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Jönsson, M., Holmefur, M., Appelros, P. & Fredriksson, C. (2024). Close relatives' perspectives of everyday activities at home for older adults repeatedly readmitted to hospital: A qualitative study. British Journal of Occupational Therapy (1), 39-48
Open this publication in new window or tab >>Close relatives' perspectives of everyday activities at home for older adults repeatedly readmitted to hospital: A qualitative study
2024 (English)In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, no 1, p. 39-48Article in journal (Refereed) Published
Abstract [en]

Introduction: Relatives are important when older adults return home after a hospital stay. The aim of this study was to describe close relatives' perspectives of the everyday activities of older adults who are repeatedly readmitted to hospital and discharged to home.

Methods: A semi-structured interview was performed to collect data from twenty relatives (aged 45-82 years). Data were analysed using a deductive qualitative content analysis based on the results of a previous study within this field.

Results: The overall theme 'In need of support to manage an unpredictable everyday life' shows that the older adults often needed support in everyday activities. In the two categories 'Difficulties in dealing with an unstable day' and 'Managing an unstable day' and the 10 subcategories, close relatives described that the older adults needed support in various ways from relatives or other individuals. Close contact was important for how everyday activities worked at home and in maintaining social contacts and contact with healthcare.

Conclusion: It was found that social needs, such as social contacts/activities, are just as important to assess at discharge as medical and functional needs.

Place, publisher, year, edition, pages
Sage Publications, 2024
Keywords
Ageing, everyday activities, patient readmission, occupational therapy, qualitative research, relatives
National Category
Occupational Therapy
Identifiers
urn:nbn:se:oru:diva-108623 (URN)10.1177/03080226231191366 (DOI)001060087200001 ()2-s2.0-85170556850 (Scopus ID)
Available from: 2023-10-03 Created: 2023-10-03 Last updated: 2024-01-29Bibliographically approved
Spang, L., Holmefur, M., Hermansson, L. & Lidström-Holmqvist, K. (2023). Applying to a nursing home is a way to maintain control of life-Experiences from Swedish nursing home applicants. Scandinavian Journal of Caring Sciences, 37(1), 106-116
Open this publication in new window or tab >>Applying to a nursing home is a way to maintain control of life-Experiences from Swedish nursing home applicants
2023 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 37, no 1, p. 106-116Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Swedish social policy enables ageing in place with support from home-based care services despite high age and/or declining health.

AIM: This study aims to describe the daily life experiences behind the decision to apply for a nursing home placement in older adults ageing in place.

MATERIALS AND METHODS: A qualitative design was chosen, and 11 semi-structured interviews were conducted and analysed using inductive qualitative content analysis.

RESULTS: The participants described a feeling of dependence in which they had to ignore their personal privacy when receiving home-based care. They reached a turning point when ageing in place was, for several reasons, no longer considered an acceptable option. This influenced their choice to apply to a nursing home where they expected that they could maintain control over their lives.

DISCUSSION AND CONCLUSION: The results indicate that when enhancing ageing in place it is important to enable older adults to receive support to maintain autonomy in daily activities and to have the opportunity to age in the right place.

Place, publisher, year, edition, pages
Blackwell Publishing, 2023
Keywords
Activities of daily living, ageing in place, nursing homes, qualitative method
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-99930 (URN)10.1111/scs.13104 (DOI)000819676800001 ()35778880 (PubMedID)2-s2.0-85133212465 (Scopus ID)
Note

Funding agency:

Research School on Successful Ageing, Örebro University, Sweden

Available from: 2022-07-04 Created: 2022-07-04 Last updated: 2023-12-29Bibliographically approved
Arvidsson, P., Janeslätt, G., Wennberg, B., Lidström-Holmqvist, K., Holmefur, M. & Hayat Roshanay, A. (2023). Evaluation of the group intervention "Let's Get Organized" for improving time management, organisational, and planning skills in people with mild intellectual disability. Scandinavian Journal of Occupational Therapy, 30(8), 1257-1266
Open this publication in new window or tab >>Evaluation of the group intervention "Let's Get Organized" for improving time management, organisational, and planning skills in people with mild intellectual disability
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2023 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 30, no 8, p. 1257-1266Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Limited time management skills cause problems in daily life for people with mild intellectual disability (ID) and "Let's Get Organized" (LGO) is a promising manual-based occupational therapy group intervention aiming to support management skills.

