture of functional limitations, incorporating self-report as well as professional assessments.Ziel der vorliegenden Studie war die Untersuchung der Beziehung zwischen selbst und professionell beurteilten Funktionseinschränkungen bei in der Gemeinschaft lebenden Menschen hohen Alters. Insgesamt wurden 306 allein lebende Erwachsene im Alter von 81-90 Jahren in diese Querschnittsstudie eingeschlossen. Die wichtigste verwendete ergebnisorientierte Messgröße war das Vorhandensein oder Fehlen von selbst und professionell beurteilten Funktionseinschränkungen. Es bestand eine signifikante Korrelation zwischen der Gesamtanzahl der selbst und professionell beurteilten Funktionseinschränkungen in der Stichprobe insgesamt (Intraclass-Korrelation=0.65) sowie in den Subgruppen mit Bezug auf Geschlecht, Alter und Depression. Bei der Beurteilung der Unterschiede unter Berücksichtigung der einzelnen Items wiesen die Ergebnisse signifikante Unterschiede bei neun der 15 Funktionseinschränkungen auf. Im Allgemeinen berichteten die Teilnehmer von mehr vorhandenen Funktionseinschränkungen als die Experten. Abschließend kann gesagt werden, dass die Forschung im Bereich der selbst und professionell beurteilten Funktionseinschränkungen zu einem besseren Verständnis dessen beiträgt, wie verschiedene Methoden der Datenerfassung die Ergebnisse beeinflussen. Im Rahmen dieser Studie wurden Funktionseinschränkungen, darunter physischer, kognitiver und perzeptiver Art, breit angelegt beurteilt. Sobald die Beurteilungsmethoden der Selbstanzeige weiterentwickelt sind, besitzen wir ein nuancierteres Bild der Funktionseinschränkungen mit eigener und professioneller Auswertung.El objetivo de este estudio fue examinar la relación entre las limitaciones funcionales indicadas por los propios sujetos y las evaluadas por profesionales en individuos de edad avanzada pertenecientes a una comunidad. En total, 306 adultos que vivían solos y de edad comprendida entre los 81 y los 90 años participaron en este estudio transversal. Los principales resultados obtenidos se basaron en la presencia y la ausencia de limitaciones funcionales indicadas por los propios sujetos y evaluadas por profesionales. Se observó una correlación significativa entre el número total de limitaciones funcionales indicadas por los propios sujetos y las evaluadas por profesionales (correlación intraclase=0.65), así como en los subgrupos, en relación con el sexo, la edad y la depresión. Tras analizar las diferencias entre los dos tipos de evaluación con respecto a las distintas variables, los resultados difirieron significativamente en nueve de las quince limitaciones funcionales. En general, los participantes indicaron que padecían más limitaciones funcionales que los profesionales. Como conclusión, la investigación sobre las limitaciones funcionales indicadas por los propios sujetos y evaluadas por profesionales contribuye a comprender cómo las distintas formas de recopilación de datos influyen en los resultados. En este estudio, las limitaciones funcionales se examinaron de manera general, incluyendo las limitaciones físicas, además de las cognitivas y las perceptivas. Una vez que se perfeccionen las evaluaciones realizadas por los propios sujetos, se poseerá una visión más clara de las limitaciones funcionales, que podrán incorporar tanto autoevaluaciones como evaluaciones realizadas por profesionales.Cette étude avait pour objet d'examiner la relation entre les limitations fonctionnelles auto-déclarées et professionnellement évaluées chez les personnes très âgées vivant dans la collectivité. Au total, 306 adultes de 81-90 ans vivant seuls ont été inclus dans cette étude transversale. Le critère de mesure principal était la présence ou l'absence de limitations fonctionnelles auto-déclarées ou professionnellement évaluées. Une corrélation significative a été observée entre le nombre total de limitations fonctionnelles autodéclarées et professionnellement évaluées dans l'échantillon total (corrélation interclasses=0.65) ainsi que dans les sous-groupes définis par sexe, âge et dépression. Lorsque les différences sur l'ensemble d'un item entre les deux évaluations ont été évaluées, les résultats ont fait apparaître des différences significatives pour neuf des 15 limitations fonctionnelles. En général, les participants ont signalé la présence d'un plus grand nombre de limitations fonctionnelles que les professionnels. En conclusion, les recherches sur les limitations fonctionnelles autodéclarées et professionnellement évaluées contribuent à la compréhension de la manière dont les différents modes de collecte des données influent sur les résultats. Dans cette étude, les limitations fonctionnelles ont été examinées sur une base large, en incluant notamment les limitations physiques ainsi que cognitives et perceptives. Une fois les évaluations autodéclarées affinées, nous aurons une image plus nuancée des limitations fonctionnelles, qui intégrera l'auto-évaluation ainsi que les évaluations professionnelles.
