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  • 1.
    Holmefur, Marie
    et al.
    Örebro University, School of Health Sciences.
    Lidström-Holmqvist, Kajsa
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Arvidsson, Patrik
    Jönköping University, Jönköping, Sweden.
    Roshanai, Afsaneh
    Uppsala University, Uppsala, Sweden.
    White, Suzanne
    SUNY Downstate University, New York, NY, USA.
    Janeslätt, Gunnel
    Uppsala University, Uppsala, Sweden.
    Let’s Get Organized: pilot study of an occupational therapy group intervention aimed to improve time management skills2018Conference paper (Refereed)
    Abstract [en]

    Introduction: Managing daily life activities requires time management and organizing skills. Individuals with cognitive disabilities commonly have poor ability to manage time, which often results in decreased ability to properly manage daily life activities. An intervention aimed to increase time management skills is "Let’s get organized" (LGO).

    Objective: The current pilot study was designed to explore the outcome of the LGO with regards to time management skills, executive functions and satisfaction with daily occupations among individuals with cognitive disabilities.

    Method: Persons with mental and neurodevelopmental disorder with decreased ability to manage time in daily life according to self-rated measures, were recruited by their local Occupational Therapist. All participants took part in LGO, which is a 10-week manual based group intervention with weekly meetings. Each session has a separate theme, with a common structure and goal to improve time management skills and to implement the use of a calendar in daily life. Measured outcomes were time management skills (Assessment of Time Management Skills), executive functioning (Weekly Calendar Planning Activity) and overall satisfaction with daily activities (Satisfaction with Daily Occupations).

    Results: In all 55 persons participated in the study. Preliminary results from a subgroup indicate significant improvements in time management skills, in aspects of executive functioning and in overall satisfaction with daily occupations.

    Conclusion: The LGO seems to be a promising intervention to improve time management skills and satisfaction with daily occupations in the short term. The used instruments appear to be sensitive to capture change from LGO.

  • 2.
    Holmefur, Marie
    et al.
    Örebro University, School of Health Sciences.
    Lidström-Holmqvist, Kajsa
    Region Örebro Län, Örebro, Sweden.
    Roshanay, Afsaneh
    Arbetsförmedlingen, Kista, Sweden.
    Arvidsson, Patrik
    Vuxenhabiliteringen, Region Gävleborg, Sweden.
    White, Suzanne
    SUNY Downstate University, Brooklyn, NY, USA.
    Janeslätt, Gunnel
    Centrum för klinisk forskning, Landstinget Dalarna, Sweden.
    Ha koll!: pilotstudie av en arbetsterapeutisk gruppintervention som syftar till förbättrad tidshantering2019Conference paper (Refereed)
  • 3.
    Holmefur, Marie
    et al.
    Örebro University, School of Health Sciences.
    Lidström-Holmqvist, Kajsa
    Örebro University, School of Health Sciences. University Health Care Research Center.
    Roshanay, Afsaneh Hayat
    Clinical Psychologist, Department of Public Health and Caring Sciences, Disability and Habilitation, Uppsala University, Uppsala, Sweden.
    Arvidsson, Patrik
    Swedish Institute for Disability Research, Jönköping University, Jönköping, Sweden; Centre for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden.
    White, Suzanne
    State University of New York Downstate Medical Center, Brooklyn, USA.
    Janeslätt, Gunnel
    Department of Public Health and Caring Sciences, Disability and Habilitation, and Researcher, Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden.
    Pilot Study of Let's Get Organized: A Group Intervention for Improving Time Management2019In: American Journal of Occupational Therapy, ISSN 0272-9490, E-ISSN 1943-7676, Vol. 73, no 5, p. 7305205020p1-7305205020p10Article in journal (Refereed)
    Abstract [en]

    IMPORTANCE: There is a need for evidence-based occupational therapy interventions to enhance time management in people with time management difficulties.

    OBJECTIVE: To pilot test the first part of the Let's Get Organized (LGO) occupational therapy intervention in a Swedish context by exploring enhancements of time management skills, aspects of executive functioning, and satisfaction with daily occupations in people with time management difficulties because of neurodevelopmental or mental disorders.