AIMS/OBJECTIVES: To evaluate the applicability of the Swedish version of LGO-S by i) exploring enhancements in time management skills, satisfaction with daily occupations, and aspects of executive functioning in people with time-management difficulties and mild ID, and ii) describing clinical experiences of using the LGO-S for people with mild ID.

MATERIAL AND METHODS: Twenty-one adults with mild ID were included. Data were collected pre-/post-intervention and at 3- and 12-month follow-ups with: Swedish version of Assessment of Time Management Skills (ATMS-S), Satisfaction with Daily Occupation (SDO-13), and Weekly Calendar Planning Activity (WCPA-SE). There were few follow-up participants (n = 6-9).

RESULTS: Significant change in time management skills that maintained at 12-months follow-ups. Significant increase in regulation of emotions at 12-month follow-up. Results at 12-months follow-up indicated sustainability in outcomes as measured by ATMS-S. A non-significant positive trend was observed in other outcomes between pre- and post-intervention.

CONCLUSIONS AND SIGNIFICANCE: LGO-S seems applicable for improving skills in time management, organisation and planning also for people with mild ID.

Place, publisher, year, edition, pages
Pharma Intelligence UK Ltd., 2023
Keywords
Daily time management, inclusion, participation, satisfaction with daily occupations
National Category
Occupational Therapy
Identifiers
urn:nbn:se:oru:diva-106403 (URN)10.1080/11038128.2023.2217545 (DOI)001002153300001 ()37278986 (PubMedID)2-s2.0-85161553996 (Scopus ID)
Available from: 2023-06-26 Created: 2023-06-26 Last updated: 2023-11-24Bibliographically approved
Spang, L., Holmefur, M., Pettersson, C. & Lidström-Holmqvist, K. (2023). Experiences of Close Relatives of Older Adults in Need of a Nursing Home: It Is We Who Manage Their Fragile Daily Life. Health & Social Care in the Community, 2023, Article ID 9490086.
Open this publication in new window or tab >>Experiences of Close Relatives of Older Adults in Need of a Nursing Home: It Is We Who Manage Their Fragile Daily Life
2023 (English)In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 2023, article id 9490086Article in journal (Refereed) Published
Abstract [en]

Home-based care is expanding, and we need to know more about what kind of support older adults need and how such support should be designed. One way to gain more knowledge is to study the experiences that underlie a nursing home application. However, older adults in need of nursing homes are often too weak to participate in research. Thus, this study aimed to describe the experiences of close relatives of the daily life of older adults in need of a nursing home. A qualitative approach was used, where fifteen relatives of nursing home applicants in central Sweden were interviewed using a study-specific interview guide. The interviews were analysed using thematic analysis. The findings are presented in one main theme "Being the person who manages a fragile life situation" with three underlying themes: Balancing and fulfilling expectations, striving to achieve a status quo, experiencing a breaking point, a change is inevitable, and waiting and moving into a nursing home, a period of tension. The main theme describes how the participants contributed to managing the older adults' life situation and acted as a representative in contacts with health and social care. They tried to offer support in their daily life but over time experienced a breaking point when ageing in place was no longer sustainable, resulting in a nursing home application. The rationale for a nursing home application was often a combination of the older adult's own wishes and the fact that their relatives felt there was a combined need for extensive care and physical proximity to staff, which cannot be provided in ordinary housing. Sometimes the decision to apply was also based on relatives no longer having the capacity to continue managing an older adult's fragile situation.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-105060 (URN)10.1155/2023/9490086 (DOI)000934532800002 ()2-s2.0-85177827274 (Scopus ID)
Available from: 2023-03-20 Created: 2023-03-20 Last updated: 2024-02-05Bibliographically approved
Eliasson, A.-C., Nordstrand, L., Backheden, M. & Holmefur, M. (2023). Longitudinal development of hand use in children with unilateral spastic cerebral palsy from 18 months to 18 years.. Developmental Medicine & Child Neurology, 65(3), 376-384
Open this publication in new window or tab >>Longitudinal development of hand use in children with unilateral spastic cerebral palsy from 18 months to 18 years.
2023 (English)In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 65, no 3, p. 376-384Article in journal (Refereed) Published
Abstract [en]

AIM: To describe the development of the use of the affected hand in bimanual tasks in children with unilateral cerebral palsy (CP) from 18 months to 18 years. Specifically, whether early development can be confirmed in a larger cohort and how development progresses during adolescence.

