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  • 1.
    Algilani, Samal
    Örebro University, School of Health Sciences.
    To be at one's best: The evolution of Optimal Functionality and its possible implementation in an ICT-platform2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    At the Nutrition and Physical Activity Research Centre for Optimal Health and Functionality through Life (NUPARC), a research gap was uncovered regarding the concept optimal functionality based on the older adult’s own perspective. The overall aim was to explore the concept of optimal functionality among older adults and the possibility of creating and developing an ICT-platform to measure it. Method: An existing cohort from NUPARC was used for recruitment in studies I-III and to some extent study IV. A scoping study design and framework was adopted for the inclusion of the articles in Study I. Study II had a descriptive design. Six focus group discussions were conducted and analysed using qualitative deductive content analysis to extend the qualitative understanding. Study III used a phenomenological approach describing the experience of mental health and its impact on the ability to function as optimally as possible. Six interviews were analysed using Giorgi’s phenomenological approach. Study IV was a feasibility study and included 8 older adults using an ICTplatform for a period of four weeks. Results: Optimal Functionality comprises three major corner stones: Body-related factors, Self-related factors and External factors (I) accompanied by nine aspects, and according to older adults it is a matter of functioning as optimally as possible (II). The three major cornerstones are intricately linked and all but the mental aspects were included in the discussions (II). Life situations affecting mental health, consequences of mental health and strategies for maintaining good mental health were described by older adults as having an impact on mental health and affecting their ability to function as optimally as possible (III). The older adults managed the usage of an ICT-tool well and it was perceived as meaningful (IV). Conclusion: Optimal functionality is holistic, subjective, dynamic and applicable to all older adults. Identification of the factors involved can help the older adults on their path to health. An ICT-platform can facilitate the identification of the factors for optimal functionality and the eventual measurement of it.

    List of papers
    1. Exploring the concept of optimal functionality in old age
    Open this publication in new window or tab >>Exploring the concept of optimal functionality in old age
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    2014 (English)In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 7, p. 69-79Article, review/survey (Refereed) Published
    Abstract [en]

    BACKGROUND: Aging is characterized by loss of function and represents a perspective that puts the focus on the negative aspects of aging. Thus, it is fundamental to shift the focus from loss of function to maintaining good health and personal satisfaction through life; in other words, to promote optimal functionality at a level appropriate for older adults. However, it is not yet known what constitutes optimal functionality from the older adult's own perspective.

    OBJECTIVE: To explore the concept of optimal functionality in old age from the older adult's perspective (ie, people over 65 years of age) in industrialized Western countries.

    METHODS: We undertook a scoping review and searched two electronic databases (PubMed and the Cumulative Index to Nursing and Allied Health Literature [CINAHL]) from January 2002 to July 2013 for scientific studies, using the key search term personal satisfaction. In total, 25 scientific studies were analyzed.

    RESULTS: Only six of the included articles applied a qualitative methodology. By analyzing the results of these articles, three major themes were identified as cornerstones in the concept of optimal functionality at old age: 1) self-related factors (eg, mental well-being); 2) body-related factors (eg, physical well-being); and 3) external factors equal to demographic and environmental factors.

    CONCLUSION: There is a lack of qualitative studies in the current literature, and hence of what constitutes optimal functionality from the older adult's perspective. The results outlined in this review identify three cornerstones (self-related factors, body-related factors, and external factors) of what constitutes optimal functionality at old age. However, it is vital that these findings are taken further and are evaluated through qualitative studies to reflect older adults' opinions.

    Place, publisher, year, edition, pages
    Dove Medical Press, 2014
    Keywords
    optimal functionality, aging, personal satisfaction
    National Category
    Nursing
    Research subject
    Medicine; Nursing Science
    Identifiers
    urn:nbn:se:oru:diva-33866 (URN)10.2147/JMDH.S55178 (DOI)24516333 (PubMedID)2-s2.0-84893293812 (Scopus ID)
    Available from: 2014-02-20 Created: 2014-02-20 Last updated: 2018-06-05Bibliographically approved
    2. Increasing the qualitative understanding of optimal functionality in older adults: a focus group based study
    Open this publication in new window or tab >>Increasing the qualitative understanding of optimal functionality in older adults: a focus group based study
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    2016 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, no 1, article id 70Article in journal (Refereed) Published
    Abstract [en]

    Background: Decreased independence and loss of functional ability are issues regarded as inevitably connected to old age. This ageism may have negative influences on older adults' beliefs about aging, making it difficult for them to focus on their current ability to maintain a good health. It is therefore important to change focus towards promoting Optimal Functionality (OF). OF is a concept putting the older adult's perspective on health and function in focus, however, the concept is still under development. Hence, the aim was to extend the concept of optimal functionality in various groups of older adults.

    Methods: A qualitative study was conducted based on focus group discussions (FGD). In total 6 FGDs were performed, including 37 older adults from three different groups: group 1) senior athletes, group 2) free living older adults, group 3) older adults living in senior living homes. All data was transcribed verbatim and analyzed following the process of deductive content analysis.

    Results: The principal outcome of the analysis was "to function as optimally as you possibly can", which was perceived as the core of the concept. Further, the concept of OF was described as multifactorial and several new factors could be added to the original model of OF. Additionally the findings of the study support that all three cornerstones comprising OF have to occur simultaneously in order for the older adult to function as optimal as possible.

    Conclusions: OF is a multifaceted and subjective concept, which should be individually defined by the older adult. This study further makes evident that older adults as a group are heterogeneous in terms of their preferences and views on health and should thus be approached as such in the health care setting. Therefore it is important to promote an individualized approach as a base when caring for older adults.

    Place, publisher, year, edition, pages
    London, United Kingdom: BioMed Central, 2016
    Keywords
    Older adults, optimal functionality, person centered care, focus group discussions
    National Category
    Geriatrics
    Research subject
    Geriatrics
    Identifiers
    urn:nbn:se:oru:diva-49605 (URN)10.1186/s12877-016-0244-z (DOI)000372822200002 ()27007861 (PubMedID)
    Funder
    Knowledge Foundation, 20110225
    Note

    Funding Agencies:

    Olle Engkvist Byggmästare Foundation

    Faculty of Medicine and Health at Örebro University

    Available from: 2016-04-02 Created: 2016-04-02 Last updated: 2018-04-27Bibliographically approved
    3. Mental health as a prerequisite for functioning as optimally as possible in old age: a phenomenological approach
    Open this publication in new window or tab >>Mental health as a prerequisite for functioning as optimally as possible in old age: a phenomenological approach
    Show others...
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-50048 (URN)
    Available from: 2016-04-29 Created: 2016-04-29 Last updated: 2017-10-17Bibliographically approved
    4. An interactive ICT-platform for early assessment and management of patient-reported concerns among older adults living in Ordinary Housing: Development and Feasibility
    Open this publication in new window or tab >>An interactive ICT-platform for early assessment and management of patient-reported concerns among older adults living in Ordinary Housing: Development and Feasibility
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-50049 (URN)
    Available from: 2016-04-29 Created: 2016-04-29 Last updated: 2017-10-17Bibliographically approved
  • 2.
    Algilani, Samal
    et al.
    Örebro University, School of Health Sciences.
    Langius-Ekelöf, Ann
    Karolinska Institutet, Stockholm, Sweden.
    Kihlgren, Annica
    Örebro University, School of Health Sciences.
    Blomberg, Karin
    Örebro University, School of Health Sciences.
    An interactive ICT-platform for early assessment and management of patient-reported concerns among older adults living in Ordinary Housing: Development and FeasibilityManuscript (preprint) (Other academic)
  • 3.
    Algilani, Samal
    et al.
    Örebro University, School of Health Sciences.
    Östlund-Lagerström, Lina
    Örebro University, School of Medical Sciences.
    Kihlgren, Annica
    Örebro University, School of Health Sciences.
    Schoultz, Ida
    Örebro University, School of Medical Sciences.
    Schröder, Agneta
    Örebro University, School of Health Sciences.
    Mental health as a prerequisite for functioning as optimally as possible in old age: a phenomenological approachManuscript (preprint) (Other academic)
  • 4.
    Amer, Ahmed
    et al.
    University Health Care Research Center, Örebro, Sweden.
    Kakooza-Mwesige, A.
    Department of Paediatrics & Child Health, Makerere University College of Health Sciences, Kampala, Uganda; Mulago Hospital, Kampala, Uganda; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Jarl, Gustav
    Örebro University, School of Medical Sciences. Örebro University Hospital. University Health Care Research Center, Örebro, Sweden; Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Tumwine, J. K.
    Department of Paediatrics & Child Health, Makerere University College of Health Sciences, Kampala, Uganda; Mulago Hospital, Kampala, Uganda.
    Forssberg, H.
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Eliasson, A.-C.
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Hermansson, Liselotte
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Prosthetics and Orthotics.
    The Ugandan version of the Pediatric Evaluation of Disability Inventory (PEDI-UG). Part II: Psychometric properties2018In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214Article in journal (Refereed)
    Abstract [en]

    Background: The Pediatric Evaluation of Disability Inventory (PEDI) has been recommended as a gold standard in paediatric rehabilitation. A Ugandan version of PEDI (PEDI-UG) has been developed by culturally adapting and translating the original PEDI. The aim of this study was to investigate the psychometric properties of the PEDI-UG in Ugandan children by testing the instrument's rating scale functioning, internal structure, and test-retest reliability.

    Methods: Two hundred forty-nine Ugandan children (125 girls) aged 6 months to 7.5 years (Mean = 3.4, SD = 1.9) with typical development were tested using the PEDI-UG. Forty-nine children were tested twice to assess test-retest reliability. Validity was investigated by Rasch analysis and reliability by intraclass correlation coefficient.

    Results: The PEDI-UG domains showed good unidimensionality based on principal component analysis of residuals. Most activities (95%) showed acceptable fit to the Rasch model. Six misfit items were deleted from the Functional Skills scales and one from the Caregiver Assistance scales. The category steps on the Caregiver Assistance scales' rating scale were reversed but functioned well when changed from a 6-point to 4-point rating scale. The reliability was excellent; intraclass correlation coefficient was 0.87-0.92 for the domains of the Functional Skills scales and 0.86-0.88 for the domains of the Caregiver Assistance scales.

    Conclusion: The PEDI-UG has good to excellent psychometric properties and provides a valid measure of the functional performance of typically developing children from the age of 6 months to 7.5 years in Uganda. Further analysis of all items, including misfit and deleted items, in children with functional disability is recommended.

  • 5.
    Anderzén-Carlsson, Agneta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Audiological Research Centre, Region Örebro County, Örebro University Hospital, Örebro, Sweden; The Swedish Institute for Disability Research (SIDR), Örebro, Sweden.
    CHARGE syndrome: a five case study of the syndrome characteristics and health care consumption during the first year in life2015In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 30, no 1, p. 6-16Article in journal (Refereed)
    Abstract [en]

    CHARGE syndrome is characterized by impaired vision and hearing, as well as physical malformations. The aim of this study is to describe the characteristics of the malformations and the health care consumption during the first year, in a Swedish sample having CHARGE syndrome. Three of the five individuals fulfilled all the traditional criteria for a clinical diagnosis of CHARGE syndrome. All infants were hospitalized from 26 to 230. days, subjected to 10-34 different diagnostic procedures and prescribed 10-28 different medications during their first year. Coordinated and individually adapted care is urged, as these infants and their families are in of need multiple health care contacts.

  • 6.
    Arnell, Susann
    et al.
    Örebro University, School of Health Sciences. University Health Care Research Center (UFC) Region Örebro County, Örebro, Sweden.
    Jerlinder, K.
    Faculty of Health and Occupational Studies, University of Gävle, Gävle , Sweden.
    Lundqvist, Lars-Olov
    Örebro University, School of Law, Psychology and Social Work. University Health Care Research Center (UFC) Region Örebro County, Örebro, Sweden.
    Participation in physical activities -a multilevel challenge for adolescents with autism spectrum disorders2017Conference paper (Other academic)
    Abstract [en]

    Introduction: Physical inactivity is one of the biggest current public health problems. Few adolescents with autism spectrum disorder (ASD) achieve the recommendation of daily physical activity (PA). The reasons for not being physically active depend on several complex factors, yet not comprehensively described from the adolescents’point of view. The absence of their perspective means that intervention strategies for health enhancing physical activity may not encompass the experiences of the adolescents themselves. Therefore the purpose of this study was to develop an understanding of the perceptions, experiences and reflections of adolescents with ASDs’participation in PA.

    Participants and methods: Twenty-four adolescents, diagnosed with ASD without a co-occurring intellectual disability, aged 12-16 years, participated in the study.Data was collected using qualitative interviews and inductively analyzed using qualitative content analysis.

    Results: Adolescents with ASD were a heterogeneous group in regard to their current PA habits and preferences. Their willingness to participate in PA was conditioned regarding; what, where, when and with whom. They described challenges in the activity and the social context during PA, especially during the mandatory physical education. Perceived demands, freedom of choice, physical ability and sense of control affected their PA participation.

    Conclusion: Findings indicate that the adolescents’willingness to participate was associated with interacting and individual-related conditions, which can be misinterpreted as unwillingness to participate in PA. Thus aspects of autonomy and knowledge about individual conditions and needs have to be recognized when intervention strategies for health enhancing physical activities are planned for this population.

  • 7.
    Arvidsson Lindvall, Mialinn
    Örebro University, School of Health Sciences.
    Physiotherapeutic perspectives on balance control after stroke: exercises, experiences and measures2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to investigate physiotherapeutic perspectives on balance after stroke, in terms of exercises, experiences and measurements. Study I was a pilot randomized controlled trial with 46 persons who had had a stroke, 24 of whom were included in the intervention group and 22 who were included in the control group. The intervention consisted of 8 weeks of body awareness therapy (BAT). There were no significant differences over time between the groups in the outcome measures of balance, walking, self-reported balance confidence and quality of life. Study II had a qualitative design using content analysis. Participants in the intervention group from Study I and the four physiotherapists who had been in charge of the BAT were interviewed. One overall theme emerged: "Simple yet challenging", which was based on six categories. Study III investigated the validity and test-retest reliability of the Six-Spot Step test (SSST), an instrument used to assess the ability to take load on each leg. A cross-sectional design with 81 persons who had had stroke was performed. The convergent validity was strong to moderate, and the test-retest reliability was good. In Study IV a mixed method design including both qualitative and quantitative data collection was used. The participants’ experiences of balance and its influence in everyday life were presented in two themes: "Feeling dizzy and unstable is a continuous challenge" and "Feeling trust and confidence despite dizziness and unsteadiness". Taken together, the different data sets provided complementary and confirmatory information about balance. All participants experienced the balance limitations as a continuous challenge in everyday life, yet they also felt trust and confidence.

