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1.
  • Nilsson, Lisbeth, et al. (författare)
  • Driving to Learn in a Powered Wheelchair: The Process of Learning Joystick Use in People With Profound Cognitive Disabilities
  • 2011
  • Ingår i: American Journal of Occupational Therapy. - : American Occupational Therapy Association. - 0272-9490 .- 1943-7676. ; 65:6, s. 652-660
  • Tidskriftsartikel (refereegranskat)abstract
    • The Driving to Learn project explored ways to help people with profound cognitive disabilities practice operating a joystick-operated powered wheelchair. The project used a grounded theory approach with constant comparative analysis and was carried out over 12 yr. The participants were 45 children and adults with profound cognitive disabilities. Reference groups included 17 typically developing infants and 64 participants with lesser degrees of cognitive disability. The data sources included video recordings, field notes, open interviews, and a rich mixture of literature. The findings that emerged yielded strategies for facilitating achievements, an 8-phase learning process, an assessment tool, and a grounded theory of deplateauing explaining the properties necessary for participants to exceed expected limitations and plateaus. Eight participants with profound cognitive disabilities reached goal-directed driving or higher. Participants were empowered by attaining increased control over tool use, improving their autonomy and quality of life.
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2.
  • Manchaiah, Vinaya, et al. (författare)
  • Problems and Life Effects Experienced by Tinnitus Research Study Volunteers : An Exploratory Study Using the ICF Classification
  • 2018
  • Ingår i: Journal of american academy of audiology. - Reston, VA, United States : American Academy of Audiology. - 1050-0545 .- 2157-3107. ; 29:10, s. 936-947
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Tinnitus is one of the most distressing hearing-related symptoms. It is often associated with a range of physiological and psychological complications, such as depression, anxiety, and insomnia. Hence, approaching tinnitus from a biopsychological perspective may be more appropriate than from purely a biomedical model.Objective: The present studywas aimed at determining the relationship between tinnitus and the problems and life effects experienced by UK-based tinnitus research study volunteers. Open-ended questions were used. Responses were classified using the International Classification of Functioning, Disability and Health (ICF) framework to understand the impact of tinnitus in a multidimensional manner using a biopsychosocial perspective.Research Design: A cross-sectional survey design was used.Study Sample: Study sample included a sample of 240 adults with tinnitus who were interested in undertaking an Internet-based intervention for tinnitus.Data Collection and Analysis: The data were collated using two open-ended questions. The first focused on problems related to having tinnitus and the second to life effects as a result of tinnitus. Responses were analyzed using a simplified content analysis approach to link concepts to ICF categories in accordance with established linking rules. A Wilcoxon signed-rank test was performed to compare the number of responses between the two questions. The most frequent responses related to body function involved ‘‘emotional functions’’ (b152), ‘‘sleep functions’’ (b134), ‘‘hearing functions’’ (b230), ‘‘sustaining attention’’ (b1400), and ‘‘energy level’’ (b1300). For activity limitations and participation restrictions they were ‘‘communicating with—receiving—spokenmessages’’ (d310), ‘‘socialization’’ (d9205), ‘‘handling stress and other psychological demands’’ (d240), and ‘‘recreation and leisure’’ (d920). The most frequently occurring responses related to environmental factors were ‘‘sound intensity’’ (e2500), ‘‘sound quality’’ (e2501), and ‘‘general products and technology for communication’’ (e1250). ‘‘Coping styles’’ was the most frequently occurring personal factor.Conclusions: The study highlights the use of open-ended questions in gathering useful information about the impact of tinnitus. The responses coded to ICF show that tinnitus impacts many domains, not only particularly body function, but also activity limitations and participation restrictions. The results demonstrate the heterogeneous nature of the impact of tinnitus on people affected.Results: There were 764 responses related to problems identified, 797 responses associated with life effects due to tinnitus, and 37 responses that did not fit into any ICF category. No significant differences were observed in the number of responses between the two questions. In addition, no significant association between the number of responses reported and demographic variables was found. Most of the problems and life effects experienced by tinnitus sufferers were related to body function, followed by activity limitations, and participation restrictions. Only a few responses were related to environmental and personal factors.
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3.
  • Dunberger, Gail, et al. (författare)
  • Cancer survivors' perception of participation in a long-term follow-up study.
