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- Johansson, Ann, 1955-, et al.
(author)
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A participatory evaluation of the health promotion programme “more healthy years of life” programme among senior citizens in Sweden
- 2018
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In: Cogent Medicine. - : Cogent OA. - 2331-205X. ; 5:1
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Journal article (peer-reviewed)abstract
- Background: Older adults have, in general, been sparsely involved in development and evaluation of programmes intended to promote their health.Aim: To describe older adults’ reflections on and involvement in the development and evaluation of a health promotion programme.Material and Method: Ten older persons participated in a health promotion programme (HPP) focusing on activity during four sessions. After each HPP session, focus group discussions were held, analysed through qualitative content analysis.Results: The main theme; “Being involved adds value and new experiences to life“, were built from sub-themes; “From sceptical individual to engaged group member”, “From beholder to active co-creator”, and “From individual knowledge recipient to collective knowledge sharer”.Conclusions: Having a leader with a gerontological competence was mentioned as important, as well as to integrate existential topics into the HPP. Social inclusion together with the possibility to influence the HPP had a positive effect on the participants and provided a sense of belonging.Significance: Several contributions to the development of the HPP were given, that would not have been captured without the reflections and involvement of the participants. However, more and larger studies are needed to develop strategies that enable older adult’s involvement in the development of HHP.
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- Johansson, Ann, 1955-
(author)
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Occupational adaptation in diverse contexts with focus on persons in vulnerable life situations
- 2017
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Doctoral thesis (other academic/artistic)abstract
- Introduction. This present thesis focuses on occupational adaptation in the empirical context of vulnerable populations relative to ageing (Study II, III), disability (Study I, II) and poverty (Study IV) and in a theoretical context (V).Aim. The overall aim was to explore and describe occupational adaptation in diverse contexts with a focus on persons in vulnerable life situations.Methods. The thesis was conducted with a mixed design embracing quantitative and qualitative methods and a literature review. The data collection methods comprised questionnaires (Study I, II, III), individual interviews (Study II, IV), group interviews (Study III) and data base searches (Study V). Altogether 115 persons participated in the studies and 50 articles were included in the literature review. Qualitative content analysis was used to analyse the interviews (Study I, II, III, IV) and the literature review (Study V). Parametric and non-parametric statistics were applied when analysing the quantitative data (Study II, III).Results: Women in St Petersburg, Russia, who have had a minor stroke reported more dependence in everyday occupations than the stroke symptoms indicated and they overemphasized their disability and dysfunction. When the environmental press did not meet their competence, it caused negative adaptive behaviour (Study I). In home rehabilitation for older persons with disabilities, interventions based on the occupational adaptation model was compared with interventions based on well-tried professional experience. The results indicated that the use of the occupational adaptation model increased experienced health and the participants acquired adaptive strategies to manage every day occupations. (Study II). An occupation based health-promoting programme for older community dwelling persons was compared with a control group. The intervention group showed statistically significant improvement in general health variables as vitality and mental health, but there were no statistically significant differences between the groups. A qualitative evaluation, in the intervention group, showed that participation in meaningful, challenging occupations in different environments stimulated the occupational adaptation process (Study III). Occupational adaptation among vulnerable EU citizens begging in Sweden was explored by interviews. The results showed that the participants experienced several occupational challenges when begging abroad. The results show a variety of adaptive responses, but whether they are experienced as positive or negative is a matter of perspective and can only be determined by the participants themselves (Study IV). Finally, the results from a literature review (Study V) showed that research on occupational adaptation was mainly based on Schkade and Schultz’s and Kielhofner’s theoretical approaches. Occupational adaptation was also used without further explanation or theoretical argument (Study V).Conclusion: The surrounding context was shown to play an important role for the participants’ occupational adaptation. There were no general occupational challenges or adaptive responses to the various vulnerable life situations, but some common features in the participant groups’ adaptive responses were found. For example, if the environment put too great demand on the person and social support was lacking, there was a risk of negative adaptation. Moreover, persons with low functional capacity were vulnerable to environmental demands and dependent on a supportive environment for their adaptive response. However, persons living in supportive environments developed adaptive responses by themselves. Further, personal factors needed to be strengthened to meet the demands of the environment. Upholding occupational roles was a driving force in finding ways to adapt and perform occupations. Considering the theoretical context, the occupational adaptation theoretical approaches need to be further developed in relation to negative adaptation and to support use within community-based and health-promotive areas.