    In summary, BAT can be a complement in physiotherapeutic stroke rehabilitation and the SSST can be used as a measuring instrument of walking balance in persons with stroke. Living with balance limitations was experienced as a challenge but the participants were still able to manage their everyday life and activities.

    List of papers
    1. Body awareness therapy in persons with stroke: a pilot randomised controlled trial
    Open this publication in new window or tab >>Body awareness therapy in persons with stroke: a pilot randomised controlled trial
    2014 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 28, no 12, p. 1180-1188Article in journal (Refereed) Published
    Abstract [en]

    Objective: To investigate the effects of body awareness therapy on balance, mobility, balance confidence, and subjective health status in persons with stroke.

    Design: A pilot randomized controlled study with follow-up at one and 4–6 weeks after the intervention period.

    Setting: Four primary healthcare centres in Örebro County Council.

    Subjects: Persons more than six months post stroke, with walking ability of 100 metres.

    Intervention: The experimental intervention was body awareness therapy in groups once a week for eight weeks. The controls were instructed to continue their usual daily activities.

    Main measures: Berg Balance Scale, Timed Up and Go Test, Timed Up and Go Test with a cognitive component, 6-minute walk test, and Timed-Stands Test. Self-rated balance confidence was assessed using the Activities-specific Balance Confidence Scale, and subjective health status using the Short Form 36 (SF-36) questionnaire.

    Results: A total of 46 participants were included (mean age 64 years); 24 in the experimental intervention group and 22 in the control group. No significant differences in changed scores over time were found between the groups. Within the experimental intervention group, significant improvements over time was found for the tests Berg Balance Scale, Timed Up and Go cognitive, and 6-minute walk test. Within the control group, significant improvements over time were found for the Timed Up and Go Cognitive, and the Timed-Stands Test.

    Conclusion: In comparison to no intervention, no effects were seen on balance, mobility, balance confidence, and subjective health status after eight weeks of body awareness therapy.

    Place, publisher, year, edition, pages
    Sage Publications, 2014
    Keywords
    Body awareness therapy, postural control, physiotherapy, stroke
    National Category
    Health Sciences Nursing
    Research subject
    Health and Medical Care Research; Rehabilitation Medicine
    Identifiers
    urn:nbn:se:oru:diva-35843 (URN)10.1177/0269215514527994 (DOI)000347118700004 ()24668360 (PubMedID)2-s2.0-84921668455 (Scopus ID)
    Note

    Funding Agencies:

    Swedish Stroke Association

    Norrbacka Eugenia Foundation 803-11

    Research Committee Orebro County Council OLL-227701

    Available from: 2014-08-04 Created: 2014-08-04 Last updated: 2018-05-09Bibliographically approved
    2. Basic Body Awareness Therapy for patients with stroke: Experiences among participating patients and physiotherapists
    Open this publication in new window or tab >>Basic Body Awareness Therapy for patients with stroke: Experiences among participating patients and physiotherapists
    2016 (English)In: Journal of Bodywork & Movement Therapies, ISSN 1360-8592, E-ISSN 1532-9283, Vol. 20, no 1, p. 83-89Article in journal (Refereed) Published
    Abstract [en]

    Background: After a stroke many patients have muscle weakness, spasticity and compromised sensation leading to decreased postural stability. Basic Body Awareness Therapy includes slow movements that challenge postural control.

    Aim: The aim was to describe experiences of 8 weeks of Basic Body Awareness Therapy from the perspective of both patients with stroke and physiotherapists.

    Method: This study had a qualitative design. Twenty-one patients and four physiotherapists were interviewed. The interviews were analysed using manifest and latent content analysis.

    Results: One overall theme emerged "Simple yet challenging" which was based on six categories: "Facing one's limitations", "Individualized movements", "A feeling of harmony", "Improved balance", "Integrated knowledge" and "Frustration and doubt". The patients described improvement in balance and stability, as well as increased wellbeing.

    Conclusion: The patients and physiotherapists related that Basic Body Awareness Therapy challenges balance but also provides an opportunity to reflect on the body. (C) 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

    Place, publisher, year, edition, pages
    Elsevier, 2016
    Keywords
    Basic Body Awareness Therapy, Physiotherapy, Qualitative study, Stroke
    National Category
    Nursing
    Research subject
    Rehabilitation Medicine
    Identifiers
    urn:nbn:se:oru:diva-52163 (URN)10.1016/j.jbmt.2015.06.004 (DOI)000381689000012 ()26891641 (PubMedID)2-s2.0-84958039596 (Scopus ID)
    Available from: 2016-09-14 Created: 2016-09-14 Last updated: 2018-05-09Bibliographically approved
    3. Validity and test-retest reliability of the Six-Spot Step Test in persons after stroke
    Open this publication in new window or tab >>Validity and test-retest reliability of the Six-Spot Step Test in persons after stroke
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-66907 (URN)
    Available from: 2018-05-09 Created: 2018-05-09 Last updated: 2018-05-09Bibliographically approved
    4. "I can still manage": a mixed-method study of balance after stroke
    Open this publication in new window or tab >>"I can still manage": a mixed-method study of balance after stroke
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-66909 (URN)
    Available from: 2018-05-09 Created: 2018-05-09 Last updated: 2018-05-09Bibliographically approved
  • 8.
    Arvidsson Lindvall, Mialinn
    et al.
    Örebro University, School of Health Sciences.
    Anderzén-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital. Karlstad University, Karlstad, Sweden.
    Appelros, Peter
    Department of University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Forsberg, Anette
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Validity and test-retest reliability of the Six-Spot Step Test in persons after strokeManuscript (preprint) (Other academic)
  • 9.
    Arvidsson Lindvall, Mialinn
    et al.
    Örebro University, School of Health Sciences.
    Forsberg, Anette
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Appelros, Peter
    Department of University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Anderzén-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital.
    "I can still manage": a mixed-method study of balance after strokeManuscript (preprint) (Other academic)
  • 10.
    Barzangi, Jir
    Örebro University, School of Health Sciences.
    Infant Dental Enucleation in Sweden: Perspectives on a Practice among Residents of Eastern African Origin2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Infant dental enucleation (IDE) is a practice consisting of the removal of deciduous canine tooth buds in infants. Practiced mainly in Eastern Africa, the purpose is to treat or to prevent bodily symptoms and diseases. IDE can cause both general and oral complications. The occurrence of IDE among Eastern African immigrants in a few European countries has been reported. However, knowledge surrounding the practice in Sweden was poor. The overall aim of this work was to explore IDE in the Swedish context. Four studies were conducted. Paper I presents a review of scientific publications. An overview of IDE was gained, and some knowledge gaps were identified. Paper II describes a cross-sectional study to determine the prevalence of IDE in small children. Dental records of 1133 children (mean age 4.6 years, SD 1.4) from a multi-ethnic area were studied. Missing deciduous canines without any registered reason were documented. One or more deciduous canines were missing in 21% of the children with known Eastern African origin (n=101), compared to only three children in the rest of the population (n=1032). Six adults of Somali origin were interviewed to explore their experiences and perceptions of IDE (paper III). These experiences and perceptions were categorised in four essentially different ways: an effective and necessary treatment, a disputed tradition, an option to failure and a desperate measure. Their experiences and perceptions were found to be highly influenced by contexts. In the final study (paper IV), the knowledge, experiences and attitudes among dental and health care personnel were examined. Questionnaires were sent to licensed personnel working in emergency departments, midwifery and child health centres, school health services and public dental health services in ten municipalities. Less than 20% had any knowledge of IDE, while 12.5% of the respondents encountering children had seen at least one patient subjected to IDE. Different attitudes were reported between clinical settings regarding responsibilities and possibilities concerning the management and prevention of IDE. From the findings presented in this thesis, it was concluded that there is a need for initiatives to increase awareness of and knowledge on IDE among dental and health care professionals. Legally obligated responsibilities in these professions regarding IDE need to be clarified, and initiatives should include guidelines regarding both the management of IDE and its prevention in Sweden. Educational programmes should also be produced for residents of Eastern African origin to change their perceptions of IDE, and a culturally sensitive approach should be adopted to ensure that such programmes are effective.

    List of papers
    1. Infant dental enucleation: A literature review on a traditional remedial practice in East Africa
    Open this publication in new window or tab >>Infant dental enucleation: A literature review on a traditional remedial practice in East Africa
    2014 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 72, no 3, p. 168-178Article, review/survey (Refereed) Published
    Abstract [en]

    Objective. To summarize and review the literature on infant dental enucleation, a traditional remedial procedure prevalent mainly in East Africa.

    Materials and methods. Literature searches were made electronically using general and specialized search engines. The main search was performed through a systematic strategy in PubMed, comprising tabulated keywords, search codes, and translated and transliterated terms. Criteria for the selection of studies were designed to provide a general understanding of the procedure. The findings were synthesized into two sections: a summary of the population prevalence studies, and a thematic literature review.

    Results. An overview of the known prevalence and clinical specifications was established. Insight was gained into the purpose of the procedure and the factors influencing its performance. Diverging suggestions were seen with regard to the rationale for use of infant dental enucleation between different populations. Moreover, reports of complications and consequences involving the general health and the dentoalveolar structures of patients were examined.

    Conclusions. Prevalence, clinical features and risks of infant dental enucleation point to a need for greater awareness of the procedure. Further, there is a need for specific guidelines regarding management of suspected cases within dental and healthcare communities.

    Place, publisher, year, edition, pages
    London: Informa Healthcare, 2014
    Keywords
    African traditional medicine, attitude to health, cuspid, post-operative complications, tooth germ surgery
    National Category
    Dentistry
    Research subject
    Medicine
    Identifiers
    urn:nbn:se:oru:diva-34848 (URN)10.3109/00016357.2013.817603 (DOI)000333047400002 ()
    Note

    Funding Agencies:

    Public Dental Health Organizations of the county of Västmanland, Sweden

    Public Dental Health Organizations of the county of Örebro, Sweden

    Available from: 2014-04-28 Created: 2014-04-25 Last updated: 2018-06-05Bibliographically approved
    2. Infant dental enucleation in an East African population in Sweden: a cross-sectional study on dental records
    Open this publication in new window or tab >>Infant dental enucleation in an East African population in Sweden: a cross-sectional study on dental records
    Show others...
    2014 (English)In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 24, no 3, p. 209-214Article in journal (Refereed) Published
    Abstract [en]

    Aim: To examine the prevalence of infant dental enucleation (IDE) of primary canines, an East African traditional remedial procedure, in a multiethnic population of children in Sweden.

    Design: A cross-sectional study was conducted of dental records of 1133 patients (mean age 4.6years, SD +/- 1.4) attending one public dental service clinic in Sweden. The clinic was located in an area with a large multiethnic community. All were born within the years 2002-2006 and had received a check-up in one of the years 2007-2009. A registry was made of missing primary canines where no reason could be found. In documented cases, information about ethnic origin was extracted. Statistical grouping was made according to known East African ethnicities.

    Results: At least 36 ethnicities were recorded. Twenty-four (2.1%) patients were missing one or more canines according to the criteria for IDE. Significant difference was seen when comparison was made between patients of known East African ethnicities, of whom 20.8% (21/101) manifested findings consistent with the criteria, and the rest of the population (3/1032; P<0.001).

    Conclusions: Prevalence of cases suggestive of IDE among patients of East African origin points to a need for increased awareness within dental and healthcare communities.

    Place, publisher, year, edition, pages
    Hoboken: Wiley-Blackwell, 2014
    Keywords
    NORTHERN UGANDA; WEST ETHIOPIA; CHILD HEALTH; MUTILATION; MORBIDITY; MORTALITY; MAASAI; SUDAN; EBINO; JUBA
    National Category
    Dentistry
    Research subject
    Medicine
    Identifiers
    urn:nbn:se:oru:diva-34940 (URN)10.1111/ipd.12063 (DOI)000333828800007 ()
    Note

    Funding Agency:

    Public Dental Services of Västmanland and Örebro in Sweden

    Available from: 2014-05-05 Created: 2014-05-05 Last updated: 2018-06-05Bibliographically approved
    3. Experiences and perceptions of infant dental enucleation among Somali immigrants in Sweden: A phenomenographic study
    Open this publication in new window or tab >>Experiences and perceptions of infant dental enucleation among Somali immigrants in Sweden: A phenomenographic study
    (Swedish)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-54270 (URN)
    Available from: 2017-01-03 Created: 2017-01-03 Last updated: 2017-10-18Bibliographically approved
    4. Knowledge, experiences and attitudes of dental and health care personnel in Sweden towards infant dental enucleation
    Open this publication in new window or tab >>Knowledge, experiences and attitudes of dental and health care personnel in Sweden towards infant dental enucleation
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-54271 (URN)
    Available from: 2017-01-03 Created: 2017-01-03 Last updated: 2017-10-18Bibliographically approved
  • 11.
    Barzangi, Jir
    et al.
    Örebro University, School of Health Sciences. Public Dental Health Service, Västmanland County Council, Västerås, Sweden.
    Arnrup, Kristina
    Örebro University, School of Health Sciences. Dental Research Department, Public Dental Helath Service, Region Örebro County, Örebro, Sweden.
    Unell, Lennart
    School of Helath Sciences, Örebro University, Örebro, Sweden; Dental Research Department, Public Dental Helath Service, Region Örebro County, Örebro, Sweden .
    Skovdahl, Kirsti
    Department of Nursing Science, University College of Southeast Norway, Drammen, Norway.
    Experiences and perceptions of infant dental enucleation among Somali immigrants in Sweden: A phenomenographic studyManuscript (preprint) (Other academic)
  • 12.
    Barzangi, Jir
    et al.
    Örebro University, School of Health Sciences. Public Dental Health Service, Västmanland County Council, Västerås, Sweden.
    Unell, Lennart
    School of Helath Sciences, Örebro University, Örebro, Sweden; Dental Research Department, Public Dental Helath Service, Region Örebro County, Örebro, Sweden .
    Skovdahl, Kirsti
    Department of Nursing Science, University College of Southeast Norway, Drammen, Norway.
    Arnrup, Kristina
    Örebro University, School of Health Sciences. Dental Research Department, Public Dental Helath Service, Region Örebro County, Örebro, Sweden.
    Knowledge, experiences and attitudes of dental and health care personnel in Sweden towards infant dental enucleationManuscript (preprint) (Other academic)
  • 13.
    Bjarnason, Sif
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Arbetsanpassning med arbetshjälpmedel2016In: Arbetsliv för alla: funktionsnedsättning och arbete / [ed] Berth Danermark & Susanna Larsson Tholén, Gleerups Utbildning AB, 2016, p. 179-192Chapter in book (Other academic)
  • 14.
    Bjarnason, Sif
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Danermark, Berth
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Möjligheter och hinder att nå arbetsmarknaden för personer med funktionsnedsättning: handikapprörelsen i civilsamhället2016In: Vägar till arbetsliv för personer med funktionsnedsättning / [ed] Susanna Larsson Tholén & Berth Danermark, Gleerups Utbildning AB, 2016, p. 85-100Chapter in book (Other academic)
  • 15.
    Bjarnason, Sif
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Larsson Tholén, Susanna
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Danermark, Berth
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Attityder till personer med funktionsnedsättning och interventioner för att påverka attityder: En systematisk kunskapsöversikt2015Report (Other academic)
  • 16.
    Boström, Marianne
    Örebro University, School of Health Sciences.
    Vardagslivets aktiviteter. Handlingen som terapeutiskt redskap vid återhämtning för personer med svårare psykiska funktionshinder: En analys av arbetsterapeuters berättelser med utgångspunkt i G H Meads teori om social handling2017Doctoral thesis, monograph (Other academic)
    Abstract [en]

    There is a need of community-based treatment methods with focus on everyday occupations, for persons with severe mental disabilities. The importance of occupation in achieving health has been highlighted in large mental hospitals and community-based service/support designed for people with severe mental disabilities who today live in society. Despite this support these people are in a vulnerable position, as they often have extensive difficulties in carrying out daily occupations which also leads to poorer well-being and health conditions. In the rehabilitation process, it is necessary to enable the person to use her own effort to perform activities. Occupational therapy has a unique role in community-based efforts for people with severe mental disabilities through their person-centered practices approaches and knowledge of daily occupations and how these can be used as therapeutic means of recovery and development of the self.

