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- Ehn, Mattias, 1972-
(author)
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Life Strategies, Work and Health in People with Usher Syndrome
- 2020
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Doctoral thesis (other academic/artistic)abstract
- Introduction: People with Usher syndrome (USH) have an inherited disorder causing congenital deafness or hearing loss combined with progressive vision loss and, in some cases, balance problems. Previous research has shown that people with USH have poor physical and psychological health. Research has, however, demonstrated that there are in-group health differences that have not yet been explored and that there is a lack of studies on life strategies as well as health in relation to working life.Aim: The aim was to explore the relationship between work and health in people with USH1 and 2 and to explore the experiences of life strategies in people with USH 2.Methods: A quantitative and a qualitative explorative design was employed comprising two cross-sectional studies of the relationship between work and health in people with USH2 (n=67) and USH1 (n=47). The third study, of life strategies, comprised focus group interviews with people with USH2a (n=14) analyzed by content analysis. The fourth study explored the lived experiences of working life by interviewing people with USH2 (n=7) using an interpretative phenomenological approach.Results: Study 1 and 2 demonstrated significant differences in health between working and nonworking people. Nonworking people showed significantly poorer health. In study 3, a variety of strategies to prevent and resolve challenges in life, as well as to comfort oneself was identified. The lived experiences of working life in people with USH2 (study 4) disclosed feelings of satisfaction, striving towards a work life balance. Work also disclosed feelings of limitations and uncertainty about the future.Conclusion: The results, which are discussed in relation to the Meikirsh model of health, demonstrated a complexity. Individual life strategies, psychological flexibility and environmental aspects, such as social determinants have to be considered to receive a comprehensive picture of the relationship between work and health in people with USH. This thesis provides new insights into the health of people with USH.
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- Ehn, Mattias, 1972-, et al.
(author)
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The relationship between work and health in persons with Usher syndrome type 2
- 2016
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In: Journal of Visual Impairment & Blindness. - New York, USA : American Foundation for the Blind. - 0145-482X .- 1559-1476. ; 110:4, s. 233-244
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Journal article (peer-reviewed)abstract
- Introduction: Persons with deafblindness may have additional physical and psychological health problems. In this study we have focused on health from a work-life perspective in persons with Usher syndrome type 2 (USH2), a disorder with sensorineural hearing loss and retinitis pigmentosa. The aim of this study was to investigate the relationship between work and disability pension and physical and psychological health in persons with USH2.Methods: Participants were recruited from the Swedish Usher database. Eighty-four persons (aged 18 to 65 years) received a health-related questionnaire and 67 (36 women and 31 men) agreed to participate. The participants formed two groups (working group, n = 34; disability pension group, n = 33). A Swedish Health on Equal Terms questionnaire comprising questions on psychological and physical health, living conditions, work activity, and social relationships was used. A chi-square test of significance was used with a significance level of p < 0.05.Results: The two groups did not differ in terms of age, gender, degree of hearing loss, visual acuity, or visual field loss. The working group had statistically significant better health compared to the disability pension group in areas such as being overweight, handling problems, concentration, feeling unhappy, depressive symptoms, and feelings of worthlessness. Suicidal thoughts and attempts were significantly more common in the disability pension group.Discussion: Persons with USH2 generally reported very poor physical and psychological health, with significant differences between persons who were working and those who were not. This study highlights the need for early rehabilitation, vocational training, and opportunities to access the labor market. Implications for practitioners: It is important that persons with USH2 receive vocational support from an early age and that professionals in the field of rehabilitation always include work activity as a key element of interventions.
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- Granberg, Sarah, 1973-
(author)
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Functioning and disability in adults with hearing loss : the preparatory studies in the ICF Core sets for hearing loss project
- 2015
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Doctoral thesis (other academic/artistic)abstract
- Hearing loss (HL) is a health condition that affects more than 360 million people worldwide. The findings from previous research point at the adverse relationship between adults with hearing loss and important aspects of everyday life such as social relations, communication and work-related tasks. However, the overall picture concerning the functional and disabling aspects of adults with HL re- mains incomplete. To identify the functional and disabling aspects, a conceptual and/or theoretical framework is required. The International Classification of Functioning, Disability and Health (ICF) offer a multidimensional framework based on bio-psycho-social assumptions about health. In previous research inves- tigations in which the ICF has been used, some utility problems in the linking (relating) of data to the classification have been highlighted.The aims of the present thesis were to explore the areas of functioning and disability of relevance for adults with HL and to explore how audiological data can be linked to ICF. The aims were explored by applying the methodology of the ‘interdisciplinary evidence-based approach to functioning and disability in adults with HL’, acknowledging the merging of three perspectives designated the Researcher, the Patient and the Professional perspective. Four studies that focus on the three perspectives were conducted. All results were linked to the ICF classification. The results were merged into a model designated ‘the integrative model of functioning and disability in adults with HL’.When the three perspectives were linked, the results revealed several aspects of relevance for the target group. Bodily (individual) dimensions, such as hear- ing, auditory perception, memory, attention, energy, and emotions, were acknowledged. Aspects of everyday life such as conversations, the usage of communication strategies, family relationships and work, were highlighted. Influential environmental factors, such as noise, assistive technical devices, the design of public buildings, social support and the attitudes of people in the envi- ronment, were also identified. In conclusion, interactions seemed to be vital as almost all identified aspects highlighted or were tied to this dimension of human functioning. Further, concerning the linking of the data it was acknowledged that the ICF and the research area of adult HL do not fully comply. Suggestions for improvements in future revisions of the ICF were highlighted and discussed.