  • 2013
  • Ingår i: Journal of medical ethics. - : BMJ Publishing Group Ltd. - 1473-4257 .- 0306-6800. ; 39:1, s. 41-5
  • Tidskriftsartikel (refereegranskat)abstract
    • Every year medical researchers make contact with a large number of cancer survivors with the aim of evaluating cancer treatment. For this reason we decided to investigate how Swedish cancer survivors perceived their participation in research studies focusing on the long-term consequences of being a survivor of gynaecological or urinary bladder cancer. Data were collected by means of two study-specific postal questionnaires, both consisting of questions covering physical symptoms, well-being and the experience of being a cancer survivor. Both questionnaires also included questions evaluating the participants' experience of being research subjects. The questionnaires were developed in close co-operation with cancer survivors. The study population consisted of 1068 cancer survivors. Of these, 95% (n=1003) reported that they thought the study was valuable and 54% (n=559) that they had been positively affected by participating. Four per cent (n=39) expressed that they had been negatively affected by their participation in the study. The vast majority of the cancer survivors thought that participating in their particular study was valuable.
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4.
  • Gerdle, Björn, et al. (författare)
  • Who benefits from multimodal rehabilitation - an exploration of pain, psychological distress, and life impacts in over 35,000 chronic pain patients identified in the Swedish Quality Registry for Pain Rehabilitation
  • 2019
  • Ingår i: Journal of Pain Research. - : DOVE MEDICAL PRESS LTD. - 1178-7090 .- 1178-7090. ; 12, s. 891-908
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Chronic pain patients frequently suffer from psychological symptoms. There is no consensus concerning the prevalence of severe anxiety and depressive symptoms and the strength of the associations between pain intensity and psychological distress. Although an important aspect of the clinical picture is understanding how the pain condition impacts life, little is known about the relative importance of pain and psychological symptoms for individual's life impact. The aims of this study were to identify subgroups of pain patients; to analyze if pain, psychological distress, and life impact variables influence subgrouping; and to investigate how patients in the subgroups benefit from treatments.Methods: Background variables, pain aspects (intensity/severity and spreading), psychological distress (depressive and anxiety symptoms), and two life impact variables (pain interference and perceived life control) were obtained from the Swedish Quality Registry for Pain Rehabilitation for chronic pain patients and analyzed mainly using advanced multivariate methods.Results: Based on >35,000 patients, 35%-40% had severe anxiety or depressive symptoms. Severe psychological distress was associated with being born outside Europe (21%-24% vs 6%-8% in the category without psychological distress) and low education level (20.7%-20.8% vs 26%-27% in the category without psychological distress). Dose relationships existed between the two psychological distress variables and pain aspects, but the explained variances were generally low. Pain intensity/severity and the two psychological distress variables were significantly associated (R2=0.40-0.48; P>0.001) with the two life impact variables (pain interference and life control). Two subgroups of patients were identified at baseline (subgroup 1: n=15,901-16,119; subgroup 2: n=20,690-20,981) and the subgroup with the worst situation regarding all variables participated less in an MMRP (51% vs 58%, P<0.001) but showed the largest improvements in outcomes.Conclusion: The results emphasize the need to assess both pain and psychological distress and not take for granted that pain involves high psychological stress in the individual case. Not all patients benefit from MMRP. A better matching between common clinical pictures and the content of MMRPs may help improve results. We only partly found support for treatment resistance in patients with psychological distress burden.
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5.
  • Hoffman, Robert D., et al. (författare)
  • Gender differences in self-care for common colds by primary care patients : a European multicenter survey on the prevalence and patterns of practices (the COCO study)
  • 2020
  • Ingår i: Journal of Gender Studies. - : Taylor & Francis Group. - 0958-9236 .- 1465-3869. ; , s. 1-16
  • Tidskriftsartikel (refereegranskat)abstract
    • Although generally harmless, the common cold disturbs the lives of billions yearly. It is frequently treated by self-care, yet little is known about the effect gender may have on self-care. Our study set out to discover whether self-care for common colds differs by gender. We also wanted to test the 'Man cold' belief: that men 'break down' when they have a cold and suffer more than women when they are sick. We distributed questionnaires asking for a selection of self-care practices in eight categories to 3,240 consecutive patients in 14 Eurasian countries at 27 primary care sites. Of 2,654 patients included, 99% reported engaging in self-care for common colds. Discomfort was reported more frequently by women (74.7% vs. 66.5%, p < 0.001). There were gender differences in several self-care categories. The mean use of self-care items was higher in women than in men (12.0 vs. 10.3, p < 0.001). Women reported a greater variety of self-care items than men. However, more men reported using alcohol (17.8% vs. 8.4%, p < 0.001). This cross-national study documented gender differences in self-care for common colds.