    The purpose of the study is to use theory about social action to contribute theoretical understanding about how everyday occupations are used as a therapeutic means for people with severe mental disabilities in occupational therapy, with the goal of contributing to their recovery and development of self. A qualitative, interpretative approach is used in the study to examine how everyday life can be used as a therapeutic tool. Empirical data of 11 events were generated from interviews with four occupational therapists. A theoretical tool developed by George Herbert Mead’s social psychological theory of the social act, were used as a frame for new-descriptions. Through abductive analyses reconstructed events are given new (theoretical) understanding.

    The result indicate that the social acts have met such difficulties that they have almost ceased and at the same time risk losing their meaning. The therapist adjusts the activity to find the level at which the person can participate with his/her own experience in the implementation of the everyday action. This gives the person with severe mental disabilities opportunities to use one self in the social process which eventually makes the person regain the ability to perform everyday activities

  • 17.
    Brunnberg, Elinor
    Örebro University, Department of Behavioural, Social and Legal Sciences.
    'Då blev jag besviken': en fenomenologisk analys av fyra berättelser2007In: Välfärdspolitik i praktiken: om perspektiv och metoder i forskning, Uppsala: NSU Press , 2007, p. 65-86Chapter in book (Other academic)
    Abstract [sv]

    I det här kapitlet diskuteras fenomenologisk filosofi och dess influenser på olika forskningsmetoder som deskriptiv fenomenologi och fenomenografi. I kapitlet kommer även att visas hur man kan göra en deskriptiv fenomenologisk analys. Utgångspunkten för analysen är fyra korta berättelser som skrivits av fyra flickor som deltagit i en kurs inom ett s.k. individuellt program. Syftet med kapitlet är att visa hur en deskriptiv fenomenologisk analys kan ge en fördjupad förståelse för flickors erfarenheter av sociala relationer samt när och hur de upplevt besvikelser i relationer till andra.

  • 18.
    Carlsson, Per-Inge
    et al.
    Department of otorhioloaryngology, Central hospital, Karlstad, Sweden; Audiological Research Center, Örebro University Hospital, Örebro, Sweden.
    Hjaldahl, Jennie
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Audiological Research Center, Örebro university hospital, Örebro, Sweden.
    Magnuson, Anders
    Clinical epidemiology and biostatistics unit, Örebro university hospital, Örebro, Sweden.
    Ternevall, Elisabeth
    Department of audiology, Karolinska University hospital, Stockholm, Sweden.
    Edén, Margareta
    Department of hearing impairment and deafness, Mölndal hospital, Göteborg, Sweden.
    Skagerstrand, Åsa
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Audiological Research Center, Örebro university hospital, Örebro, Sweden.
    Jönsson, Radi
    Department of Otorhinolaryngology, Sahlgrenska university Hospital, Göteborg, Sweden.
    Severe to profound hearing impairment: quality of life, psychosocial consequences and audiological rehabilitation2014In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 20, p. 1849-1856Article in journal (Refereed)
    Abstract [en]

    Purpose: To study the quality of life (QoL) and psychosocial consequences in terms of sick leave and audiological rehabilitation given to patients with severe to profound hearing impairment.

    Method: A retrospective study of data on 2319 patients with severe to profound hearing impairment in The Swedish Quality Register of Otorhinolaryngology, followed by a posted questionnaire including The Hospital Anxiety and Depression Scale (HADS). 

    Results: The results indicate greater levels of anxiety and depression among patients with severe or profound hearing impairment than in the general population, and annoying tinnitus and vertigo had strong negative effects on QoL. The proportion of sick leave differed between the studied dimensions in the study. The proportion of patients who received extended audiological rehabilitation was 38% in the present study. 

    Conclusions: Treatment focused on anxiety, depression, tinnitus and vertigo must be given early in the rehabilitation process in patients with severe or profound hearing impairment. Because sick leave differs greatly within this group of patients, collaboration with the regional Social Insurance Agency is crucial part of the rehabilitation. The study also shows that presently, only a small proportion of patients in Sweden with severe to profound hearing impairment receive extended audiological rehabilitation. Implications for Rehabilitation

    • Greater levels of anxiety and depression have been found among patients with severe or profound hearing impairment than in the general population, and annoying tinnitus and vertigo have strong negative effects on QoL in this group of patients.

    • Only a small proportion of patients with severe to profound hearing impairment receive extended audiological rehabilitation today, including medical, technical and psychosocial efforts.

    • Extended audiological rehabilitation focused on anxiety, depression, tinnitus and vertigo must be given, together with technical rehabilitation, early in the rehabilitation process in patients with severe or profound hearing impairment.

  • 19.
    Chen, Rong
    et al.
    Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm.
    Enberg, Gösta
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm.
    Klein, Gunnar O.
    Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm; Department of Medicine, Karolinska Institutet, Stockholm.
    Julius: a template based supplementary electronic health record system2007In: BMC Medical Informatics and Decision Making, ISSN 1472-6947, E-ISSN 1472-6947, Vol. 7, article id 10Article in journal (Refereed)
    Abstract [en]

    Background: EHR systems are widely used in hospitals and primary care centres but it is usually difficult to share information and to collect patient data for clinical research. This is partly due to the different proprietary information models and inconsistent data quality. Our objective was to provide a more flexible solution enabling the clinicians to define which data to be recorded and shared for both routine documentation and clinical studies. The data should be possible to reuse through a common set of variable definitions providing a consistent nomenclature and validation of data. Another objective was that the templates used for the data entry and presentation should be possible to use in combination with the existing EHR systems.

    Methods: We have designed and developed a template based system (called Julius) that was integrated with existing EHR systems. The system is driven by the medical domain knowledge defined by clinicians in the form of templates and variable definitions stored in a common data repository. The system architecture consists of three layers. The presentation layer is purely web-based, which facilitates integration with existing EHR products. The domain layer consists of the template design system, a variable/clinical concept definition system, the transformation and validation logic all implemented in Java. The data source layer utilizes an object relational mapping tool and a relational database.

    Results: The Julius system has been implemented, tested and deployed to three health care units in Stockholm, Sweden. The initial responses from the pilot users were positive. The template system facilitates patient data collection in many ways. The experience of using the template system suggests that enabling the clinicians to be in control of the system, is a good way to add supplementary functionality to the present EHR systems.

    Conclusion: The approach of the template system in combination with various local EHR systems can facilitate the sharing and reuse of validated clinical information from different health care units. However, future system developments for these purposes should consider using the openEHR/CEN models with shareable archetypes.

  • 20.
    Chen, Rong
    et al.
    Department of Biomedical Engineering, Linköping University, Linköping.
    Garde, Sebastian
    Ocean Informatics UK, London, United Kingdom.
    Beale, Thomas
    Ocean Informatics UK, London, United Kingdom.
    Nyström, Mikael
    Department of Biomedical Engineering, Linköping University, Linköping.
    Karlsson, Daniel
    Department of Biomedical Engineering, Linköping University, Linköping.
    Klein, Gunnar
    Karolinska Institute, Stockholm.
    Ahlfeldt, Hans
    Department of Biomedical Engineering, Linköping University, Linköping.
    An archetype-based testing framework2008In: eHealth Beyond the Horizon: Get IT There, Amsterdam, Netherlands: IOS Press, 2008, Vol. 136, p. 401-6Conference paper (Refereed)
    Abstract [en]

    With the introduction of EHR two-level modelling and archetype methodologies pioneered by openEHR and standardized by CEN/ISO, we are one step closer to semantic interoperability and future-proof adaptive healthcare information systems. Along with the opportunities, there are also challenges. Archetypes provide the full semantics of EHR data explicitly to surrounding systems in a platform-independent way, yet it is up to the receiving system to interpret the semantics and process the data accordingly. In this paper we propose a design of an archetype-based platform-independent testing framework for validating implementations of the openEHR archetype formalism as a means of improving quality and interoperability of EHRs.

  • 21.
    Chen, Rong
    et al.
    Department of Biomedical Engineering, Linköping University.
    Klein, Gunnar
    Department of Medicine, Karolinska Institutet, Stockholm.
    The openEHR Java reference implementation project2007In: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 129, no Pt 1, p. 58-62Article in journal (Refereed)
    Abstract [en]

    The openEHR foundation has developed an innovative design for interoperable and future-proof Electronic Health Record (EHR) systems based on a dual model approach with a stable reference information model complemented by archetypes for specific clinical purposes.A team from Sweden has implemented all the stable specifications in the Java programming language and donated the source code to the openEHR foundation. It was adopted as the openEHR Java Reference Implementation in March 2005 and released under open source licenses. This encourages early EHR implementation projects around the world and a number of groups have already started to use this code. The early Java implementation experience has also led to the publication of the openEHR Java Implementation Technology Specification. A number of design changes to the specifications and important minor corrections have been directly initiated by the implementation project over the last two years. The Java Implementation has been important for the validation and improvement of the openEHR design specifications and provides building blocks for future EHR systems.

  • 22.
    Chen, Rong
    et al.
    Linköping University, Linköping, Sweden; Cambio Healthcare System, Linköping, Sweden.
    Klein, Gunnar O.
    Karolinska Institutet, Solna, Sweden.
    Sundvall, Erik
    Linköping University, Linköping, Sweden.
    Karlsson, Daniel
    Linköping University, Linköping, Sweden.
    Åhlfeldt, Hans
    Linköping University, Linköping, Sweden.
    Archetype-based conversion of EHR content models: pilot experience with a regional EHR system2009In: BMC Medical Informatics and Decision Making, ISSN 1472-6947, E-ISSN 1472-6947, Vol. 9, p. 33-, article id 33Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Exchange of Electronic Health Record (EHR) data between systems from different suppliers is a major challenge. EHR communication based on archetype methodology has been developed by openEHR and CEN/ISO. The experience of using archetypes in deployed EHR systems is quite limited today. Currently deployed EHR systems with large user bases have their own proprietary way of representing clinical content using various models. This study was designed to investigate the feasibility of representing EHR content models from a regional EHR system as openEHR archetypes and inversely to convert archetypes to the proprietary format.

    METHODS: The openEHR EHR Reference Model (RM) and Archetype Model (AM) specifications were used. The template model of the Cambio COSMIC, a regional EHR product from Sweden, was analyzed and compared to the openEHR RM and AM. This study was focused on the convertibility of the EHR semantic models. A semantic mapping between the openEHR RM/AM and the COSMIC template model was produced and used as the basis for developing prototype software that performs automated bi-directional conversion between openEHR archetypes and COSMIC templates.

    RESULTS: Automated bi-directional conversion between openEHR archetype format and COSMIC template format has been achieved. Several archetypes from the openEHR Clinical Knowledge Repository have been imported into COSMIC, preserving most of the structural and terminology related constraints. COSMIC templates from a large regional installation were successfully converted into the openEHR archetype format. The conversion from the COSMIC templates into archetype format preserves nearly all structural and semantic definitions of the original content models. A strategy of gradually adding archetype support to legacy EHR systems was formulated in order to allow sharing of clinical content models defined using different formats.

    CONCLUSION: The openEHR RM and AM are expressive enough to represent the existing clinical content models from the template based EHR system tested and legacy content models can automatically be converted to archetype format for sharing of knowledge. With some limitations, internationally available archetypes could be converted to the legacy EHR models. Archetype support can be added to legacy EHR systems in an incremental way allowing a migration path to interoperability based on standards.

  • 23. Coniavitis Gellerstedt, Lotta
    et al.
    Bjarnason, Sif
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    "Vad var det du inte hörde?": Hörteknik och dess användning i skolan – HODA2015Report (Other academic)
  • 24.
    Coorevits, Pascal
    et al.
    Ghent University, Ghent, Belgium; The European Institute for Health Records (EuroRec), Sint-Martens-Latem, Belgium.
    Sundgren, M
    AstraZeneca R&D, Mölndal, Sweden.
    Klein, Gunnar O.
    University of Science and Technology, Trondheim, Norway.
    Bahr, A
    Sanofi R&D, Chilly-Mazarin, France.
    Claerhout, B
    Custodix NV, Sint-Martens-Latem, Belgium.
    Daniel, C
    Paris Descartes University, INSERM, Paris, France.
    Dugas, M
    University of Münster, Münster, Germany.
    Dupont, D
    Data Mining International SA, Geneva, Switzerland.
    Schmidt, A
    Pharma Product Development, F Hoffmann-La Roche Ltd, Basel, Switzerland.
    Singleton, P
    Cambridge Health Informatics, Cambridge, UK.
    De Moor, G
    Ghent University, Ghent, Belgium; The European Institute for Health Records (EuroRec), Sint-Martens-Latem, Belgium.
    Kalra, D
    University College London, London, UK.
    Electronic health records: new opportunities for clinical research2013In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 274, no 6, p. 547-60Article in journal (Refereed)
    Abstract [en]

    Clinical research is on the threshold of a new era in which electronic health records (EHRs) are gaining an important novel supporting role. Whilst EHRs used for routine clinical care have some limitations at present, as discussed in this review, new improved systems and emerging research infrastructures are being developed to ensure that EHRs can be used for secondary purposes such as clinical research, including the design and execution of clinical trials for new medicines. EHR systems should be able to exchange information through the use of recently published international standards for their interoperability and clinically validated information structures (such as archetypes and international health terminologies), to ensure consistent and more complete recording and sharing of data for various patient groups. Such systems will counteract the obstacles of differing clinical languages and styles of documentation as well as the recognized incompleteness of routine records. Here, we discuss some of the legal and ethical concerns of clinical research data reuse and technical security measures that can enable such research while protecting privacy. In the emerging research landscape, cooperation infrastructures are being built where research projects can utilize the availability of patient data from federated EHR systems from many different sites, as well as in international multilingual settings. Amongst several initiatives described, the EHR4CR project offers a promising method for clinical research. One of the first achievements of this project was the development of a protocol feasibility prototype which is used for finding patients eligible for clinical trials from multiple sources.