    DESIGN: One-group pretest-posttest design with 3-mo follow-up.

    SETTING: Outpatient psychiatric and habilitation settings.

    PARTICIPANTS: Fifty-five people with confirmed or suspected mental or neurodevelopmental disorder and self-reported difficulties with time management in daily life.

    INTERVENTION: Swedish version of Let's Get Organized (LGO-S) Part 1, with structured training in the use of cognitive assistive techniques and strategies using trial-and-error learning strategies in 10 weekly group sessions of 1.5 hr.

    OUTCOMES AND MEASURES: Time management, organization and planning, and emotional regulation were measured with the Swedish version of the Assessment of Time Management Skills (ATMS-S). Executive functioning was measured with the Swedish version of the Weekly Calendar Planning Activity, and satisfaction with daily occupations was assessed with the Satisfaction With Daily Occupations measure.

    RESULTS: Participants displayed significantly improved time management, organization and planning skills, and emotional regulation, as well as satisfaction with daily occupations. Aspects of executive functioning were partly improved. ATMS-S results were sustained at 3-mo follow-up.

    CONCLUSION AND RELEVANCE: LGO-S Part 1 is a promising intervention for improving time management skills and satisfaction with daily occupations and should be investigated further.

    WHAT THIS ARTICLE ADDS: This study shows that LGO-S Part 1 is feasible for use in psychiatric and habilitation outpatient services. The results are promising for improved time management skills, organization and planning skills, and satisfaction with daily occupations and need to be confirmed in further studies.

  • 4.
    Holmefur, Marie
    et al.
    Örebro University, School of Health Sciences.
    Lidström-Holmqvist, Kajsa
    Örebro University, School of Health Sciences.
    White, Suzanne
    College Of Health Related Professions, SUNY Downstate Medical Center, New York, USA.
    Janeslätt, Gunnel
    Centre For Clinical Research, Dalarna County Council, Falun, Sweden.
    Assessment of Time Management Skills: psychometric properties of the Swedish version (ATMS-S)2017Conference paper (Refereed)
  • 5.
    Holmefur, Marie
    et al.
    Örebro University, School of Health Sciences.
    Lidström-Holmqvist, Kajsa
    Örebro University, School of Health Sciences.
    White, Suzanne
    Occupational Therapy Program, Downstate University, New York, USA.
    Janeslätt, Gunnel
    Centrum för klinisk forskning, Landstinget i Dalarna, Falun, Sverige.
    Prövning av validitet hos den svenska versionen av Assessment of Time Management Skills (ATMS-S)2017Conference paper (Refereed)
  • 6.
    Holmqvist, Kajsa
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Kognitiva funktionsnedsättningarefterförvärvad hjärnskada. Konsekvenser i vardagen och rehabiliteringmed fokus på arbetsterapi2014Report (Other academic)
  • 7.
    Holmqvist, Kajsa
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Occupational therapist practice patterns in relation to clients with cognitive impairment following acquired brain injury2014In: 16th International Congress of the World federation of Occupational Therapists, 2014Conference paper (Refereed)
    Abstract [en]

    Introduction: Persons with cognitive impairments following acquired brain injury are a common client group among occupational therapists and occupational therapy has shown to have a positive effect on occupational performance. However, the scarcity of research into occupational therapists practice patterns has resulted in a lack of knowledge of the exact nature of the interventions used.

    Primary objective: To describe Swedish Occupational Therapists’ practice patterns for clients with cognitive impairment following acquired brain injury.

    Research design: A cross-sectional stratified random sample of 462 occupational therapists.

    Methods: An online questionnaire was used to collect data.

    Main results: The predominant practice pattern was the use of ADL-activities for assessment and intervention regardless of whether limitations in occupational performance or cognitive function were assessed, or whether the approach was remedial or compensatory. For assessment general ADL- instruments were more used than instruments assessing cognitive function. Instruments were used more within regional-, county- and primary care compared to municipality rehabilitation. Interventions focusing abilities related to executive functioning represented the highest percentages. Another prominent practice pattern was the collaborative approach toward clients, relatives and other staff.  Theories used to support practice were to a large extent general not focusing cognitive functioning in specific.