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- Hedberg-Kristensson, Elizabeth, et al.
(author)
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Therapist attitudes and strategies to client-centred approaches in the provision of mobility devices to older clients.
- 2013
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In: Disability and rehabilitation. Assistive technology. - : Informa UK Limited. - 1748-3115 .- 1748-3107.
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Journal article (peer-reviewed)abstract
- Abstract Purpose: This study explored therapists' attitudes to and strategies for developing client-centred approaches in relation to the provision of mobility devices. Method: Four physiotherapists and eight occupational therapists in a Swedish municipality context were interviewed according to a semi-structured interview guide. Data collection and analysis were guided by a qualitative approach, applying manifest content analysis. Results: The analysis resulted in a main theme: "Awareness and positive attitudes towards a client-centred approach" and two sub-themes: "Challenges to a client-centred approach" and "Strategies for developing a client-centred approach". Conclusions: Therapists in municipality-based geriatric rehabilitations are aware of and have ambitions to apply a client-centred approach in mobility device provision, despite different kinds of obstacles for client interaction. The examples of different strategies they suggested to facilitate a client-centred approach can be used to improve clinical practice. While more research is needed in this field, the results can be used as a basis for practice development which may increase activity among older clients. Implications for Rehabilitation The fact that therapists seem aware of the client's legal right to interact with them in the rehabilitation process, in relation to the provision of mobility devices, is promising and an important prerequisite for the development of more client-centred practices. The identification of different types of obstacles that could interfere with applying a client-centred approach has the potential to increase the therapists' attention to such aspects. The results show that it is necessary for practitioners to develop strategies to be successful in applying a client-centred approach. The examples provided can serve as a basis for continuing discussions among practitioners, increasing their awareness of strategies and opportunities for client interaction.
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- Kylberg, Marianne, et al.
(author)
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The use of assistive devices and change in use during the ageing process among very old Swedish people.
- 2013
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In: Disability and rehabilitation. Assistive technology. - : Informa UK Limited. - 1748-3115 .- 1748-3107. ; 8:1, s. 58-66
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Journal article (peer-reviewed)abstract
- Purpose: To investigate the characteristics and change in use among very old Swedish users and non-users of assistive devices (ADs) for mobility and personal care, over a six-year period, and to investigate factors predicting AD use over a six-year period. Method: Descriptive statistics and logistic regression were used to analyse quantitative data from a subsample from the Swedish part of the ENABLE-AGE Survey Study, n = 154. Variables according to socio-demographics, environment and health were utilized. Results: The number of users increased over time, particularly those using both types of ADs (mobility and personal care). There were differences in health between users and non-users, while no such differences were seen regarding socio-demographics or environmental factors. Health factors most prominent predicted AD use after six years, but also variables within socio-demographics and the environment had an impact on the use; income for ADs for personal care and aspects in the outdoor environment for ADs for mobility. Conclusions: As ADs increases over time, it is important, to pay attention to health as well as other factors, among users and non-users of ADs, to provide important information in planning for and supporting healthy and active ageing. [Box: see text].
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- Löfqvist, Charlotte, et al.
