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- Larsson, Ellinor, 1982-
(author)
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Promoting social activities and participation among seniors : exploring and evaluating social and Internet-based occupational therapy interventions
- 2016
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Doctoral thesis (other academic/artistic)abstract
- IntroductionThe use of technology and Internet-based activities (IBAs) is increasing in society. However, seniors with limited experiences with the Internet can experience restricted participation in meaningful activities that are dependent on the Internet. Also, social transitions during aging might lead to reduced social activities and social contacts and to increased experiences of loneliness, all of which might have negative health implications. Therefore, there is a need to advance the knowledge of how occupational therapists can support seniors’ use of IBAs and create opportunities for social contacts and social activities during aging.AimThe overall aim of this thesis is to increase the knowledge of how Internet-based activities influence seniors’ participation in society, how seniors experience and are influenced by support from a social Internet-based occupational therapy intervention, and how different aspects of this intervention can contribute to healthy ageing.MethodsIn study I, seniors’ experiences of IBAs were explored and described through interviews with 10 seniors (66–82 years old) that were analyzed with the constant comparative method. In study II, a multiple case study with five seniors (65–85 years old) was used to explore the design of an Internet-based occupational therapy social intervention program and how it influenced social activities and social contacts among the participants. The qualitative and quantitative data from multiple sources were analyzed by pattern matching. In study III, an explorative randomized crossover study with an AB/BA design was conducted with 30 seniors (61–89 years old) who were vulnerable to loneliness and who participated in the intervention program. The quantitative data were analyzed with parametric and non-parametric statistics. In study IV, a qualitative interview study was conducted to collect the experiences of 15 seniors (66–87 years old) from the previous intervention process in study III. The interviews were analyzed with the constant comparative method. All participants in studies I–IV were community-dwelling, retired seniors without home-care services. ResultsComplex interactions of different aspects influence seniors’ possibilities and preferences for taking part in IBAs. The performance of IBAs yielded different experiences of participation in society (study I). The initial explorative results indicated that the client-centered and individually adapted intervention program supports participation in social IBAs (SIBAs) and other social contexts (study II). After participation in the intervention program, the experiences of loneliness significantly decreased, and satisfaction with social contacts on the Internet increased for one group (study III). If an individual’s requirements are met during the intervention process, experiences of habitual SIBA usage, increased self-reliance, and enriched social contacts and social activities both on and off the Internet might be facilitated (study IV).ConclusionThis thesis provides knowledge of how social support, experiences of and accessibility to technology, life-changing events, and identified meaningfulness with online activities influence the motivation to participate in social and Internet-based activities. The occupational therapist should address the individual’s perspective in the intervention program so as to adapt the intervention and to support experiences of satisfactory participation and enhanced social activities and social contacts for seniors. In addition, healthy aging might be supported by the intervention program due to the reduction in loneliness and increased participation in social activities and society. Further evaluation of the framework and content of the intervention program for seniors with restricted participation in IBAs and SIBAs and high levels of loneliness is suggested.
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| 2. |
- Nordin, Therese, 1980-
(author)
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Harnessing togetherness : perceptions of loneliness and promotion of social participation in the home care context
- 2023
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Doctoral thesis (other academic/artistic)abstract
- Introduction: It is well known that older adults have a higher risk for loneliness, which is detrimental to health. Home care in Sweden has a responsibility to address social needs, but systematic approaches are lacking and there is a know–do gap. The overall aim of this thesis was to develop knowledge about older home care recipients’ and home care providers' perceptions of loneliness and social participation among older adults, and furthermore, to develop a work model for supporting social participation in home care and explore that process.Methods: Four studies were included. In the first study, care recipient interviews explored perceptions of social participation. In the second, a total population survey investigated the association between perceived care quality and loneliness. The third study used individual and group interviews with home care providers to explore discourses on loneliness and social support. The fourth applied a participatory action research(PAR) process with care workers to develop strategies to alleviate care recipients’ loneliness.Findings: Enjoying personally relevant occupations, both in solitude and with others, was found to be important for satisfactory social participation. Low perceived quality in home care quality was statistically associated with loneliness. Two discourses, one in which care recipients were described as valued but vulnerable “others”, and another in which they were described as competent peers, were identified. A work model facilitating social participation was created, and the process was applied to a “framework for occupational enablement for change in community practice”.Conclusion: The understanding of loneliness and social participation in the complex home care context has been nuanced, as have discourses that affect home care practice. The work model itself could become a first step towards systematically addressing loneliness and social needs, and the application of an occupational enablement framework onto the PAR process ties the methodologies together and facilitates participatory research for occupational therapy and science.
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| 3. |
- Jonsson Henningsson, Anna, et al.