  • 25.
    Dahlberg, Karuna
    Örebro University, School of Health Sciences.
    e-Assessed follow-up of postoperative recovery: developement, evaluation and patient experiences2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The majority of all surgeries are performed as day surgery. After discharge, patients are expected to take responsibility for their postoperative recovery themselves. Recovery Assessment by Phone Points (RAPP) is an e-assessment developed for assessing and providing follow-up on postoperative recovery, which includes the Swedish web-version of the Quality of Recovery questionnaire (SwQoR). It also enables the patient to get in contact with the day surgery unit. The overall aim of this thesis was to further develop and evaluate a systematic follow-up of postoperative recovery using a mobile app in adult persons undergoing day surgery, as well as to describe their experiences of postoperative recovery when using the mobile app. Study I: This study included three steps. Equivalence testing between the paper and app versions of the SwQoR showed agreement (n=69). The feasibility and acceptability evaluation showed that participants (n=63) were positive towards using a mobile phone application during postoperative recovery. Content validity of the SwQoR reduced the original 31 items to 24. Studies II and III: A multicentre, two-group, parallel, single-blind randomized controlled trial including 997 participants was conducted to investigate the effect of e-assessment on postoperative recovery (II) and cost-effectiveness (III) in a RAPP group compared with a control group. The RAPP group reported significantly better quality of postoperative recovery on postoperative days 7 and 14 compared with the control group. Moreover, RAPP may be cost-effective as it provides low-cost care. Study IV: Explored experience of postoperative recovery in participants using a mobile phone app during their postoperative recovery. Qualitative inductive semi-structured interviews (n=18) were performed. Findings showed that feeling safe is important during postoperative recovery. This feeling can be created by patients themselves, but sufficient support and information from health care and next of kin is needed. Overall, this thesis showed positive results for RAPP, suggesting that RAPP is a solution that may benefit patients after day surgery.

    List of papers
    1. Evaluation of the Swedish Web-Version of Quality of Recovery (SwQoR): Secondary Step in the Development of a Mobile Phone App to Measure Postoperative Recovery
    Open this publication in new window or tab >>Evaluation of the Swedish Web-Version of Quality of Recovery (SwQoR): Secondary Step in the Development of a Mobile Phone App to Measure Postoperative Recovery
    2016 (English)In: JMIR Research Protocols, ISSN 1929-0748, E-ISSN 1929-0748, Vol. 5, no 3, article id e192Article in journal (Refereed) Published
    Abstract [en]

    Background: The majority of all surgeries are performed on an outpatient basis (day surgery). The Recovery Assessment by Phone Points (RAPP) app is an app for the Swedish Web-version of Quality of Recovery (SwQoR), developed to assess and follow-up on postoperative recovery after day surgery.

    Objectives: The objectives of this study are (1) to estimate the extent to which the paper and app versions of the SwQoR provide equivalent values; (2) to contribute evidence as to the feasibility and acceptability of a mobile phone Web-based app for measuring postoperative recovery after day surgery and enabling contact with a nurse; and (3) to contribute evidence as to the content validity of the SwQoR.

    Methods: Equivalence between the paper and app versions of the SwQoR was measured using a randomized crossover design, in which participants used both the paper and app version. Feasibility and acceptability was evaluated by a questionnaire containing 16 questions regarding the value of the app for follow-up care after day surgery. Content validity evaluation was based on responses by day surgery patients and the staff of the day surgery department.

    Results: A total of 69 participants completed the evaluation of equivalence between the paper and app versions of the SwQoR. The intraclass correlation coefficient (ICC) for the SwQoR was .89 (95% CI 0.83-0.93) and .13 to .90 for the items. Of the participants, 63 continued testing the app after discharge and completed the follow-up questionnaire. The median score was 69 (inter-quartile range, IQR 66-73), indicating a positive attitude toward using an app for follow-up after day surgery. A total of 18 patients and 12 staff members participated in the content validity evaluation. The item-level content validity index (I-CVI) for the staff group was in the 0.64 to 1.0 range, with a scale-level content validity index (S-CVI) of 0.88. For the patient group, I-CVI was in the range 0.30 to 0.92 and S-CVI was 0.67. The content validity evaluation of the SwQoR, together with three new items, led to a reduction from 34 to 24 items.

    Conclusions: Day surgery patients had positive attitudes toward using the app for follow-up after surgery, and stated a preference for using the app again if they were admitted for a future day surgery procedure. Equivalence between the app and paper version of the SwQoR was found, but at the item level, the ICC was less than .7 for 9 items. In the content validity evaluation of the SwQoR, staff found more items relevant than the patients, and no items found relevant by either staff or patients were excluded when revising the SwQoR.

    Place, publisher, year, edition, pages
    Toronto, Canada: JMIR Publications, Inc, 2016
    Keywords
    mHealth, ambulatory surgical procedures, postoperative period, mobile phones
    National Category
    Nursing
    Identifiers
    urn:nbn:se:oru:diva-52584 (URN)10.2196/resprot.5881 (DOI)27679867 (PubMedID)
    Available from: 2016-09-27 Created: 2016-09-27 Last updated: 2018-05-22Bibliographically approved
    2. Evaluation of postoperative recovery in day surgery patients using a mobile phone application: a multicentre randomized trial
    Open this publication in new window or tab >>Evaluation of postoperative recovery in day surgery patients using a mobile phone application: a multicentre randomized trial
    2017 (English)In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 119, no 5, p. 1030-1038Article in journal (Refereed) Published
    Abstract [en]

    Background: Many patients undergoing anaesthesia and surgery experience postoperative complications. Our aim was to investigate whether a systematic follow-up smartphone-based assessment, using recovery assessment by phone points (RAPP) compared with standard care, had a positive effect on day surgery patients' postoperative recovery. We also investigated whether there were differences in women and men's recovery and recovery scores.

    Methods: The study was a single-blind, multicentre randomized controlled trial. A total of 997 patients were randomly allocated to either RAPP or standard care. The Swedish web version of a quality of recovery (SwQoR) questionnaire was used to evaluate the patients' postoperative recovery, either on paper or using an application (RAPP) on postoperative days seven and 14.

    Results: On postoperative day seven the RAPP group reported significantly better values in seven out of 24 items of the SwQoR: sleeping difficulties; not having a general feeling of wellbeing; having difficulty feeling relaxed/comfortable; and dizziness; headache; pain in the surgical wound; and a swollen surgical wound compared with the control group, implying a good postoperative recovery. Both men and women in the RAPP group reported significantly better values (and, hence good postoperative recovery) compared with the control group in the items sleeping difficulties; not having a general feeling of wellbeing and pain in the surgical wound.

    Conclusions: Measurement of patient-reported outcomes using a smartphone-based application was associated with decreased discomfort from several postoperative symptoms. Systematic e-assessment can thereby increase patients' quality of recovery and identify key areas for improvement in perioperative care.

    Place, publisher, year, edition, pages
    Oxford University Press, 2017
    Keywords
    Mobile application, patient outcome assessment, postoperative complications, postoperative period
    National Category
    Anesthesiology and Intensive Care
    Identifiers
    urn:nbn:se:oru:diva-61084 (URN)10.1093/bja/aex331 (DOI)000413642900026 ()29077818 (PubMedID)2-s2.0-85034763250 (Scopus ID)
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare, 2013-4765Swedish Research Council, 2015-02273
    Available from: 2017-09-19 Created: 2017-09-19 Last updated: 2018-05-22Bibliographically approved
    3. Cost-effectiveness of a systematic e-assessed follow-up of postoperative recovery after day surgery: a multicentre randomized trial
    Open this publication in new window or tab >>Cost-effectiveness of a systematic e-assessed follow-up of postoperative recovery after day surgery: a multicentre randomized trial
    Show others...
    2017 (English)In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 119, no 5, p. 1039-1046Article in journal (Refereed) Published
    Abstract [en]

    Background: Most surgeries are done on a day-stay basis. Recovery assessment by phone points (RAPP) is a smartphonebased application (app) to evaluate patients after day surgery. The aim of this study was to estimate the cost-effectiveness of using RAPP for follow-up on postoperative recovery compared with standard care.

    Methods: This study was a prospective parallel single-blind multicentre randomized controlled trial. Participants were randomly allocated to the intervention group using RAPP or the control group receiving standard care. A cost-effectiveness analysis was performed based on individual data and included costs for the intervention, health effect [quality-adjusted life-years (QALYs)], and costs or savings in health-care use.

    Results: The mean cost for health-care consumption during 2 weeks after surgery was estimated at e37.29 for the intervention group and e60.96 for the control group. The mean difference was e23.66 (99% confidence interval 46.57 to0.76; P¼0.008). When including the costs of the intervention, the cost-effectiveness analysis showed net savings of e4.77 per patient in favour of the intervention. No difference in QALYs gained was seen between the groups (P¼0.75). The probability of the intervention being cost-effective was 71%.

    Conclusions: This study shows that RAPP can be cost-effective but had no effect on QALY. RAPP can be a cost-effective toolin providing low-cost health-care contacts and in systematically assessing the quality of postoperative recovery.

    Clinical trial registration:NCT02492191

    Place, publisher, year, edition, pages
    Oxford University Press, 2017
    Keywords
    Ambulatory surgery, cost effectiveness, mobile applications, postoperative period
    National Category
    Anesthesiology and Intensive Care
    Identifiers
    urn:nbn:se:oru:diva-61954 (URN)10.1093/bja/aex332 (DOI)000413642900027 ()29077819 (PubMedID)2-s2.0-85034731856 (Scopus ID)
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare, 2013-4765Swedish Research Council, 2015-02273
    Available from: 2017-10-25 Created: 2017-10-25 Last updated: 2018-05-22Bibliographically approved
    4. Holding it together: patients’ perspectives on postoperative recovery when using an e-assessed follow-up
    Open this publication in new window or tab >>Holding it together: patients’ perspectives on postoperative recovery when using an e-assessed follow-up
    Show others...
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-67060 (URN)
    Available from: 2018-05-21 Created: 2018-05-21 Last updated: 2018-05-22Bibliographically approved
  • 26.
    Dahlberg, Karuna
    et al.
    Örebro University, School of Health Sciences.
    Jaensson, Maria
    Örebro University, School of Health Sciences.
    Nilsson, Ulrica
    Örebro University, School of Health Sciences.
    Eriksson, Mats
    Örebro University, School of Health Sciences.
    Odencrants, Sigrid
    Örebro University, School of Health Sciences.
    Holding It Together - Patients' Perspectives on Postoperative Recovery When Using an e-Assessed Follow-Up: Qualitative Study2018In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 20, no 5, article id e10387Article in journal (Refereed)
    Abstract [en]

    Background: There is an emerging trend to perform surgeries as day surgery. After a day surgery, most of the recovery period takes place at home, and patients are responsible for their own recovery. It has been suggested that electronic health (eHealth) technologies can support patients in this process. A mobile app has recently been developed to assess and follow up on postoperative recovery after a day surgery.

    Objective: The aim of this study was to explore experiences associated with postoperative recovery after a day surgery in patients using a mobile app to assess the quality of their recovery.

    Methods: This is a qualitative interview study with an explorative and descriptive design. Participants were recruited from 4 different day surgery units in different parts of Sweden. The study included 18 participants aged >17 years who had undergone day surgery and used the Recovery Assessment by Phone Points, a mobile app for follow-up on postoperative recovery after day surgery. Participants were purposively selected to ensure maximum variation. Semistructured individual interviews were conducted. Data were analyzed using thematic analysis.

    Results: A total of two themes and six subthemes emerged from the data: (1) the theme Give it all you’ve got with the subthemes Believing in own capacity, Being prepared, and Taking action, where participants described their possibilities of participating and themselves contributing to improving their postoperative recovery; and (2) the theme The importance of feeling safe and sound with the subthemes Feeling safe and reassured, Not being acknowledged, and Not being left alone, which describe the importance of support from health care professionals and next of kin.

    Conclusions: It is important that patients feel safe, reassured, and acknowledged during their postoperative recovery. They can achieve this themselves with sufficient support and information from the health care organization and their next of kin. Using a mobile app, both for assessment and to enable contact with the day surgery unit during the postoperative recovery period, can improve care and create a feeling of not being alone after surgery. We propose that postoperative recovery starts in the prerecovery phase when patients prepare for their recovery to get the best possible outcome from their surgery.