(author)
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Mobility and mobility-related participation outcomes of powered wheelchair and scooter interventions after 4-months and 1-year use
- 2012
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In: Disability and Rehabilitation. - : Informa Healthcare. - 1748-3107 .- 1748-3115. ; 7:3, s. 211-218
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Journal article (peer-reviewed)abstract
- PURPOSE: The aim was to investigate outcomes of powered wheelchair and scooter interventions after 4-months and 1-year use regarding need for assistance when moving around, frequency of mobility-related participation, easiness/difficulty in mobility during participation, and number of participation aspects performed in everyday life.METHOD: The study was a prospective cohort study, using an instrument focusing on mobility-related participation outcomes of mobility device interventions (NOMO 1.0), at baseline, after 4-months and 1-year use.RESULTS: The results show that the outcomes in terms of participation frequency and easiness in mobility occur in a short time perspective, and that the effects remained stable at 1-year follow-up. The frequency of going for a walk increased most prominently (26%). Even though the majority of the participation aspects were not performed, more often they became easier to perform: 56-91% found that shopping, walking and visiting family/friends were easier. Moreover, independence outdoors and indoors increased.CONCLUSIONS: This small study provides knowledge about the outcomes of powered wheelchairs and scooters in terms of mobility and mobility-related participation in real-life situations. The study supports results from former studies, but even so, larger studies are required in order to provide evidence for the effectiveness of powered wheelchairs and scooters. [Box: see text].
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- Ståhl, Agneta, et al.
(author)
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Detection of warning surfaces in pedestrian environments: The importance for blind people of kerbs, depth, and structure of tactile surfaces
- 2010
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In: DISABILITY AND REHABILITATION. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 32:6, s. 469-482
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Journal article (peer-reviewed)abstract
- Purpose. The overall purpose was to study whether and how persons with blindness detect warning surfaces with a long white cane in a real pedestrian environment after following a natural guidance surface to the warning surfaces. Of particular interest was the importance of kerb, depth, and structure of the warning surfaces. Method. A concurrently mixed methods approach, with a combination of observation using a structured form together with ‘think aloud’ and a structured interview, was used. It was done with well-defined samples and study sites in an inter-disciplinary research context. Results. The results show that the most important design characteristic for detection of the warning surfaces with a white cane is the structure of the surface, while the depth of the surface and availability of a kerb do not have any impact on the detection. A precondition was that there is a distinct natural guidance surface leading up to the warning surface. Conclusions. The probability among pedestrians with blindness to detect a tactile surface is not higher if the design solution has a kerb. This study also confirms the complexity of being a blind pedestrian in the traffic environment. The results can be used for evidence-based physical planning. The study also has implications for development of more efficient vision rehabilitation.
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| 10. |
- Thordardottir, Björg, et al.
(author)
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"You plan, but you never know" - participation among people with different levels of severity of Parkinson's disease.
- 2014
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In: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 36:26, s. 2216-2224
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Journal article (peer-reviewed)abstract
- Abstract Purpose: The aim of this study was to improve our understanding of important aspects of participation in everyday life for people with different levels of severity of Parkinson's disease (PD). Methods: A qualitative design was used, with empirical data obtained from focus groups. The participants had all been diagnosed with PD at least one year prior to the start of the study. Purposeful sampling was used to ensure that both sexes, with variations in age, marital status, living arrangements, education and employment, were represented. Recruitment continued until saturation was reached and resulted in 29 participants. Homogeneity within each focus group was based on self-rated PD severity (mild, moderate or severe). Findings: The aspects that influence participation at different stages of PD are that those with PD stand out in public, as a result of disease-specific features, and that the disease is unpredictable. Planning was highlighted as a strategy that is required to support participation and cope with stress and to compensate for the fact that everyday activities demanded a great deal of time and energy. Conclusion: These findings are of importance to the development of rehabilitation interventions that support people with PD in maintaining their participation in everyday life, throughout the course of the disease. Implications for Rehabilitation PD severity and disease-specific problems (e.g. freezing of gait) need to be taken into account when tackling restrictions that affect participation. Interventions that aim to facilitate participation require different components and expertise depending on PD severity, as well as on individual preferences and needs. Structuring and planning everyday life might not facilitate participation for all those with PD, but concrete measures, such as making a schedule in order to structure daily life, may benefit those with milder PD.
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