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- Johansson, Ann, 1955-, et al.
(author)
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Occupational challenges and adaptations of vulnerable EU citizens from Romania begging in Sweden
- 2019
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In: Journal of Occupational Science. - : Taylor & Francis. - 1442-7591 .- 2158-1576. ; 26:2, s. 200-210
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Journal article (peer-reviewed)abstract
- Introduction: People from European Union (EU) countries such as Latvia, Romania and Bulgaria who beg on the streets have become a common part of the townscape in Sweden. While demanding situations in their home countries drive them abroad to earn their living, those who turn to begging still face challenges in their everyday lives. Additional knowledge is needed, from their perspective, about the occupational challenges of begging, as well as how they adapt to those challenges.Aim: To describe the occupational challenges and related adaptations of vulnerable EU citizens begging in Sweden.Methods: We used a descriptive qualitative design. Individual interviews with 20 Romanian participants were conducted and analysed using qualitative content analysis with a deductive and inductive approach.Results: Six categories of occupational adaptation responses were identified: Keeping the family tier intact despite distance; Dealing with shame and stress; Managing body and mind when begging despite the monotony; Living as cheaply as possible; Trying to get a night's sleep without drawing attention to oneself; and Seeking alternatives for earning their living.Conclusion: Everyday life, when begging abroad, is filled with occupational challenges requiring occupational adaptations, for better or for worse, to sustain basic human needs. To further understand the needs of this vulnerable and marginalised group in society, human rights discourses that go beyond the individual level are needed.
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- Johansson, Ann, 1955-, et al.
(author)
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The use of occupational adaptation in research articles : a scoping review
- 2018
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In: Occupational Therapy in Health Care. - : Taylor & Francis. - 0738-0577 .- 1541-3098. ; 32:4, s. 422-439
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Research review (peer-reviewed)abstract
- The aim of this scoping review was to identify and describe how occupational adaptation has been used in different research studies published from 1992 to 2015 and to identify possible gaps in study design. Four categories of studies were identified: those focused on understanding how occupational adaptation occurs in different life situations and different health conditions, those focused on the use of occupational adaptation as a guide or model in organizing the occupational therapy process, and those using occupational adaptation as a part of instrument development. Several gaps in research are evident including updating the theory development on occupational adaptation, types of maladaptation, studies conducted in less affluent countries, quantitative studies with robust designs, inclusion of men and younger persons as subjects, vulnerable groups, health promotion, and community settings.
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- Lazarevic, Vladimir, et al.
(author)
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Failure matters : unsuccessful cytogenetics and unperformed cytogenetics are associated with a poor prognosis in a population-based series of acute myeloid leukaemia
- 2015
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In: European Journal of Haematology. - Hoboken, USA : Wiley-Blackwell. - 0902-4441 .- 1600-0609. ; 94:5, s. 419-423
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Journal article (peer-reviewed)abstract
- Unsuccessful cytogenetics (UC) in patients with acute myeloid leukaemia (AML) treated on different SWOG trials was recently reported to be associated with increased age and dismal outcome. To ascertain whether this holds true also in unselected patients with AML, we retrieved all cytogenetic reports in cases from the population-based Swedish AML Registry. Between 1997 and 2006, 1737 patients below 80 yr of age without myelosarcoma or acute promyelocytic leukaemia received intensive treatment. The frequencies of UC and unperformed cytogenetics (UPC) were 2.1% and 20%, respectively. The early death rates differed between the cytogenetic subgroups (P = 0.006) with the highest rates in patients with UC (14%) and UPC (12%) followed by high-risk (HR) AML, intermediate risk (IR) and standard risk (SR) cases successfully karyotyped (8.6%, 5.9%, and 5.8%, respectively). The complete remission rate was lower in UC and UPC and HR compared with the other risk groups (P < 0.001). The overall five-year survival rates were 25% for UC and 22% for UPC, whereas the corresponding frequencies for SR, IR and HR AML patients without UC and UPC were 64%, 31% and 15%, respectively. In conclusion, lack of cytogenetic data translates into a poor prognosis.
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