METHOD: In total, 171 participants (95 males, 76 females; mean age 3 years 1 month [SD 3 years 8 months], range 18 months-16 years at inclusion) were classified in Manual Ability Classification System (MACS) levels I (n = 41), II (n = 91), and III (n = 39). Children were assessed repeatedly (median 7, range 2-16 times) with the Assisting Hand Assessment: in total 1197 assessments. Developmental trajectories were estimated using a nonlinear mixed effects model. To further analyse the adolescent period, a linear mixed model was applied.

RESULTS: The developmental trajectories were different between participants in MACS levels (MACS I-II, II-III) in both rate (0.019, 95% confidence interval [CI] 0.006-0.031, p = 0.034; 0.025, 95% CI 0.015-0.037, p < 0.001) and limit (19.9, 95% CI 16.6-23.3, p = 0.001; 7.2, 95% CI 3.3-11.2, p < 0.003). The individual variations were large within each level. The developmental trajectories were stable over time for all MACS levels between 7 and 18 years (p > 0.05).

INTERPRETATION: Children and adolescents with unilateral CP have considerable development at an early age and a stable ability to use their affected hand in bimanual activities from 7 to 18 years in all MACS levels.

Place, publisher, year, edition, pages
Mac Keith Press, 2023
National Category
Psychology (excluding Applied Psychology) Pediatrics
Identifiers
urn:nbn:se:oru:diva-100626 (URN)10.1111/dmcn.15370 (DOI)000831136400001 ()35899928 (PubMedID)2-s2.0-85135063446 (Scopus ID)
Note

Plain Language Summary:

Developmental Medicine & Child Neurology. Vol. 65, Issue 10, e101-e102

DOI: 10.1111/dmcn.15735

WOS: 001051762500001

PubMed ID: 37587730

Available from: 2022-08-19 Created: 2022-08-19 Last updated: 2023-12-08Bibliographically approved
Adaszak, S., Gustafsson, J., Källström, Å., Holmefur, M. & Farias Vera, L. (2023). Navigating barriers and facilitators to support victims of violence in a close relationship with cognitive disability: Social workers´ perspectives. In: : . Paper presented at 23rd Annual Conference of the European Society of Criminology (Eurocrim 2023), Florence, Italy, September 6-9, 2023.
Open this publication in new window or tab >>Navigating barriers and facilitators to support victims of violence in a close relationship with cognitive disability: Social workers´ perspectives
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2023 (English)Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

The risk of violence in close relationships is higher for people with cognitive disabilities than in the general population. This is due to social isolation, and physical or financial dependence on others in everyday activities. To enable adequate protection for these victims, social workers need to take decisions and provide support that is based on knowledge about both violence and disability-related needs. By contrast, people with cognitive disabilities are de facto less likely to be provided with support adapted to their needs. Therefore, this study explores how social workers navigate barriers and facilitating aspects to support victims of violence with cognitive disabilities.Data were collected in individual interviews with 18 social workers, and analysed using content analysis. The inclusion criteria were 3 years or more experience in identifying and/or assessing exposure to violence in close relationships among people with cognitive disabilities.

The emerging categories illustrate how social workers face dilemmas when navigating the balance between individuals’ rights for self-determination and complex needs for protection and support. The policies that frame social workers' practice in Sweden are discussed in relation to the need for flexible interventions and accessible support based on interprofessional collaboration related to violence and cognitive disability. The categories also problematize the power dynamics involved and how different actors’ experiences, values, and power influence the support process. The different actors involved add to the complexity that social workers need to navigate.

This presentation focus on how social workers' practice is governed and hindered by policy, a focus on individuals' rights for self-determination, and the need to support and protect a group that may have difficulties to identify both violence and their needs for support.

Keywords
disability, violence, victims, accessible support
National Category
Social Sciences Interdisciplinary Other Health Sciences
Research subject
Disability research; Social Work
Identifiers
urn:nbn:se:oru:diva-110690 (URN)
Conference
23rd Annual Conference of the European Society of Criminology (Eurocrim 2023), Florence, Italy, September 6-9, 2023
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2021-02063
Available from: 2024-01-12 Created: 2024-01-12 Last updated: 2024-01-15Bibliographically approved
Baric, V. B., Yngve, M., Holmefur, M., Feldman, I., Wilder, J., Johansen, K., . . . Borgestig, M. (2023). Partnering for change (P4C) in Sweden: a study protocol of a collaborative school-based service delivery model to create inclusive learning environments. BMC Public Health, 23(1), Article ID 2219.
Open this publication in new window or tab >>Partnering for change (P4C) in Sweden: a study protocol of a collaborative school-based service delivery model to create inclusive learning environments
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2023 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 23, no 1, article id 2219Article in journal (Refereed) Published
Abstract [en]

Background: Inclusive learning environments are considered as crucial for children's engagement with learning and participation in school. Partnering for change (P4C) is a collaborative school-based service delivery model where services are provided at three levels of intensity based on children's needs (class, group-, individual interventions). Interventions in P4C are provided universally to support all children with learning, not only children with special education needs (SEN), and as such are expected to be health-promoting.