  • 27.
    Dahlberg, Karuna
    et al.
    Örebro University, School of Health Sciences.
    Jaensson, Maria
    Örebro University, School of Health Sciences.
    Nilsson, Ulrica
    Örebro University, School of Health Sciences.
    Eriksson, Mats
    Örebro University, School of Health Sciences.
    Odencrants, Sigrid
    Örebro University, School of Health Sciences.
    Holding it together: patients’ perspectives on postoperative recovery when using an e-assessed follow-upManuscript (preprint) (Other academic)
  • 28.
    Danermark, Berth
    Örebro University, School of Health Sciences. Institutet för Handikappvetenskap.
    The role of communication partners in the audiological rehabilitation2018In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, article id 1Article in journal (Refereed)
  • 29.
    Danermark, Berth
    et al.
    Örebro University, School of Health and Medical Sciences.
    Cieza, Alarcos
    Inst Hlth & Rehabil Sci, ICF Res Branch, WHO CC FIC, Univ Munich, Munich, Germany.
    Gangé, Jean-Pierre
    Inst Univ Geriatrie Montreal, Ecole Orthophonie & Audiol, Univ Montreal, Montreal PQ, Canada.
    Gimigliano, Francesca
    Dept Audiol & Speech Sci, Univ Naples 2, Naples, Italy.
    Granberg, Sarah
    Örebro University, School of Health and Medical Sciences.
    Hickson, Louise
    Sch Hlth & Rehabil Sci, Commun Disabil Ctr, Univ Queensland, Brisbane Qld, Australia.
    Kramer, Sophia
    Med Ctr, Dept ENT Audiol, EMGO Inst Hlth & Care Res, Vrije, Univ Amsterdam, Amsterdam, Netherlands.
    McPherson, Bradley
    Ctr Commun Disorders, Univ Hong Kong, Hong Kong, Peoples R China.
    Möller, Claes
    Centre for Audiological Research, The University Hospital, Örebro, Sweden.
    Russo, Ieda
    Programa Estudos Posgrad Fonoaudiol, Pontificia Univ Catolica Sao Paulo, Sao Paulo, Brazil.
    Strömgren, Jan Peter
    Nottwil & Seminar Hlth Sci & Hlth Policy, Univ Lucerne, Luzern, Switzerland.
    Stucki, Gerold
    Nottwil & Seminar Hlth Sci & Hlth Policy, Univ Lucerne, Luzern, Switzerland.
    Swanepoel, DeWet
    Dept Commun Pathol, Univ Pretoria, Pretoria, South Africa; Callier Ctr Commun Disorders, Univ Texas Dallas, Dallas TX, USA.
    International classification of functioning, disability, and health core sets for hearing loss: A discussion paper and invitation2010In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 49, no 4, p. 256-262Article in journal (Refereed)
    Abstract [en]

    The World Health Organization’s International Classification of Functioning, Disability and Health (ICF) has adopted a multifactorial understanding of functioning and disability, merging a biomedical paradigm with a social paradigm into a wider understanding of human functioning. Altogether there are more than 1400 ICF-categories describing different aspects of human functioning and there is a need to developing short lists of ICF categories to facilitate use of the classification scheme in clinical practice. To our knowledge, there is currently no such standard measuring instrument to facilitate a common validated way of assessing the effects of hearing loss on the lives of adults. The aim of the project is the development of an internationally accepted, evidence-based, reliable, comprehensive and valid ICF Core Sets for Hearing Loss. The processes involved in this project are described in detail and the authors invite stakeholders, clinical experts and persons with hearing loss to actively participate in the development process.

  • 30.
    Danermark, Berth
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Audiological Research Centre, Örebro University Hospital, Örebro, Sweden; Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
    Granberg, Sarah
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Swedish Institute for Disability Research, Örebro University, Örebro, Sweden; Audiological Research Centre, Örebro University Hospital, Örebro, Sweden; HEAD (Hearing and Deafness) Research School, Linköping University, Linköping, Sweden.
    Kramer, Sophia E.
    Vrije University Medical Center, Amsterdam, Netherlands.
    Selb, Melissa
    WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI), Nottwil, Switzerland; Swiss Paraplegic Research, Nottwil, Switzerland.
    Möller, Claes
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Audiological Research Centre, Örebro University Hospital, Örebro, Sweden; Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
    The Creation of a Comprehensive and a Brief Core Set for Hearing Loss Using the International Classification of Functioning, Disability and Health2013In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 22, no 2, p. 323-328Article in journal (Refereed)
    Abstract [en]

    Purpose: In May 2001, to integrate biological, psychological, and social aspects of human functioning, the World Health Assembly endorsed the International Classification of Functioning, Disability and Health (ICF). The aim of this article is to describe the creation of Comprehensive and Brief ICF Core Sets for Hearing Loss. The core sets consist of the most relevant ICF categories for hearing loss. Method and Results: Four preparatory studies were carried out and presented at a consensus conference, resulting in a Comprehensive ICF Core Set for Hearing Loss, consisting of 117 ICF categories, and a Brief ICF Core Set for Hearing Loss, consisting of 27 categories (of the 117). Conclusion: The Comprehensive ICF Core Set for Hearing Loss can be a user-friendly tool for conducting comprehensive, multidisciplinary assessments. The Brief ICF Core Set can be used for many purposes, such as research and population studies. However, its most common use is by individuals seeking to provide a brief description and assessment of functioning of a person with hearing loss.

  • 31.
    Duberg, Anna
    Örebro University, School of Health Sciences.
    Dance Intervention for Adolescent Girls with Internalizing Problems: Effects and Experiences2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Globally, psychological health problems are currently among the most serious public health challenges. Adolescent girls suffer from internalizing problems, such as somatic symptoms and mental health problems, at higher rates than in decades. By age 15, over 50 % of all girls experience multiple health complaints more than once a week and one in five girls reports fair or poor health.

    The overall aim of this study was to investigate the effects of and experiences with an after-school dance intervention for adolescent girls with internalizing problems. The intervention comprised dance that focused on resources twice weekly for 8 months. Specifically, this thesis aimed to: I) investigate the effects on self-rated health (SRH), adherence and over-all experience; II) evaluate the effects on somatic symptoms, emotional distress and use of medication; III) explore the experiences of those participating in the intervention; and IV) assess the cost-effectiveness.

    A total of 112 girls aged 13 to 18 years were included in a randomized controlled trial. The dance intervention group comprised 59 girls, and the control group 53. In paper I, the dance group showed increased SRH scores compared to the control group (p = .02). Girls in the intervention group showed high adherence and a positive overall experience. In paper II, the dance group exhibited a decrease in somatic symptoms (p = .021), emotional distress (p = .023) and use of medication (p = .020) compared to the control group. In paper III, a strategic sample of 24 girls was interviewed. Qualitative content analysis was performed, and five generic categories emerged. Two were “An Oasis from Stress” and “Supportive Togetherness”, which was shown to represent the fundamental basis and setting of the intervention. The main category, participants’ central experience, was understood as “Finding embodied self-trust that opens new doors”. Paper IV revealed that, due to decreased number of visits to the school nurse and an increase in health related quality of life; the intervention was considered to be cost-effective (combined with the usual school health services). In summary, the results of this thesis show that this dance intervention for adolescent girls with internalizing problems generated positive health effects and proved to be cost-effective. For this target group, a non-judgmental environment and supportive togetherness proved to be of importance for participation. The results of this study may provide practical information for school health care staff and caregivers in designing future interventions.

    List of papers
    1. Influencing self-rated health among adolescent girls with dance intervention: a randomized controlled trial
    Open this publication in new window or tab >>Influencing self-rated health among adolescent girls with dance intervention: a randomized controlled trial
    2013 (English)In: JAMA pediatrics, ISSN 2168-6203, E-ISSN 2168-6211, Vol. 167, no 1, p. 27-31Article in journal (Refereed) Published
    Abstract [en]

    Objective: To investigate whether dance intervention influenced self-rated health for adolescent girls with internalizing problems.

    Design: Randomized controlled intervention trial with follow-up measures at 8, 12, and 20 months after baseline.

    Setting: A Swedish city with a population of 130 000.

    Participants: Girls aged 13 to 18 years with internalizing problems, ie, stress and psychosomatic symptoms. A total of 59 girls were randomized to the intervention group and 53 were randomized to the control group.

    Intervention: The intervention comprised dance classes twice weekly during 8 months. Each dance class lasted 75 minutes and the focus was on the joy of movement, not on performance.

    Main Outcome Measures: Self-rated health was the primary outcome; secondary outcomes were adherence to and experience of the intervention.

    Results: The dance intervention group improved their self-rated health more than the control group at all follow-ups. At baseline, the mean score on a 5-point scale was 3.32 for the dance intervention group and 3.75 for the control group. The difference in mean change was 0.30 (95% CI, −0.01 to 0.61) at 8 months, 0.62 (95% CI, 0.25 to 0.99) at 12 months, and 0.40 (95% CI, 0.04 to 0.77) at 20 months. Among the girls in the intervention group, 67% had an attendance rate of 50% to 100%. A total of 91% of the girls rated the dance intervention as a positive experience.

    Conclusions: An 8-month dance intervention can improve self-rated health for adolescent girls with internalizing problems. The improvement remained a year after the intervention

    Place, publisher, year, edition, pages
    Chicago, USA: American Medical Association, 2013
    National Category
    Other Health Sciences Nursing
    Research subject
    Medicine
    Identifiers
    urn:nbn:se:oru:diva-24206 (URN)10.1001/jamapediatrics.2013.421 (DOI)000316797500007 ()23403597 (PubMedID)2-s2.0-84873503070 (Scopus ID)
    Note

    Funding Agencies:

    Örebro County Council 

    municipality of Örebro 

    Available from: 2012-08-03 Created: 2012-08-03 Last updated: 2018-05-15Bibliographically approved
    2. Dance Intervention for Adolescent Girls: Effects on Somatic Symptoms, Emotional Distress, and Use of Medication. A Randomized Controlled Trial
    Open this publication in new window or tab >>Dance Intervention for Adolescent Girls: Effects on Somatic Symptoms, Emotional Distress, and Use of Medication. A Randomized Controlled Trial
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-50024 (URN)
    Available from: 2016-04-29 Created: 2016-04-28 Last updated: 2017-10-17Bibliographically approved
    3. “I feel free”: Experiences of a Dance Intervention for Adolescent Girls with Internalizing Problems
    Open this publication in new window or tab >>“I feel free”: Experiences of a Dance Intervention for Adolescent Girls with Internalizing Problems
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-50025 (URN)
    Available from: 2016-04-29 Created: 2016-04-28 Last updated: 2017-10-17Bibliographically approved
    4. Cost-utility analysis of a dance intervention for adolescent girls with internalizing problems
    Open this publication in new window or tab >>Cost-utility analysis of a dance intervention for adolescent girls with internalizing problems
    2013 (English)In: Cost Effectiveness and Resource Allocation, ISSN 1478-7547, E-ISSN 1478-7547, Vol. 11, no 1, p. 4-Article in journal (Refereed) Published
    Abstract [en]

    Background: The increasing prevalence of psychological health problems among adolescent girls is alarming. Knowledge of beneficial effects of physical activity on psychological health is widespread. Dance is a popular formof exercise that could be a protective factor in preventing and treating symptoms of depression. The aim of thisstudy was to assess the cost-effectiveness of a dance intervention in addition to usual school health services foradolescent girls with internalizing problems, compared with usual school health services alone.

    Methods: A cost-utility analysis from a societal perspective based on a randomized controlled intervention trial wasperformed. The setting was a city in central Sweden with a population of 130 000. A total of 112 adolescent girls, 13–18 years old, with internalizing problems participated in the study. They were randomly assigned to intervention (n =59) or control (n = 53) group. The intervention comprised dance twice weekly during eight months in addition to usualschool health services. Costs for the stakeholder of the intervention, treatment effect and healthcare costs wereconsidered. Gained quality-adjusted life-years (QALYs) were used to measure the effects. Quality of life was measuredwith the Health Utility Index Mark 3. Cost-effectiveness ratios were based on the changes in QALYs and net costs forthe intervention group compared with the control group. Likelihood of cost-effectiveness was calculated.

    Results: At 20 months, quality of life had increased by 0.08 units more in the intervention group than in the controlgroup (P = .04), translating to 0.10 gained QALYs. The incremental cost-effectiveness ratio was USD $3,830 per QALYand the likelihood of cost-effectiveness was 95%.

    Conclusions: Intervention with dance twice weekly in addition to usual school health services may be consideredcost-effective compared with usual school health services alone, for adolescent girls with internalizing problems.

    Keywords
    Internalizing problems, Adolescent girls, Physical activity, Dance, Cost-utility analysis
    National Category
    Business Administration Health Care Service and Management, Health Policy and Services and Health Economy
    Research subject
    Business Studies
    Identifiers
    urn:nbn:se:oru:diva-38723 (URN)10.1186/1478-7547-11-4 (DOI)23425608 (PubMedID)2-s2.0-84873979104 (Scopus ID)
    Note

    Trial registration:

    Name of the trial registry: “Influencing Adolescent Girls’ With Creative Dance Twice Weekly”

    Trial registration number: NCT01523561

    Available from: 2014-11-18 Created: 2014-11-18 Last updated: 2018-05-22Bibliographically approved
  • 32.
    Duberg, Anna
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden; Örebro County Council, Örebro, Sweden.
    Hagberg, Lars
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden; Örebro County Council, Örebro, Swedenes, Örebro; Örebro County Council, Örebro.
    Sunvisson, Helena
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Möller, Margareta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro County Council, Örebro University Hospital, Örebro, Sweden.
    Influencing self-rated health among adolescent girls with dance intervention: a randomized controlled trial2013In: JAMA pediatrics, ISSN 2168-6203, E-ISSN 2168-6211, Vol. 167, no 1, p. 27-31Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate whether dance intervention influenced self-rated health for adolescent girls with internalizing problems.

    Design: Randomized controlled intervention trial with follow-up measures at 8, 12, and 20 months after baseline.

    Setting: A Swedish city with a population of 130 000.

    Participants: Girls aged 13 to 18 years with internalizing problems, ie, stress and psychosomatic symptoms. A total of 59 girls were randomized to the intervention group and 53 were randomized to the control group.

    Intervention: The intervention comprised dance classes twice weekly during 8 months. Each dance class lasted 75 minutes and the focus was on the joy of movement, not on performance.

    Main Outcome Measures: Self-rated health was the primary outcome; secondary outcomes were adherence to and experience of the intervention.

    Results: The dance intervention group improved their self-rated health more than the control group at all follow-ups. At baseline, the mean score on a 5-point scale was 3.32 for the dance intervention group and 3.75 for the control group. The difference in mean change was 0.30 (95% CI, −0.01 to 0.61) at 8 months, 0.62 (95% CI, 0.25 to 0.99) at 12 months, and 0.40 (95% CI, 0.04 to 0.77) at 20 months. Among the girls in the intervention group, 67% had an attendance rate of 50% to 100%. A total of 91% of the girls rated the dance intervention as a positive experience.

    Conclusions: An 8-month dance intervention can improve self-rated health for adolescent girls with internalizing problems. The improvement remained a year after the intervention

  • 33.
    Duberg, Anna
    et al.
    Örebro University, School of Health Sciences.
    Jutengren, Göran
    University of Borås.
    Hagberg, Lars
    Örebro University, School of Health Sciences.
    Möller, Margareta
    Örebro University, School of Health Sciences.
    Dance Intervention for Adolescent Girls: Effects on Somatic Symptoms, Emotional Distress, and Use of Medication. A Randomized Controlled TrialManuscript (preprint) (Other academic)
  • 34.
    Duberg, Anna
    et al.
    Örebro University, School of Health Sciences.
    Möller, Margareta
    Örebro University, School of Health Sciences.
    Sunvisson, Helena
    Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    “I feel free”: Experiences of a Dance Intervention for Adolescent Girls with Internalizing ProblemsManuscript (preprint) (Other academic)
  • 35.
    Edström, Evelina
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Löfgren, Sofia
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Förskolepersonalens faktiska och upplevda bullerbelastning på arbetet2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Buller är benämningen på icke önskvärda ljud och blir skadliga när ljudnivåerna blir tillräckligt höga. Effekterna av bullerexponering är många. Höga ljudnivåer förekommer bl.a. inom förskolor. Trots att detta är allmänt känt saknas det en del forskning kring hur just förskolepersonal upplever och påverkas av den höga ljudnivån på arbetet.