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6.
  • Nordanstig, Annika, 1974, et al. (författare)
  • Impact of the Swedish National Stroke Campaign on stroke awareness
  • 2017
  • Ingår i: Acta Neurologica Scandinavica. - : Wiley-Blackwell. - 0001-6314 .- 1600-0404. ; 136:4, s. 345-351
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundTime delay from stroke onset to arrival in hospital is an important obstacle to widespread reperfusion therapy. To increase knowledge about stroke, and potentially decrease this delay, a 27-month national public information campaign was carried out in Sweden. MethodsThe variables used to measure campaign effects were knowledge of the AKUT test [a Swedish equivalent of the FAST (Face-Arm-Speech-Time)] test and intent to call 112 (emergency telephone number) . Telephone interviews were carried out with 1500 randomly selected people in Sweden at eight points in time: before, three times during, immediately after, and nine, 13 and 21months after the campaign. ResultsBefore the campaign, 4% could recall the meaning of some or all keywords in the AKUT test, compared with 23% during and directly after the campaign, and 14% 21months later. Corresponding figures were 15%, 51%, and 50% for those remembering the term AKUT and 65%, 76%, and 73% for intent to call 112 when observing or experiencing stroke symptoms. During the course of the campaign, improvement of stroke knowledge was similar among men and women, but the absolute level of knowledge for both items was higher for women at all time points. ConclusionThe nationwide campaign substantially increased knowledge about the AKUT test and intention to call 112 when experiencing or observing stroke symptoms, but knowledge declined post-intervention. Repeated public information therefore appears essential to sustain knowledge gains.
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7.
  • Sundell, Susanne, et al. (författare)
  • Does social capital protect mental health among migrants in Sweden?
  • 2016
  • Ingår i: Health Promotion International. - : Oxford University Press. - 1460-2245 .- 0957-4824. ; 31:3, s. 644-652
  • Tidskriftsartikel (refereegranskat)abstract
    • Poor mental health is common among migrants. This has been explained by migration-related and socio-economic factors. Weak social capital has also been related to poor mental health. Few studies have explored factors that protect mental health of migrants in the post-migration phase. Such knowledge could be useful for health promotion purposes. Therefore, this study aimed to analyse associations between financial difficulties, housing problems and experience of discrimination and poor mental health; and to detect possible effect modification by social capital, among recently settled Iraqi migrants in Sweden. A postal questionnaire in Arabic was sent to recently settled Iraqi citizens. The response rate was 51% (n = 617). Mental health was measured by the GHQ-12 instrument and social capital was defined as social participation and trust in others. Data were analysed by means of logistic regression. Poor mental health was associated with experience of discrimination (OR 2.88, 95% CI 1.73-4.79), housing problems (OR 2.79, 95% CI 1.84-4.22), and financial difficulties (OR 2.14, 95% CI 1.44-3.19), after adjustments. Trust in others seemed to have a protective effect for mental health when exposed to these factors. Social participation had a protective effect when exposed to experience of discrimination. Social determinants and social capital in the host country play important roles in the mental health of migrants. Social capital modifies the effect of risk factors and might be a fruitful way to promote resilience to factors harmful to mental health among migrants, but must be combined with policy efforts to reduce social inequities.
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8.
  • Parker, Vanessa, et al. (författare)
  • The Association Between Mid-Life Socioeconomic Position and Health After Retirement—Exploring the Role of Working Conditions
  • 2013
  • Ingår i: Journal of Aging and Health. - 0898-2643 .- 1552-6887. ; 25:5, s. 863-881
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To explore the role of working conditions in the association between socioeconomic position and health after retirement age using over 20 years follow-up.Method: Two Swedish nationally representative Level of Living Surveys (total N = 1,131) were used. Ordered logistic regression was used to assess the association between socioeconomic position and health (self-rated health, psychological distress, musculoskeletal pain, circulatory problems, physical and cognitive impairment). The role of physical and psychological working conditions was also assessed.Results: Lower socioeconomic position was associated with more adverse physical, but not psychological, working conditions. Physical working conditions partially explained the differences in physical impairment and musculoskeletal pain in old age attributed to socioeconomic position, but not differences in self-rated health, circulatory problems, psychological distress, and cognitive impairment. Socioeconomic position was a stronger correlate of health than psychological working conditions alone.Discussion: Improving physical working conditions may be important for reducing the influence of socioeconomic position on health after retirement.