Aim: The aim of the study is to evaluate the effectiveness and cost-effectiveness of P4C as well as school staff members' and children's experiences after P4C.

Methods: In a parallel, non-randomised controlled intervention design, 400 children, aged 6-12 years, and their teachers, will be recruited to either intervention classes, working according to the P4C, or to control classes (allocation ratio 1:1). Data will be collected at baseline, post-intervention (4 months), and 11 months follow-up post baseline. The primary outcome is children's engagement with learning in school. Secondary outcomes include for example children's health-related quality of life and wellbeing, occupational performance in school, attendance, and special educational needs. The difference-in-differences method using regression modelling will be applied to evaluate any potential changes following P4C. Focus group interviews focusing on children, and professionals' experiences will be performed after P4C. A health economic evaluation of P4C will be performed, both in the short term (post intervention) and the long term (11-month follow-up). This study will provide knowledge about the effectiveness of P4C on children's engagement with learning, mental health, and wellbeing, when creating inclusive learning environments using a combination of class-, group- and individual-level interventions.

Place, publisher, year, edition, pages
Springer Nature, 2023
Keywords
Children with special needs, Dynamic performance analysis (DPA), Inclusive learning environments, Mental health, Partnering for change (P4C), Response to intervention (RtI), School-based service delivery model
National Category
Pedagogy
Identifiers
urn:nbn:se:oru:diva-109703 (URN)10.1186/s12889-023-17053-0 (DOI)001103430500002 ()37950243 (PubMedID)2-s2.0-85176263547 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, STY-2022/0007Sven Jerring FoundationLars Hierta Memorial FoundationClas Groschinski Memorial Foundation
Note

This project is funded and peer reviewed by FORTE: the Swedish Research Council for Health, Working Life and Welfare (STY-2022/0007), Jerringfonden, Stiftelsen Sunderdahls handikappfond, Clas Groschinskys Memorial Foundation, Lars Hiertas Memorial Foundation and ERASMUS + Small-scale partnerships in school education.

Available from: 2023-11-13 Created: 2023-11-13 Last updated: 2023-12-11Bibliographically approved
Thorsson, M., Holmefur, M. & Lidström-Holmqvist, K. (2023). Test-retest reliability of the assessment of time management skills (ATMS-S) in adults with neurodevelopmental disorders. Scandinavian Journal of Occupational Therapy, 30(5), 714-720
Open this publication in new window or tab >>Test-retest reliability of the assessment of time management skills (ATMS-S) in adults with neurodevelopmental disorders
2023 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 30, no 5, p. 714-720Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Time-management skills are essential in handling daily life, and adults with neurodevelopmental disorders often have difficulty with these skills. Therefore, interventions targeting such skills are common in occupational therapy. The Assessment of Time-Management Skills (ATMS) is a self-rated instrument for measuring time-management skills.

AIM: This study aims to evaluate the test-retest reliability of the Swedish version of the ATMS (ATMS-S).

MATERIALS AND METHODS: A total of 33 participants with neurodevelopmental disorders and difficulty with time management completed the test twice, approximately 1 week apart. The test-retest reliability for the three subscales in the ATMS-S was analyzed using intraclass correlation coefficients. The smallest detectable change was calculated to determine the precision of individual ATMS units.

RESULTS AND CONCLUSION: The results showed overall moderate to good stability for the measures. The intraclass correlation coefficients were 0.79 (time management), 0.82 (organization and planning), and 0.50 (regulation of emotions) for the three subscales, and the smallest detectable changes were 9.5, 6.9, and 15.7 ATMS units for the respective subscales. These results suggest that the ATMS-S is a sufficiently stable tool for measuring time management and organization and planning skills in adults with neurodevelopmental disorders, but may be less reliable for measuring emotional regulation.