(author)
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Laboratory Methods for Detection of Infectious Agents and Serological Response in Humans With Tick-Borne Infections : A Systematic Review of Evaluations Based on Clinical Patient Samples
- 2021
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In: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 9
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Research review (peer-reviewed)abstract
- Background: For the most important and well-known infections spread by Ixodes ticks, Lyme borreliosis (LB) and tick-borne encephalitis (TBE), there are recommendations for diagnosis and management available from several health authorities and professional medical networks. However, other tick-borne microorganisms with potential to cause human disease are less known and clear recommendations on diagnosis and management are scarce. Therefore, we performed a systematic review of published studies and reviews focusing on evaluation of laboratory methods for clinical diagnosis of human tick-borne diseases (TBDs), other than acute LB and TBE. The specific aim was to evaluate the scientific support for laboratory diagnosis of human granulocytic anaplasmosis, rickettsiosis, neoehrlichiosis, babesiosis, hard tick relapsing fever, tularemia and bartonellosis, as well as tick-borne co-infections and persistent LB in spite of recommended standard antibiotic treatment.Methods: We performed a systematic literature search in 11 databases for research published from 2007 through 2017, and categorized potentially relevant references according to the predefined infections and study design. An expert group assessed the relevance and eligibility and reviewed the articles according to the QUADAS (diagnostic studies) or AMSTAR (systematic reviews) protocols, respectively. Clinical evaluations of one or several diagnostic tests and systematic reviews were included. Case reports, non-human studies and articles published in other languages than English were excluded.Results: A total of 48 studies fulfilled the inclusion criteria for evaluation. The majority of these studies were based on small sample sizes. There were no eligible studies for evaluation of tick-borne co-infections or for persistent LB after antibiotic treatment.Conclusions: Our findings highlight the need for larger evaluations of laboratory tests using clinical samples from well-defined cases taken at different time-points during the course of the diseases. Since the diseases occur at a relatively low frequency, single-center cross-sectional studies are practically not feasible, but multi-center case control studies could be a way forward.
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| 4. |
- Nilsson, Ingeborg, 1969-
(author)
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Occupational Engagement among Older People : Evaluation, Repertoire and Relation to Life satisfaction
- 2006
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Doctoral thesis (other academic/artistic)abstract
- Occupational engagement among older people is important to investigate as older people are the fastest growing segment in our society, and because occupational engagement is viewed within occupational therapy as one of the basic premises for health. Three perspectives of engagement are highlighted in this thesis: evaluation of occupational engagement, the repertoire of occupational engagement, and finally, the relation between occupational engagement and life satisfaction. The overall aim of this thesis was to study aspects of occupational engagement among older people, with a special focus on evaluation of the experiences of an occupation-based group programme, evaluation of leisure, the leisure repertoire, and the relation between occupational engagement and life satisfaction. The thesis is comprised of four studies which all contribute in different ways to an increasing understanding of occupational engagement among older people. In the first study (Study I), three older persons participated in a group activity programme and were interviewed about their experiences of occupational engagement. The qualitative interviews were done with each participant after each group session, in total 15 interviews. The other three studies (Studies II-IV) were based on a subgroup of a population studied in a cross-sectional population-based study, the Umeå 85+ study. Very old people with an MMSE score of 20 or more were included in Studies II, III, and IV (n=156). During home visits, they were interviewed about their occupational engagement (ADL and leisure) and their life satisfaction. The qualitative interviews analysed using a Grounded theory approach, revealed two different dimensions of experiences while engaged in a group programme. The participants described experiences of activation, with a creative force and a place for learning, but also experiences of transformation with reflection, adaptation, and finally, a personal synthesis. Evaluation of occupational engagement through measurement using the modified NPS Interest Checklist (MNPS) was made possible using Rasch analysis. The results revealed preliminary evidence for internal scale validity and person response validity. Scale and person reliability were Rasch equivalents of Cronbach alpha of .98 for items and .66 to .75 for persons, respectively. In their leisure repertoire, very old people were more likely to endorse Social and Cultural activities and least likely to endorse Ballgames and Equipment sport. Traditional gender differences and some differences between older persons in rural versus urban areas and between persons with different cognitive levels were also found. Finally, significant correlations were found between life satisfaction and both engagement in ADL (r =.31) and engagement in leisure (r =.34) among very old people. A forced entry regression revealed that both variables together explained slightly more (12.4%) than leisure alone (11.2%). As a conclusion and in relation to evaluation of occupational engagement during therapy, the experiences of engagement are described by the respondents from both a perspective of action and a perspective of inner reflection, and together they might support the developmental process among older people. Through using Rasch analysis, it was possible to convert ordinal data into linear measures and also to organize leisure occupations into a hierarchical repertoire of engagement. This repertoire gives further understanding for specific tasks and about the general relation between leisure dimensions. Finally, the contribution of occupational engagement to life satisfaction is likely essential, but explains only about 12% of total life satisfaction among very old people.
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