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9.
  • Larsson, Caroline (författare)
  • Chronic pain and kinesiophobia among older adults. Prevalence, characteristics and impact on physical activity.
  • 2016
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Background: Chronic pain is common in older adults, yet little is known of its development in old age. Although fear-avoidance beliefs in chronic pain have been explored in younger adults, the relationship between chronic pain, kinesiophobia and physical activity levels has not been investigated in older adults.Objectives: The overall aim was to explore prevalence, development and related factors of chronic pain and kinesiophobia in older adults with a focus on psychosocial and pain related factors and their impact on physical activity among older adults.Methods: The study had a longitudinal design and data were obtained through posted surveys and collected at baseline and after 12 and 24 months during 2011–2013. Participants (N=2000) were selected through simple randomization of the Swedish register of inhabitants using the whole Swedish population aged 65+, as sampling frame. A total of 1141 older adults were included at baseline (aged 65–103 years). Prevalence, incidence rate and cumulative incidence of chronic pain over 2 years in different age strata were estimated. To estimate associations for demographic, psychosocial and pain-related variables as functions of chronic pain (persistence and onset), kinesiophobia and physical activity linear/logistic regression analysis were performed.Results: In paper I, chronic pain was reported by 38.5% of the participants, more common among females and those over 85 years. The incidence was estimated at 5.4%. Being female, having lower BMI, high intensity/severity, long duration and multiple locations of pain were able to predict persistence of chronic pain among older women. Paper II showed that TSK-11 had acceptable construct validity, factor structure and test-retest reliability. In Papers III–IV generally low levels of kinesiophobia were found among those with chronic pain, except among frailer and older adults living in care homes. Despite this, it was found that kinesiophobia was independently associated with levels of physical activity and significantly lower levels of physical activity among those with chronic pain.Conclusions: Even though chronic pain was often highly prevalent and persistent, both onset and recovery occurred over time. The findings highlight the importance of early pain management in prevention of future pain among older adults. It must also be considered that older adults with chronic pain are at higher risk of functional decline and additional chronic diseases, due to significantly lower levels of physical activity compared to older without chronic pain. Kinesiophobia among older adults can be captured by the TSK-11 and plays an important role in predicting future physical activity levels and is hence important to consider. Potential interventions against kinesiophobia among older adults should aim to decrease pain intensity and strengthen health beliefs.
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10.
  • Tøllefsen, Ingvild Maria, et al. (författare)
  • Accidents and undetermined deaths : re-evaluation of nationwide samples from the Scandinavian countries
  • 2016
  • Ingår i: BMC Public Health. - 1471-2458 .- 1471-2458. ; 16
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: National mortality statistics should be comparable between countries that use the World Health Organization's International Classification of Diseases. Distinguishing between manners of death, especially suicides and accidents, is a challenge. Knowledge about accidents is important in prevention of both accidents and suicides. The aim of the present study was to assess the reliability of classifying deaths as accidents and undetermined manner of deaths in the three Scandinavian countries and to compare cross-national differences. Methods: The cause of death registers in Norway, Sweden and Denmark provided data from 2008 for samples of 600 deaths from each country, of which 200 were registered as suicides, 200 as accidents or undetermined manner of deaths and 200 as natural deaths. The information given to the eight experts was identical to the information used by the Cause of Death Register. This included death certificates, and if available external post-mortem examinations, forensic autopsy reports and police reports. Results: In total, 69 % (Sweden and Norway) and 78 % (Denmark) of deaths registered in the official mortality statistics as accidents were confirmed by the experts. In the majority of the cases where disagreement was seen, the experts reclassified accidents to undetermined manner of death, in 26, 25 and 19 % of cases, respectively. Few cases were reclassified as suicides or natural deaths. Among the extracted accidents, the experts agreed least with the official mortality statistics concerning drowning and poisoning accidents. They also reported most uncertainty in these categories of accidents. In a second re-evaluation, where more information was made available, the Norwegian psychiatrist and forensic pathologist increased their agreement with the official mortality statistics from 76 to 87 %, and from 85 to 88 %, respectively, regarding the Norwegian and Swedish datasets. Among the extracted undetermined deaths in the Swedish dataset, the two experts reclassified 22 and 51 %, respectively, to accidents. Conclusion: There was moderate agreement in reclassification of accidents between the official mortality statistics and the experts. In the majority of cases where there was disagreement, accidents were reclassified as undetermined manner of death, and only a small proportion as suicides.
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