    Syfte: Syftet med studien är att undersöka ljudnivån på en förskola samt hur förskolepersonalen upplever och påverkas av ljudmiljön på arbetet.

    Metod: En egen tillverkad enkätundersökning riktad till förskolepersonal samt dosmätning genomfördes på en småbarnsavdelning och en äldrebarnsavdelning. Enkäten berörde frågor gällande ljudnivån på förskolan samt förskolepersonalens upplevelse och påverkan.

    Resultat: De ekvivalenta ljudnivåerna på småbarnsavdelningen låg mellan 73,2 – 78,5 dB(A) och på äldrebarnsavdelningen 71,7 – 78,1 dB(A). Impulstoppvärdena på småbarnsavdelningen låg mellan 110,6 – 135,7 dB(C) och på äldrebarnsavdelningen 116,5 – 143,4 dB(C). Majoriteten av förskolepersonalen upplever hög ljudnivå på arbetet dagligen.

    Slutsatser: Resultatet visar att förskolepersonalen inte utsätts för högre ekvivalenta ljudnivåer än tillåtet. Trots detta upplever majoriteten av förskolepersonalen att de dagligen utsätts för höga ljudnivåer på arbetet. En orsak till detta kan vara att impulstoppvärdena i vissa fall överskrider insatsvärdena. Denna studie är dock inte representativ för populationen, utan är enbart en deskriptiv studie för denna specifika förskola.

  • 36.
    Ehn, Mattias
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital, Audiological Research Centre, Örebro, Sweden; Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
    Möller, Kerstin
    Örebro University, School of Health Sciences. Örebro University Hospital, Audiological Research Centre, Örebro, Sweden; Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
    Danermark, Berth
    Örebro University, School of Health Sciences. Örebro University Hospital, Audiological Research Centre, Örebro, Sweden; Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
    Möller, Claes
    Örebro University, School of Health Sciences. Örebro University Hospital, Audiological Research Centre, Örebro, Sweden; Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
    The relationship between work and health in persons with Usher syndrome type 22016In: Journal of Visual Impairment & Blindness, ISSN 0145-482X, E-ISSN 1559-1476, Vol. 110, no 4, p. 233-244Article in journal (Refereed)
    Abstract [en]

    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.

  • 37.
    Emmanouil, A.
    et al.
    Centre for Health Telematics, Karolinska Institute, Stockholm, Sweden.
    Klein, Gunnar O.
    Centre for Health Telematics, Karolinska Institute, Stockholm, Sweden.
    Anamnesis via the Internet: Prospects and pilot results2001In: MEDINFO 2001: Proceedings of the 10th World Congress on Medical Informatics, PTS 1 and 2 / [ed] V.L. Patel, R. Rogers, R. Haux, Amsterdam, Netherlands: IOS Press, 2001, Vol. 84, p. 805-809Chapter in book (Refereed)
    Abstract [en]

    A comprehensive computerized questionnaire was developed to obtain the anamnesis of patients seeking contact with a physician for any type of new problem. The purpose of this pilot study was to investigate ifa structured questionnaire filled out by the patient and complementing an interview at the physician’s office would contribute to a better quality of the total anamnesis and/or lead to savings in time at the visit. The results encourage further developments in this direction. The potential uses proposed are, in addition to being used to improve a visit, the correct assessment of the history for prioritization and scheduling of visits and in some situations, the anamnesis obtained over the net may be the basis for medical advice without a visit. This study emphasizes the great improvement of information captured by this type of questionnaire based on medical knowledge about associated symptoms and relevant questions depending on the problem presented compared to the results obtained by a simple open question used in many e-health services today.

  • 38.
    Englund, Ulrika
    Örebro University, School of Health Sciences.
    Samverkansprojekt, och sen då?: en uppföljande studie av samverkansprocessen kring barn och unga som far illa eller riskerar att fara illa2017Doctoral thesis, monograph (Other academic)
    Abstract [en]

    Satisfactory collaboration regarding children and youth in need of a comprehensive support is particularly important. Despite extensive research on collaborative work, knowledge of long term development of the collaboration process is lacking. The present thesis concerns inter-organizational collaboration within the framework of a former Swedish policy effort – focusing collaboration between schools, social services, police and the child and youth psychiatry – for the benefit of children and young people in distress or at risk. Applying a critical realist perspective, the overall aim of the thesis is to describe how former collaboration projects develop over time, and to identify significant mechanisms within this development. Through three questionnaire studies, the collaborative process development within the same collaborative settings is described (n=66) over a period of close to seven years. Estimations of 58 collaboration quality indicators within three categories *rules and regulations, *structural aspects and *shared perspectives/ consensus were collected at baseline in 2008, after one year at the final project stage in 2009, as well as five years after the project period (and the policy effort) ended, in 2014 (n=38). Two developmental trends occur: I) an overall positive trend and II) a negative trend on a comprehensive level. I) Collaboration on the target group has increased over time, are mainly incorporated into permanent organizational structures and is judged to have worked well/very well over time. II) Overall deteriorations of high estimates of the 58 quality indicators for collaborations is seen over the five year period, following the project period. However, less dramatic changes is noted on quality indicators concerning shared perspectives/consensus than on matters regarding rules and regulations and structural aspects. Five mechanisms of particular importance for the collaboration development are identified: anchoring, holistic perspectives, engagement, knowledge and clarity.

  • 39. Eriksson, Madeleine
    et al.
    Eriksson, Anni
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Jämlik vård: en undersökning om den tekniska hörselrehabiliteringen påverkas av patientens ålder2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Jämlik vård är att alla ska bemötas, behandlas och vårdas på lika villkor oavsett enskilda faktorer. I hörselrehabiliteringen ingår det flera delar och varje del ska utgå från helhetsperspektivet och ske i samverkan med den enskilde. Audionomen ska inte påverkas av faktorer såsom kön eller ålder. Tidigare studier visar dock att ålder är en avgörande faktor i många fall, det råder en form av ålderism och åldersdiskriminering inom vården. Inga tidigare studier har hittats på hur den tekniska rehabiliteringen påverkas av ålder inom hörselvården varför detta låg i vårt intresse.

    Syfte: Syftet med studien är att undersöka hur jämlik den tekniska rehabiliteringen är inom hörselvården beroende på patienternas ålder.

    Metod: Studien är deskriptiv retrospektiv och är gjord genom journalgenomgång.

    Resultat: Resultatet visar inte några tydliga skillnader i den tekniska rehabiliteringen beroende på patientens ålder. Patienternas behov varierade mycket både inom grupperna och mellan grupperna. Skillnader kunde dock ses gällande patienter med samma behov och typ av hörapparat där patienter oavsett ålder kunde ha fått olika typer av hörapparater trots samma behov/mål.

    Slutsatser: Inga generella slutsatser kan dras huruvida den tekniska hörselrehabiliteringen är jämlik eller ej. Fler studier behövs inom ämnet där urvalet är större.

  • 40.
    Ewertsson, Mona
    Örebro University, School of Health Sciences.
    Lärande av praktiska färdigheter inom sjuksköterskeprofessionen: studier av lärande i olika arenor2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    A central part of the nursing profession is the performance of practical skills. In order to provide adequate care, maintain patient-safety, and feel comfortable in the profession, registered nurses (RNs) need to be equipped with requisite skills. Overall aim: To explore and describe how learning and development of practical skills occurs during the preparatory phases and within the nursing profession. Method: Qualitative (I, III, IV) and quantitative methods (II) were used. Data were collected through individual interviews (I, IV), questionnaires (II) and participant observations, including informal talks (III, IV). Results: Both students and new RNs expressed a need to learn and develop practical skills (I, II, III, IV). Less than half of the new RNs had access to a clinical skill laboratory (CSL), where they could learn and practice practical skills (II). The students described that learning at a CSL had been meaning for their clinical practice. They also expressed a great need for continuing learning in real patient situations (I, III, IV). During clinical practice, preceptors and students took different approaches which affected student’s learning processesö (I, III, IV). There was a tension between learning at a CSL and learning in clinical practice sites because students perceived differences in the performance of skills. Students described that they understood that performance of skills could be done in different ways without injuring patients. However, the data also showed deviations in performances that could jeopardize patientsafety. In these situations, student’s behavior differed (I, IV). One third of new RNs deviated from evidence based guidelines when they performed practical skills which they were unfamiliar with (II). Both students and new RNs reported that reflection in connection with the performance of practical skills was not common (I, II III, IV). Conclusions: Cooperation between university CSLs and clinical settings must be intensified in order to enhance the understanding of learning processes regarding practical skills. A consensus regarding academic approaches should be reached. Universities need to support preceptors in educational issues where the importance of reflection is clarified and exemplified. Increasing patient-safety requires that new RNs receive opportunities for training in artificial environments, and that a culture that reinforces the use of guidelines and a reflective stance is cultivated.

    List of papers
    1. Walking the bridge: Nursing students' learning in clinical skill laboratories
    Open this publication in new window or tab >>Walking the bridge: Nursing students' learning in clinical skill laboratories
    2015 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 15, no 4, p. 277-283Article in journal (Refereed) Published
    Abstract [en]

    Despite an increasing focus on simulation as a learning strategy in nursing education, there is limited evidence on the transfer of simulated skills into clinical practice. Therefore it's important to increase knowledge of how clinical skills laboratories (CSL) can optimize students' learning for development of professional knowledge and skills, necessary for quality nursing practice and for patient safety. Thus, the aim was to describe nursing students' experiences of learning in the CSL as a preparation for their clinical practice. Interviews with 16 students were analysed with content analysis. An overall theme was identified walking the bridge in which the CSL formed a bridge between the university and clinical settings, allowing students to integrate theory and practice and develop a reflective stance. The theme was based on categories: conditions for learning, strategies for learning, tension between learning in the skills laboratory and clinical settings, and development of professional and personal competence. The CSL prepared the students for clinical practice, but a negative tension between learning in CSL and clinical settings was experienced. However, this tension may create reflection. This provides a new perspective that can be used as a pedagogical approach to create opportunities for students to develop their critical thinking.

    Keywords
    Clinical skills laboratory, Learning, Nursing education, Nursing students, Practical skills, Simulation
    National Category
    Nursing
    Research subject
    Caring sciences
    Identifiers
    urn:nbn:se:oru:diva-45675 (URN)10.1016/j.nepr.2015.03.006 (DOI)000358807100005 ()25892366 (PubMedID)
    Available from: 2015-08-28 Created: 2015-08-28 Last updated: 2018-07-01Bibliographically approved
    2. Use of technical skills and medical devices among new registered nurses: A questionnaire study
    Open this publication in new window or tab >>Use of technical skills and medical devices among new registered nurses: A questionnaire study
    Show others...
    2015 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 35, no 12, p. 1169-1174Article in journal (Refereed) Published
    Abstract [en]

    Background: One comprehensive part of nursing practice is performing technical skills and handling of medical equipment. This might be challenging for new registered nurses (RNs) to do in patient-safe way.

    Objectives: The aim of this study was to describe and compare the extent to which new RNs perform various technical skills and handle medical devices in different settings, and to investigate their possibility for continued learning in this respect. A further aim was to describe their perceptions of incident reporting related to technical skills and medical devices.

    Design: A cross-sectional study with descriptive and comparative design.

    Participants: RNs who recently graduated from a nursing programme at three Swedish universities and had worked as a RN for up to 1year were included in the study (n=113, response rate 57%).

    Method: Data were collected by means of a postal questionnaire.

    Results: Half of the RNs reported that they performed several of the listed tasks every day or every week, regardless of workplace. These tasks were most frequently performed in surgical departments. The majority of the participants (76%) stated a need of continued practical training. However, less than half of them (48%) had access to a training environment. Several participants (43%) had been involved in incidents related to technical skills or medical devices, which were not always reported. Nearly a third of the participants (31%) did not use the existing guidelines when performing technical skills, and reflection on performance was uncommon.

    Conclusions: This study highlights the importance of shared responsibilities between nurse educators and health care employers to provide learning opportunities for new RNs in technical skills, to maintain patient safety. To increase the safety culture where nursing students and new RNs understand the importance of using evidence-based guidelines and taking a reflective approach in the performance of technical tasks is needed.

    Place, publisher, year, edition, pages
    Churchill Livingstone, 2015
    Keywords
    Clinical competence, Clinical laboratory, Equipment and supplies, Incident reports, Medical devices, New registered nurses, Nursing skills, Patient safety
    National Category
    Nursing
    Research subject
    Caring sciences
    Identifiers
    urn:nbn:se:oru:diva-47060 (URN)10.1016/j.nedt.2015.05.006 (DOI)000365372700007 ()26059922 (PubMedID)2-s2.0-84946492078 (Scopus ID)
    Available from: 2015-12-11 Created: 2015-12-11 Last updated: 2018-07-02Bibliographically approved
    3. Nursing students’ socialisation into practical skills
    Open this publication in new window or tab >>Nursing students’ socialisation into practical skills
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-56895 (URN)
    Available from: 2017-03-29 Created: 2017-03-29 Last updated: 2017-10-18Bibliographically approved
    4. Tensions in learning professional identities: nursing students narratives and participation in practical skills during their clinical practice
    Open this publication in new window or tab >>Tensions in learning professional identities: nursing students narratives and participation in practical skills during their clinical practice
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-56896 (URN)
    Available from: 2017-03-29 Created: 2017-03-29 Last updated: 2017-10-18Bibliographically approved
  • 41.
    Ewertsson, Mona
    et al.
    Örebro University, School of Health Sciences.
    Bagga-Gupta, Sangeeta
    Jönköping University.
    Allvin, Renèe
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Blomberg, Karin
    Örebro University, School of Health Sciences.
    Tensions in learning professional identities: nursing students narratives and participation in practical skills during their clinical practiceManuscript (preprint) (Other academic)
  • 42.
    Ewertsson, Mona
    et al.
    Örebro University, School of Health Sciences.
    Bagga-Gupta, Sangeeta
    Örebro University, School of Humanities, Education and Social Sciences.
    Blomberg, Karin
    Örebro University, School of Health Sciences.
    Nursing students’ socialisation into practical skillsManuscript (preprint) (Other academic)
  • 43.
    Faag, Carina
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    A comprehensive nurse-led intervention for patients with peripheral vestibular disorders: the feasibility and benefits2015Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    Dizziness and balance problems are common symptoms at all ages, the symptoms are more common in women than in men and increases with age. Several studies clearly demonstrate that peripheral vestibular disorders symptoms may lead to the patients reporting functional consequences of a physical, mental and social character. The overall aim of this thesis was to investigate the efficacy and feasibility of an intervention for patients with peripheral vestibular disorders that contains patient education in groups in combination with individual support. The study is a randomized controlled trial (RCT). Thirty-six patients participated in the study: the intervention group (n = 18), who received the intervention and standard care, and patients in a control group (n = 18), who received standard care. The intervention includes a patient education program and individualized nursing support during a six-month period. Outcomes were collected by self-assessment questionnaires about dizziness-related symptoms, well-being, sense of coherence, and self-care measured at baseline before randomization and at six and nine months later. All patients were also instructed to complete a diary where they recorded symptoms that arose during an episode of dizziness. The main results show that the patients who received the intervention rated statistically significant fewer vertigo-related symptoms and a higher sense of coherence than the control group at the ninemonth follow-up. The intervention was feasible and seems to support the patients to manage symptoms. The effects were small and must be considered in relation to the efforts of the intervention. Confirmative studies are warranted.