Place, publisher, year, edition, pages
Pharma Intelligence UK Ltd., 2023
Keywords
ADHD, autism spectrum disorder, emotional regulation, occupational therapy, planning and organization, psychometrics, time management
National Category
Occupational Therapy
Identifiers
urn:nbn:se:oru:diva-104136 (URN)10.1080/11038128.2023.2175723 (DOI)000934446600001 ()36773026 (PubMedID)2-s2.0-85148281789 (Scopus ID)
Funder
Örebro University
Note

Funding agencies:

University Health Care Research Center, Region Örebro County

Available from: 2023-02-13 Created: 2023-02-13 Last updated: 2023-12-08Bibliographically approved
Holmefur, M., Elvrum, A.-K. G. & Krumlinde-Sundholm, L. (2023). The assisting hand assessment for children and youth with brachial plexus birth injury: a study of validity and item hierarchy of AHA-Plex. Journal of Rehabilitation Medicine, 55, Article ID jrm15325.
Open this publication in new window or tab >>The assisting hand assessment for children and youth with brachial plexus birth injury: a study of validity and item hierarchy of AHA-Plex
2023 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 55, article id jrm15325Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Functional assessments that focus on activity performance and that produce valid outcome measures for people with brachial plexus birth injury are lacking. The primary aim of this study was to re-evaluate the internal scale validity of the Assisting Hand Assessment specifically for children and adolescents with brachial plexus birth injury. Two further aims were investigating whether the scale could be shortened for this group while maintaining psychometric quality, and exploring and presenting its item difficulty hierarchy.

DESIGN: A cross-sectional psychometric study.

SUBJECTS: A convenience sample of 105 children and adolescents (aged 18 months to 18 years, mean 6 years, 7 months, standard deviation (SD) 4 years, 4 months) from Sweden, Norway, and the Netherlands with brachial plexus birth injury.

METHODS: Participants were assessed with the Assisting Hand Assessment. Data were analysed with Rasch measurement analysis. RESULTS: The 20 Assisting Hand Assessment items together measured a unidimensional construct with high reliability (0.97) and the 4-level rating scale functioned well. Item reduction resulted in 15 items with good item fit, unidimensionality, reliability and acceptable targeting.

CONCLUSION: Assisting Hand Assessment for people with brachial plexus birth injury, called AHA-Plex, has 15 items and good internal scale validity. A unique item hierarchy for people with brachial plexus birth injury is presented.

Place, publisher, year, edition, pages
Foundation for Rehabilitation Information, 2023
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-108595 (URN)10.2340/jrm.v55.15325 (DOI)37752629 (PubMedID)
Available from: 2023-09-28 Created: 2023-09-28 Last updated: 2023-10-30Bibliographically approved
Hugelius, K., Semrau, M. & Holmefur, M. (2023). Use of the HESPER Web to assess perceived needs immediately after multiple disaster events in Fiji. Disaster Medicine and Public Health Preparedness, 17, Article ID e385; PII S1935789323000472.
Open this publication in new window or tab >>Use of the HESPER Web to assess perceived needs immediately after multiple disaster events in Fiji
2023 (English)In: Disaster Medicine and Public Health Preparedness, ISSN 1935-7893, E-ISSN 1938-744X, Vol. 17, article id e385; PII S1935789323000472Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: In January 2022, Fiji was hit by multiple natural disasters including a cyclone causing flooding, an underwater volcanic eruption and tsunami. This study aimed to investigate perceived needs among the disaster-affected people in Fiji and to evaluate the feasibility of the Humanitarian Emergency Settings Perceived Needs Scale (HESPER Web) during the early stage after multiple natural disasters.

METHODS: A cross-sectional study using a self-selected, non-representative study sample was conducted. The HESPER Web was used to collect data.

RESULTS: In all, 242 people participated. The number of perceived serious needs ranged between 2 and 14 (out of a possible 26), with a mean of 6 (SD 3). The top three most reported needs were access to toilets (60%), care for people in the community who are on their own (55%), and distress (51%). Volunteers reported fewer needs than the general public.

CONCLUSIONS: The top three needs reported were related to water and sanitation and psychosocial needs. Such needs should not be underestimated in the emergency phase after natural disasters, and may require more attention from responding actors. The HESPER Web was be considered as a usable tool for needs assessment in a sudden onset disaster.

Place, publisher, year, edition, pages
Cambridge University Press, 2023
Keywords
Fiji, disaster response, natural disasters, needs assessment, online surveys
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-105453 (URN)10.1017/dmp.2023.47 (DOI)000982443700001 ()37037495 (PubMedID)2-s2.0-85153709447 (Scopus ID)
Available from: 2023-04-14 Created: 2023-04-14 Last updated: 2023-05-26Bibliographically approved
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