    Conclusions and contribution to the practice and evidence base of occupational therapy: Swedish occupational therapy practice for clients with cognitive impairments following acquired brain injury highly focuses on occupational performance. Much instruments and theories used are general. The result contributes with knowledge of the specific content of practice, and shows that occupational therapists practice patterns both follow and do not follow current evidence in the area of cognitive rehabilitation.

  • 8.
    Holmqvist, Kajsa
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Therapeutic use of self as defined by Swedish occupational therapists working with clients with cognitive impairments following acquired brain injury2014Conference paper (Refereed)
    Abstract [en]

    Introduction: The concept therapeutic use of self has mainly been described theoretically and empirical descriptions are few. With empirical validation the concept will become more useful for informing practice and explaining what occupational therapists do in the interaction with their clients to facilitate successful outcomes.

    The objective of this study was to empirically define the aspects that occupational therapists working with clients with cognitive impairments following acquired brain injury (CIABI) find are consistent with the concept of therapeutic use of self.

    Method: Thirteen expert occupational therapists participated. Reactive Delphi technique in three rounds was used where each round built on the results of the previous one. A questionnaire based on current literature was developed for the first round.

    Results: Twenty out of 33 statements reached a consensus level of 75% or more. These statements reflected the therapists’ consciousness, self awareness and use of personal characteristics. The statements also concerned the intentions of therapeutic use of self including client group specific intentions such as enhancing self- awareness. The results indicate that the content of the concept may be defined differently depending on the client group.

    Conclusions and contribution to practice: The empirical descriptions generated from this study may help occupational therapists working with clients with CIABI to describe how and with what intention they use themselves therapeutically in the rehabilitation process. In occupational therapy education the results may be used to highlight how the concept may be understood in practice and to discuss it in relation to different client groups.

  • 9.
    Holmqvist, Kajsa
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ivarsson, Ann-Britt
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Holmefur, Marie
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Occupational therapists' practice patterns for clients having cognitive impairments following acquired brain injury2012In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 26, no 4-5, p. 458-459Article in journal (Refereed)
    Abstract [en]

    Objectives: Studies have shown that occupational therapy interventions for clients with cognitive impairment following acquired brain injury (CIABI) have a positive effect on performance of activities of daily living, although the exact nature of the interventions are not clearly described. A better understanding of current practice is therefore needed to move further in the search for evidence based occupational therapy for clients with CIABI. Research on occupational therapists’ (OTs’) practice can play an important role to explore and describe current practice and furthermore define and evaluate the effectiveness of different components in OT interventions. The aim of this study was to survey Swedish OTs’ practice patterns for clients having CIABI.

    Methods: The study had a cross-sectional design using a questionnaire developed in two former studies. A stratified random sample was done with 250 OTs each from the following areas: regional care, somatic county care, primary care and municipal eldercare. The questionnaire was sent out using on-line survey software and 462 participants responded. Data is currently analyzed by descriptive and comparative statistics.

    Results: Preliminary results show that the interventions targeted a wide range of cognitive impairments and its consequences. Interventions were both remedial and compensatory with graded activity as the most common remediating intervention. To compensate for activity limitations prescription, or recommendation, of assistive devices (AD) as well as supporting clients in finding internal strategies were used extensively. The ADs used consisted of both high and low technology devices. Eighty-two percent also included different specific interventions to improve clients’ decreased self-awareness in their practice. A vast majority of the OTs (94%) preferred to use observations in daily activities to assess both activity limitations and cognitive impairment. Almost all participants also used interviews and sixty-two percent used tests on impairment level. To support practice general Occupational Therapy models were widely used while theories focusing on cognitive impairments specifically were used less. The participants’ answers reflected a client-centered attitude with collaborative goal-setting and feedback discussions after each session. Eighty- four percent felt dependent on relatives to reach a successful outcome and most of them worked deliberately to involve relatives in the rehabilitation. The OTs responses were evenly distributed over the spheres of activity. Ninety-two percent of the participants worked in team and the most common diagnoses were stroke and traumatic brain injury. There were some differences in responses between the spheres.