    List of papers
    1. Feasibility and effects of a nursing intervention for patients with peripheral vestibular disorders
    Open this publication in new window or tab >>Feasibility and effects of a nursing intervention for patients with peripheral vestibular disorders
    (English)Manuscript (preprint) (Other academic)
    National Category
    Nursing
    Identifiers
    urn:nbn:se:oru:diva-51599 (URN)
    Available from: 2016-08-08 Created: 2016-08-08 Last updated: 2017-10-17Bibliographically approved
    2. Symptoms experienced by patients with peripheral vestibular disorders: evaluation of the Vertigo Symptom Scale for clinical application
    Open this publication in new window or tab >>Symptoms experienced by patients with peripheral vestibular disorders: evaluation of the Vertigo Symptom Scale for clinical application
    2007 (English)In: Clinical Otolaryngology, ISSN 1749-4478, E-ISSN 1365-2273, Vol. 32, no 6, p. 440-446Article in journal (Refereed) Published
    Abstract [en]

    Objectives: To describe symptoms during an episode of dizziness in a sample of patients suffering from peripheral vestibular disorders and to compare them with the items in the Vertigo Symptom Scale.

    Design: A descriptive study from a sample of patients with peripheral vestibular disorders.

    Setting: Patients visiting a department of audiology at a university hospital.

    Participants: Twenty patients with peripheral vestibular disorders. The inclusion criteria were that the patient had had at least three spontaneous attacks of vertigo and/or was constantly unsteady during the last 3 months for at least 75% of the time when awake.

    Main outcome measure: Patients were instructed to complete a diary where they recorded symptoms that arose during an episode of dizziness. These symptoms were compared with the content of the Vertigo Symptom Scale.

    Results: The most frequent symptoms as mentioned by the patients in their diaries were a feeling that things are spinning or moving around, nausea, feeling unsteady/about to lose one's balance, fatigue, headache, a feeling as if the ground you walk on is distant and ear-related such as tinnitus and a feeling of pressure in the ear. Pain in the heart or chest region, a heavy feeling in the arms or legs, pain in the lower part of the back and excessive sweating were not mentioned at all or by very few patients. Analysis showed that some of the symptoms included in the Vertigo Symptom Scale occurred less during an episode of dizziness than others in this sample of patients with peripheral vestibular disorders.

    Conclusion: It was found that the Vertigo Symptom Scale is an adequate base but may need to be developed for use in patients diagnosed with peripheral vestibular symptoms to be able to evaluate care and treatment.

    Place, publisher, year, edition, pages
    John Wiley & Sons, 2007
    National Category
    Otorhinolaryngology
    Identifiers
    urn:nbn:se:oru:diva-51596 (URN)000251414800004 ()18076429 (PubMedID)2-s2.0-36849088281 (Scopus ID)
    Available from: 2016-08-08 Created: 2016-08-08 Last updated: 2017-11-28Bibliographically approved
  • 44.
    Forsberg, Anette
    et al.
    Örebro University Hospital. Division of Neurology, Karolinska Institutet, Stockholm, Sweden; Family Medicine Research Centre, Örebro County Council, Örebro, Sweden.
    Widén-Holmqvist, Lotta
    Division of Neurology, Karolinska Institutet, Stockholm, Sweden; Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.
    Ahlström, Gerd
    Department of Health Sciences, Lund University, Lund, Sweden.
    Balancing everyday life two years after falling ill with Guillain-Barre syndrome: a qualitative study2015In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 29, no 6, p. 601-610Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim was to describe experiences of disability in everyday life and managing the recovery process two years after falling ill with Guillain-Barré syndrome.

    Design: Qualitative interview study.

    Methods: Interviews were conducted with 35 persons (22 male, mean age 50 years) two years after the onset of Guillain-Barré syndrome. The interviews were transcribed verbatim and analysed using content analysis.

    Results: The analysis revealed four categories and an overall theme: ‘Striving for balance in everyday life’. The participants described persistent lived body restrictions that affected their arms, legs, and face. Bodily symptoms and loss of energy limited or restricted many everyday activities. In connection with healthcare, both satisfaction and feeling vulnerable in a critical situation were described. Experiences of the recovery process varied. The participants described acceptance and reappraisal of a new life situation despite their limitations, and having gained the knowledge that life can change suddenly. However, they also expressed disappointment following an overly positive prognosis in the early stages, and over a continuous wait for recovery. For some participants life had returned to as before.

    Conclusion: The participants experienced limitations in everyday life and decreased functioning in several parts of the body. The recovery process may still be ongoing two years after onset. Rehabilitation intervention with an extended focus on supporting individualized coping processes could facilitate ways to live with persistent disability.

  • 45.
    Fredriksson, Ingela
    Örebro University, School of Health Sciences.
    Leisure-time youth-center as health-promotion settings2016Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    Leisure time is an important part of young people’s lives. Despite this, leisure-time settings have hitherto had only a minor role in setting-based health-promotion initiatives. Improving adolescents’ quality of leisuretime activities can reduce social differences in health, thus youth-centers can be appropriate settings for promoting health. However, young people with immigrant backgrounds participate less in organized leisure-time activities.

    The overall aim of this study is to explore young people’s leisure time as their health-promotion setting in two NGO-run youth-centers in multicultural, socially deprived suburbs in Sweden.

    This study took a practice-based approach using a mixture of methods in close collaboration with the youth-centers. Data collection was done through surveys with young people (n = 207) and interviews with young people and leaders (n = 16). Study I, about who participates in youthcenter activities, used an explanatory mixed method. Study II, about the youth-centers’ strategies, used an explorative qualitative method with an inductive content analysis.

    This study shows that youth-centers have great potential to be a healthpromotion setting if their strategies include some important factors, both in theory and in daily practice. To be a health-promotion setting, a youthcenter needs to be open and inclusive for its target group, foster supportive relationships, emphasize youth empowerment, and integrate family, school, and community in its strategies.

    Local knowledge about young people's backgrounds, needs, interests, and motivations to attend youth-center activities – as well as good contact with young people's families – is important because it can increase participation in leisure-time activities for young people in multicultural and socio- economically disadvantaged neighborhoods and can thus help to reduce social inequalities in health.

    List of papers
    1. Two NGO-run youth-centers in multicultural, socially deprived suburbs in Sweden: Who are the participants?
    Open this publication in new window or tab >>Two NGO-run youth-centers in multicultural, socially deprived suburbs in Sweden: Who are the participants?
    2015 (English)In: Health, ISSN 1949-4998, Vol. 7, no 9, p. 1158-1174Article in journal (Refereed) Published
    Abstract [en]

    Objective: Leisure-time is an important part of young people’s lives. One way to reduce social differences in health is to improve adolescents’ living conditions, for example by enhancing the quality of after-school activities. Multicultural, socially deprived suburbs have less youth participation in organized leisure-time activities. This study explores who the participants are at two NGO-run youth-centers in multicultural, socially deprived suburbs in Sweden and whether socio-demographic, health-related, and leisure-time factors affect the targeted participation. Methods: The study can be seen as an explanatory mixed-methods study where qualitative data help explain initial quantitative results. The included data are a survey with youth (n = 207), seven individual interviews with staff, and six focus-groups interviews with young people at two youth-centers in two different cities. Results and Conclusions: The participants in the youth-centers are Swedish born youths having foreign-born parents who live with both parents, often in crowded apartments with many siblings. Moreover they feel healthy, enjoy school and have good contact with their parents. It seems that strategies for recruiting youths to youth-centers have a large impact on who participates. One way to succeed in having a more equal gender and ethnicity distribution is to offer youth activities that are a natural step forward from children’s activities. The youth-centers’ proximity is also of importance for participation, in these types of neighborhoods.

    Place, publisher, year, edition, pages
    Scientific Research Publishing, 2015
    Keywords
    Youth-Center, Leisure-Time, Participation, Suburbs, NGO
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Research subject
    Public health
    Identifiers
    urn:nbn:se:oru:diva-45914 (URN)10.4236/health.2015.79131 (DOI)
    Funder
    Swedish National Institute of Public Health
    Available from: 2015-09-24 Created: 2015-09-24 Last updated: 2018-04-04Bibliographically approved
    2. Important Strategies for Youth Centers to be Health-Promoting Settings
    Open this publication in new window or tab >>Important Strategies for Youth Centers to be Health-Promoting Settings
    2015 (English)In: Health Science Journal, ISSN 1791-809X, Vol. 10, no 1, article id 13Article in journal (Refereed) Published
    Abstract [en]

    Background: Adolescence is a time that offers many opportunities for good health. It is also when the foundations for future patterns of adult health are established. Leisure time is a significant part of young people’s lives, and is often spent together with peers, it could therefore be a crucial arena for helping adolescents develop their full potential and attain the best possible health in the transition to adulthood. Since many young people spend their leisure time at youth centers they can play an active role in health promotion and be a health-promoting setting.

    This study aims to explore different strategies at two NGO-driven youth centers in multicultural, socially deprived suburbs in Sweden, and to determine what factors are important for making the youth centers health-promoting settings.

    Method and findings: The study includes data from seven individual interviews with staff and six group interviews with youth at two youth centers. The groups consisted of three to five members with different ages (13–17 years), ethnicities, experiences and number of years at the center, totally 26 young people. An inductive qualitative content analysis was performed to analyze the interviews. The two youth centers studied are located in suburbs of two top-ten (by population) cities in Sweden. Both suburbs are characterized by apartment blocks and a high proportion of people with immigrant backgrounds and lower socio- economic status. The results show that youth centers can be health-promoting settings when their strategies include some important factors, both in theory and in daily practice.

    Conclusion: To be a health-promoting setting a youth center needs to be open and inclusive towards its target groups, foster supportive relationships, emphasize youth empowerment, and integrate family, school and community into its strategies.

    Place, publisher, year, edition, pages
    Athens, Greece: Technological Educational Institute of Athens, 2015
    Keywords
    Youth center, leisure time, health promotion, settings, NGO, strategies
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Research subject
    Public health
    Identifiers
    urn:nbn:se:oru:diva-48465 (URN)
    Funder
    Public Health Agency of Sweden
    Available from: 2016-02-22 Created: 2016-02-22 Last updated: 2017-10-17Bibliographically approved
  • 46.
    Frölander, Hans Erik
    et al.
    Örebro University, School of Health Sciences. Örebro Audiological Research Centre, Örebro, Sweden; The Swedish Institute for Disability Research, Linköping, Sweden; The Linnaeus Centre HEAD, Linköping, Sweden; Research on Hearing and Deafness (HEAD) Graduate School, Linköping, Sweden .
    Lyxell, Björn
    Department of Behavioral Science and Learning, Linköping University, Linköping; The Swedish Institute for Disability Research, Linköping, Sweden; The Linnaeus Centre HEAD, Linköping, Sweden.
    Marshall, Jan D
    Jackson laboratory, Bar Harbor, Maine, ME, USA; Alstrom Syndrome international, Mt. Desert, Maine, ME, USA.
    Piacentini, Heather
    Alstrom Syndrome international, Mt. Desert, Maine, ME, USA.
    Möller, Claes
    Örebro University, School of Health Sciences. Örebro Audiological Research Centre, Örebro, Sweden; Department of Audiology, Örebro University Hospital, Örebro, Sweden; The Swedish Institute for Disability Research, Sweden; The Linnaeus Centre HEAD, Linköping, Sweden.
    Theory-of-mind in young adults with Alström syndrome is affected by social relationshipsManuscript (preprint) (Other academic)
  • 47.
    Frölander, Hans-Erik
    Örebro University, School of Health Sciences.
    Deafblindness: Theory-of-mind, cognitive functioning and social network in Alström syndrome2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis addresses young adults with Alström syndrome (AS). AS causes acquired deafblindness, a severe, progressive, combined auditory and visual impairment affecting daily life and self-reliance to a degree that full participation depends on help from others and society. AS is an autosomal, recessively inherited single-gene disorder that affects the ALMS1 gene. AS has a multi-systemic pathology including a high incidence of additional multiple endocrine abnormalities, cardiomyopathy, pulmonary fibrosis, restrictive lung disease and progressive hepatic and renal failure leading to reduced life expectancy. The focus in the present thesis is on the development of Theory-of-mind (ToM) and on how ToM relates to the development of certain cognitive skills and the characteristics of the individual social network. ToM refers to the ability to understand the thoughts and feelings of others.

    The results reveal that individuals with AS displayed a significantly higher degree of heterogeneity in the performance of ToM tasks, and some individuals with AS performed on an equal level with nondisabled individuals. ToM performance was predicted by verbal ability and executive functioning (EF), whereas working memory capacity (WM) proved to be an indirect predictor. Later onset of visual loss further characterized AS individuals with better ToM. The sizes of the social networks of individuals with AS were smaller relative to those of nondisabled individuals, and many of the acquaintances were professionals working with individuals with AS. The number of friends correlated with ToM performance.

    Methods to improve verbal ability and EF, and interventions to enhance social participation in childhood of individuals with AS might prove to be fruitful. In addition assistive technology to establish and maintain friendships in adulthood is required.

    List of papers
    1. Theory-of-mind in adolescents and young adults with Alström Syndrome
    Open this publication in new window or tab >>Theory-of-mind in adolescents and young adults with Alström Syndrome
    Show others...
    2014 (English)In: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 78, no 3, p. 530-537Article in journal (Refereed) Published
    Abstract [en]

    Objective: The study focuses on theory-of-mind in adolescents and young adults with Alström syndrome (ALMS). ALMS, an autosomal recessive syndrome causes juvenile blindness, sensorineural hearing loss, cardiomyopathy, endocrinological disorders and metabolic dysfunction. Theory-of-mind (ToM) refers to the ability to impute mental states to one self and to others. Clinical observations have revealed an increased occurence of deviances in mental state understanding in ALMS. In the present study ToM will be examined and related to working memory (WM), verbal ability and sensory loss.