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- Granberg, Sarah, 1973-, et al.
(author)
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The ICF Core Sets for hearing loss: researcher perspective, Part II : Linking outcome measures to the International Classification of Functioning, Disability and Health (ICF)
- 2014
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In: International Journal of Audiology. - : Informa Healthcare. - 1499-2027 .- 1708-8186. ; 53:2, s. 77-87
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Research review (peer-reviewed)abstract
- Objective: To link outcome measures used in audiological research to the ICF classification and thereby describe audiological research from the ICF perspective.Design: Through a peer-reviewed or a joint linking procedure, link outcome measures to the ICF classification system using standardized ICF linking rules. Additional linking rules were developed in combination with the established rules to overcome difficulties when connecting audiological data to ICF. Absolute and relative frequencies of ICF categories were reported.Study sample: The identified outcome measures from the previous study (Part I) constituted the empirical material. Results: In total, 285 ICF categories were identified. The most prevalent categories were related to listening, hearing functions, auditory perceptions, emotions and the physical environment, such as noise and hearing aids. Categories related to communication showed lower relative frequencies, as did categories related to the social and attitudinal environment.Conclusions: Based on the linked outcome measures, communication as a research topic is subordinated to other research topics. The same conclusion can be drawn for research targeting the social and attitudinal environment of adults with HL. Difficulties in the linking procedure were highlighted and discussed, and suggestions for future revisions of the ICF from the audiological perspective were described.
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- Kollén, Lena, 1960-, et al.
(author)
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Benign Paroxysmal Positional Vertigo is a common cause of dizziness and unsteadiness in a large population of 75-year-olds
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Other publication (other academic/artistic)abstract
- Background and aims: Dizziness is a common problem among the elderly. Studies have shown that 65% of people with dizziness may have a vestibular etiologic diagnosis, possibly Benign Paroxysmal Positional Vertigo (BPPV). The diagnosis of BPPV is made by history and findings in the Dix-Hallpike test. It can be difficult to perform the Dix-Hallpike test in elderly persons due to limited range of motion when extending the neck. In this study we used a side-lying test to stimulate the posterior semicircular canal while the head and neck were fully supported on the examination table. The aims were to investigate the prevalence of dizziness or impaired balance and BPPV in a 75-year old population. Methods: A representative population sample of 675 persons completed a questionnaire about dizziness and 571 persons performed side-lying, static balance and dynamic walking tests.Results: Subjective dizziness and/or impaired balance was found in 36% especially when walking outdoors. A significant gender difference was found with a higher prevalence in women (40%) compared to men (30%) (p<0.01). BPPV was found in 11%. This was significantly more common in women compared to men (p<0.01). Elderly persons with BPPV also showed significantly impaired balance ability in static and dynamic balance tests compared to age matched persons without BPPV(p<0.01). Persons with BPPV reported significantly more subjective problems with dizziness and balance compared to persons without BPPV (p<0.001).Conclusions: Subjective and objective unsteadiness, dizziness and BPPV are common in elderly. The side-lying test is a good screening test for BPPV.
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- Kollén, Lena, 1960-, et al.
(author)
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Benign paroxysmal positional vertigo is a common cause of dizziness and unsteadiness in a large population of 75-year-olds
- 2012
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In: Aging Clinical and Experimental Research. - New York, USA : Springer. - 1594-0667 .- 1720-8319. ; 24:4, s. 317-323
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Journal article (peer-reviewed)abstract
- Background and aims: Studies have shown that 65% of people with dizziness may have a vestibular etiologic diagnosis, possibly benign paroxysmal positional vertigo (BPPV). The diagnosis of BPPV is based on medical history and findings after the Dix-Hallpike test. It is sometimes difficult to perform the Dix-Hallpike test in elderly persons, due to the limited range of motion when extending the neck. In this study, we used a side-lying test to stimulate the posterior semicircular canal, while the head and neck were fully supported on the examination table. The aims of this study were to investigate the prevalence of dizziness and/or impaired balance and BPPV in a population of 75-year-olds by means of a questionnaire and clinical tests, and to compare elderly persons with and without BPPV.Methods: A representative population sample of 675 persons completed a questionnaire about dizziness and 571 persons underwent side-lying, static balance and dynamic walking tests.Results: Subjective dizziness and/or impaired balance were found in 36% of subjects, especially when walking outdoors. A significant gender difference was found, with a higher prevalence in women (40%) compared with men (30%) (p<0.01). BPPV was found in 11% and was significantly more common in women (p<0.01). Elderly individuals with BPPV also displayed significantly impaired balance in static and dynamic balance tests compared with persons without BPPV (p<0.01). Persons with BPPV reported significantly more subjective problems with dizziness and balance compared with persons without BPPV (p<0.001).Conclusions: Subjective and objective unsteadiness, dizziness and BPPV are common in the elderly.
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