    Methods: Twelve young individuals (16-37 years) with ALMS and 24 nondisabled individuals matched on age, gender and educational level participated. ToM was assessed by means of a multiple task that taxes the ability to understand thoughts and feelings of story chraracters´. WM was examined by means of a reading span task and verbal ability by means of a vocabulary test.

    Results: The ALMS group performed at significantly lower levels in ToM tasks and displayed a higher variability in performance than the control group. Individuals with ALMS and a relatively poor level performance provided fewer correct mental state inferences in ToM tasks than ALMS individuals with relatively higher performance levels. ALMS individuals with relatively high performance levels made as many correct inferences in ToM tasks as the control group, but their inferences were more often incomplete. Vocabulary skills and educational level, but not WM-capacity predicted ToM performance. Degree of deafblindness did not have an impact on ToM. Age of onset of visual loss but not hearing loss related to ToM.

    Conclusions: The individuals with ALMS display a high degree of heterogeneity in terms of ToM, where some individuals reached performance levels comparable to nondisabled individuals. The results are discussed with respect to how cognitive and verbal abilities and factors related to the disability affect ToM.

    Place, publisher, year, edition, pages
    Elsevier, 2014
    Keywords
    Alström syndrome (ALMS), Deafblindness, Theory-of-mind, Working memory, Verbal ability, Dual sensory loss
    National Category
    Otorhinolaryngology Pediatrics
    Identifiers
    urn:nbn:se:oru:diva-33957 (URN)10.1016/j.ijporl.2013.12.038 (DOI)000334394400026 ()24485176 (PubMedID)2-s2.0-84893729756 (Scopus ID)
    Note

    Funding Agencies:

    Linnaeus Centre HEAD

    JDM

    NIH

    Available from: 2014-02-27 Created: 2014-02-27 Last updated: 2018-06-05Bibliographically approved
    2. Theory of mind and cognitive function in adults with Usher or Alström syndrome
    Open this publication in new window or tab >>Theory of mind and cognitive function in adults with Usher or Alström syndrome
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Research subject
    Disability Research
    Identifiers
    urn:nbn:se:oru:diva-49433 (URN)
    Available from: 2016-03-18 Created: 2016-03-18 Last updated: 2017-10-17Bibliographically approved
    3. Theory-of-mind in individuals with Alström syndrome is related to executive functions, and verbal ability
    Open this publication in new window or tab >>Theory-of-mind in individuals with Alström syndrome is related to executive functions, and verbal ability
    Show others...
    2015 (English)In: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 6, article id 1426Article in journal (Refereed) Published
    Abstract [en]

    Objective: This study focuses on cognitive prerequisites for the development of theory-of-mind (ToM), the ability to impute mental states to self and others in young adults with Alström syndrome (AS). AS is a rare and quite recently described recessively inherited ciliopathic disorder which causes progressive sensorineural hearing loss and juvenile blindness, as well as many other organ dysfunctions. Two cognitive abilities were considered; Phonological working memory (WM) and executive functions (EF), both of importance in speech development.                                                                                              

    Methods: Ten individuals (18–37 years) diagnosed with AS, and 20 individuals with no known impairment matched for age, gender, and educational level participated. Sensory functions were measured. Information about motor functions and communicative skills was obtained from responses to a questionnaire. ToM was assessed using Happés strange stories, verbal ability by a vocabulary test, phonological WM by means of an auditory presented non-word serial recall task and EF by tests of updating and inhibition.                                           

    Results: The AS group performed at a significantly lower level than the control group in both the ToM task and the EF tasks. A significant correlation was observed between recall of non-words and EF in the AS group. Updating, but not inhibition, correlated significantly with verbal ability, whereas both updating and inhibition were significantly related to the ability to initiate and sustain communication. Poorer performance in the ToM and EF tasks were related to language perseverance and motor mannerisms.                                                     

    Conclusion: The AS group displayed a delayed ToM as well as reduced phonological WM, EF, and verbal ability. A significant association between ToM and EF, suggests a compensatory role of EF. This association may reflect the importance of EF to perceive and process input from the social environment when the social interaction is challenged by dual sensory loss. We argue that limitations in EF capacity in individuals with AS, to some extent, may be related to early blindness and progressive hearing loss, but maybe also to gene specific abnormalities.

    Keywords
    Alström syndrome (AS), ciliopathy, deafblindness, theory-of-mind, verbal ability, executive functions
    National Category
    Psychology (excluding Applied Psychology)
    Research subject
    Psychology
    Identifiers
    urn:nbn:se:oru:diva-46002 (URN)10.3389/fpsyg.2015.01426 (DOI)000361813000001 ()26441796 (PubMedID)
    Funder
    NIH (National Institute of Health), HDO36878
    Note

    Funding Agency:

    Linnaeus Centre HEAD

    Available from: 2015-10-02 Created: 2015-10-02 Last updated: 2018-07-02Bibliographically approved
    4. Theory-of-mind in young adults with Alström syndrome is affected by social relationships
    Open this publication in new window or tab >>Theory-of-mind in young adults with Alström syndrome is affected by social relationships
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    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Research subject
    Disability Research
    Identifiers
    urn:nbn:se:oru:diva-49434 (URN)
    Available from: 2016-03-18 Created: 2016-03-18 Last updated: 2017-10-17Bibliographically approved
  • 48. Fu, Qiang
    et al.
    Xue, Zhanggang
    Klein, Gunnar
    Örebro University, Örebro University School of Business.
    Using mobile information technology to build a database for anesthesia quality control and to provide clinical guidelines.2003In: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 95, p. 629-634Article in journal (Refereed)
    Abstract [en]

    The paper describes a mobile information system to collect patient information for anaesthesia quality control. In this system we use handheld computers, to collect patient data at the bedside with a daily synchronization of the data of the anaesthesiologist's handheld with the anaesthesia database center, later used for quality control analysis. Further, we design mobile clinical guidelines to be used on the same handhelds.

  • 49.
    Fu, Qiang
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Xue, Zhanggang
    Zhongshan Hospital affiliated to Fudan University, Shanghai, China.
    Zhu, Jie
    Computer Informatics College of Fudan University, Shanghai, China.
    Fors, Uno
    Karolinska Institutet, Stockholm, Sweden.
    Klein, Gunnar
    Karolinska Institutet, Stockholm, Sweden.
    Anaesthesia record system on handheld computers: pilot experience and uses for quality control and clinical guidelines2005In: Computer Methods and Programs in Biomedicine, ISSN 0169-2607, E-ISSN 1872-7565, Vol. 77, no 2, p. 155-63Article in journal (Refereed)
    Abstract [en]

    This paper describes a mobile information system to collect patient information for anesthesia quality control. In this system, a mobile database program was designed for use on handheld computers (Pocket PC). This program is used to collect patient data at the bedside on the handhelds, with a daily synchronization of the data between the anaesthesiologists' handhelds with the anaesthesia database. All collected data are later used for quality control analysis. Furthermore, clinical guidelines will be included on these same handhelds. During the pilot phase, data from a sample set of about 300 patients were incorporated. The processes and interfaces of the system are presented in the paper. The current mobile database system has been designed to replace the original paper-based data collection system. The individual anaesthesiologist's handheld synchronizes patient data daily with anaesthesia database center. This information database is analyzed and used not only to give feedback to the individual doctor or center, but also to review the use of the guidelines provided and the results of their utilization.

  • 50.
    Granberg, Sarah
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Functioning and disability in adults with hearing loss: the preparatory studies in the ICF Core sets for hearing loss project2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    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.

    List of papers
    1. The ICF Core Sets for hearing loss - researcher perspective. Part I: Systematic review of outcome measures identified in audiological research
    Open this publication in new window or tab >>The ICF Core Sets for hearing loss - researcher perspective. Part I: Systematic review of outcome measures identified in audiological research
    Show others...
    2014 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no 2, p. 65-76Article, review/survey (Refereed) Published
    Abstract [en]

    Objective: To review the literature in order to identify outcome measures used in research on adults with hearing loss (HL) as part of the ICF Core Sets development project, and to describe study and population characteristics of the reviewed studies.

    Design: A systematic review methodology was applied using multiple databases. A comprehensive search was conducted and two search pools were created, pool I and pool II.

    Study sample: The study population included adults (>= 18 years of age) with HL and oral language as the primary mode of communication.

    Results: 122 studies were included. Outcome measures were distinguished by 'instrument type', and 10 types were identified. In total, 246 (pool I) and 122 (pool II) different measures were identified, and only approximately 20% were extracted twice or more. Most measures were related to speech recognition. Fifty-one different questionnaires were identified. Many studies used small sample sizes, and the sex of participants was not revealed in several studies.

    Conclusion: The low prevalence of identified measures reflects a lack of consensus regarding the optimal outcome measures to use in audiology. Reflections and discussions are made in relation to small sample sizes and the lack of sex differentiation/descriptions within the included articles.

    Place, publisher, year, edition, pages
    London, UK: Informa Healthcare, 2014
    Keywords
    Hearing loss, audiology, ICF, ICF core sets, outcome assessment, systematic literature review
    National Category
    Other Health Sciences Otorhinolaryngology
    Research subject
    Disability Science
    Identifiers
    urn:nbn:se:oru:diva-33754 (URN)10.3109/14992027.2013.851799 (DOI)000329834600001 ()24313738 (PubMedID)2-s2.0-84892578224 (Scopus ID)
    Note

    Funding Agencies:

    Oticon Foundation  

    Stinger Foundation

    Available from: 2014-02-14 Created: 2014-02-14 Last updated: 2018-06-04Bibliographically approved
    2. The ICF Core Sets for hearing loss: researcher perspective, Part II: Linking outcome measures to the International Classification of Functioning, Disability and Health (ICF)
    Open this publication in new window or tab >>The ICF Core Sets for hearing loss: researcher perspective, Part II: Linking outcome measures to the International Classification of Functioning, Disability and Health (ICF)
    Show others...
    2014 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no 2, p. 77-87Article, review/survey (Refereed) Published
    Abstract [en]

    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.

    Place, publisher, year, edition, pages
    Informa Healthcare, 2014
    Keywords
    Hearing loss, audiology, ICF, linking, ICF core sets
    National Category
    Other Health Sciences Otorhinolaryngology
    Research subject
    Medicine
    Identifiers
    urn:nbn:se:oru:diva-33755 (URN)10.3109/14992027.2013.858279 (DOI)000329834600002 ()24329490 (PubMedID)2-s2.0-84892619855 (Scopus ID)
    Note

    Funding Agencies:

    Oticon Foundation  

    Stinger Foundation

    Available from: 2014-02-14 Created: 2014-02-14 Last updated: 2018-06-04Bibliographically approved
    3. The ICF core sets for hearing loss project: International expert survey on functioning and disability of adults with hearing loss using the International classification of functioning, disability, and health (ICF)
    Open this publication in new window or tab >>The ICF core sets for hearing loss project: International expert survey on functioning and disability of adults with hearing loss using the International classification of functioning, disability, and health (ICF)
    Show others...
    2014 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no 8, p. 497-506Article in journal (Refereed) Published
    Abstract [en]

    Objective: To identify relevant aspects of functioning, disability, and contextual factors for adults with hearing loss (HL) from hearing health professional perspective summarized using the ICF classification as reference tool.

    Design: Internet-based cross-sectional survey using open-ended questions. Responses were analysed using a simplified content analysis approach to link concept to ICF categories according to linking rules.

    Study sample: Hearing health professionals (experts) recruited through e-mail distribution lists of professional organizations and personal networks of ICF core set for hearing loss steering committee members. Stratified sampling according to profession and world region enhanced the international and professional representation.

    Results: Sixty-three experts constituted the stratified sample used in the analysis. A total of 1726 meaningful concepts were identified in this study, resulting in 209 distinctive ICF categories, with 106 mentioned by 5% or more of respondents. Most categories in the activities & participation component related to communication, while the most frequent environmental factors related to the physical environment such as hearing aids or noise. Mental functions, such as confidence or emotional functions were also frequently highlighted.

    Conclusions: More than half (53.3%) of the entire ICF classification categories were included in the expert survey results. This emphasizes the importance of a multidimensional tool, such as the ICF, for assessing persons with hearing loss.

    Place, publisher, year, edition, pages
    Informa Healthcare, 2014
    Keywords
    Hearing loss; audiology; ICF; ICF core sets; hearing health professionals; expert survey
    National Category
    Other Health Sciences Otorhinolaryngology
    Research subject
    Disability Science
    Identifiers
    urn:nbn:se:oru:diva-34834 (URN)10.3109/14992027.2014.900196 (DOI)000339630500001 ()24754459 (PubMedID)2-s2.0-84904126425 (Scopus ID)
    Note

    Funding Agencies:

    Oticon Foundation

    Hörselforskningsfonden (Swedish hearing research foundation)

    Available from: 2014-04-24 Created: 2014-04-24 Last updated: 2018-06-05Bibliographically approved
    4. The ICF core sets for hearing loss project: Functioning and disability from the patient perspective
    Open this publication in new window or tab >>The ICF core sets for hearing loss project: Functioning and disability from the patient perspective
    Show others...
    2014 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no 11, p. 777-786Article in journal (Refereed) Published
    Abstract [en]

    Objective: To explore areas of functioning, disability, and environmental factors of adults with hearing loss (HL) by using the ICF classification as a tool to determine and document each element. Design: A qualitative study applying mainly focus-group methodology was applied.

    Study sample: Thirty-six Dutch and South African adults (18 years of age) with HL (20–95 dB HL) who used oral communication as first communication. Summative content analysis was performed on the transcripts by linkage to appropriate ICF categories.

    Results: 143 ICF categories were identified, most of which belonged to the Activities & Participation (d) component, closely followed by the Environmental factors component. Participants specifically mentioned categories related to oral communication and interaction. Assistive technology (such as hearing aids), noise, and support by and attitudes of others in the environment of the participants were considered highly influential for functioning and disability.

    Conclusions: The present study illustrates the complex and encompassing nature of aspects involved in functioning and disability of adults with HL. Findings highlight the necessity of using a multidimensional tool, such as the ICF, to map functioning and disability with hearing loss, allowing consideration and evaluation of aspects that are both internal and external.

    Place, publisher, year, edition, pages
    London, UK: Informa Healthcare, 2014
    Keywords
    ICF, ICF core sets, focus groups, qualitative study, patient perspective
    National Category
    Other Health Sciences Otorhinolaryngology
    Research subject
    Disability Science
    Identifiers
    urn:nbn:se:oru:diva-39251 (URN)10.3109/14992027.2014.938370 (DOI)000343928200001 ()25311099 (PubMedID)2-s2.0-84911460995 (Scopus ID)
    Note

    Funding Agency:

    Oticon Foundation  

    Available from: 2014-12-02 Created: 2014-12-02 Last updated: 2018-06-14Bibliographically approved
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