    Conclusions: Preliminary conclusions are that the OTs practice patterns included interventions targeting most cognitive impairments and their consequences in daily activities. The use of daily activities as a mean was preferred irrespective of whether the interventions were remediative or compensatory. Interventions targeting decreased self-awareness as well as the use of ADs were common. A client-centered approach was dominating including collaboration with relatives.

    For personal

    centered approach was dominating including collaboration

    with relatives.

  • 10.
    Holmqvist, Kajsa
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ivarsson, Ann-Britt
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Olstam, Margaretha
    Örebro Läns Landsting, Örebro, Sverige.
    Pettersson, Ingvor
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Yilmaz, Maria
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Kartläggning kognitiva hjälpmedel: Projektrapport2011Report (Other academic)
  • 11.
    Holmqvist, Kajsa
    et al.
    Örebro University, School of Health and Medical Sciences.
    Kamwendo, Kitty
    Örebro University, School of Health and Medical Sciences.
    Ivarsson, Ann-Britt
    Örebro University, School of Health and Medical Sciences.
    Occupational therapists' descriptions of their work with persons suffering from cognitive impairment following acquired brain injury2009In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 16, no 1, p. 13-24Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to investigate how Swedish occupational therapists’ describe their work with persons suffering from cognitive impairment following acquired brain injury. A qualitative descriptive approach was used and interviews were conducted with 12 occupational therapists working in community and county council care. Qualitative content analysis was used and revealed three main themes: 1) “To make the invisible visible”, 2) “To collaborate- a prerequisite for success” and 3) “Dilemmas to handle”. The findings showed a complex scenario where the occupational therapists worked to make the cognitive impairments visible to themselves, the clients, and persons close to the client. Collaboration was perceived as a key factor. The dilemmas concerned different aspects in the rehabilitation process, which affected the occupational therapists’ work with the clients. Identified areas in need of improvement are prioritisations and additional education regarding both intervention methods and theory. A reluctance to use standardised assessments was expressed and research that identifies and overcomes those hindrances in clinical practice is needed. Therapeutic use of self was described as important. To understand and illuminate the occupational therapists’ comprehension of the concept further research is required.  

  • 12.
    Holmqvist, Kajsa
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Kamwendo, Kitty
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ivarsson, Ann-Britt
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Occupational therapists' practice patterns for clients with cognitive impairment following acquired brain injury: development of a questionnaire2012In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 19, no 2, p. 150-163Article in journal (Refereed)
    Abstract [en]

    Clients with cognitive impairment following acquired brain injury (CIABI) are a common group to receive occupational therapy services. Research has shown that occupational therapy has a positive effect on occupational performance for these clients, but the exact nature of the interventions is not clearly described and needs to be better understood and defined. The aim of this study was to develop and evaluate an empirically derived questionnaire for the purpose of surveying occupational therapists' (OTs') practice patterns in relation to CIABI. The questionnaire was developed from the results of a former qualitative study. It was evaluated for content validity by a group of six OT researchers with experience in CIABI, using the content validity index (CVI). Reliability was evaluated by a test-retest design with a group of 51 OTs. Data were analysed by non-parametric statistical methods. Initially the questionnaire consisted of 90 items dealing with OT practice and nine demographic questions. After the reliability and content validity process the OT practice items were reduced to 44. The revised questionnaire will be used to survey and explicitly describe occupational therapy practice for clients with CIABI.

  • 13.
    Janeslätt, Gunnel Kristina
    et al.
    Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden; Department of Public Health and Caring Sciences, Disability and Habilitation, Uppsala University, Uppsala, Sweden.
    Lidström-Holmqvist, Kajsa
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    White, Suzanne
    Occupational therapy program, State University of New York Downstate Medical Center, Brooklyn NY, USA.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Assessment of time management skills: psychometric properties of the Swedish version2018In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 25, no 3, p. 153-161Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Persons with impaired time management skills are often in need of occupational therapy. Valid and reliable instruments to assess time management and organizational skills are needed for the evaluation of intervention. The purpose of this study was to evaluate the psychometric properties of a Swedish version of the Assessment of Time Management Skills (ATMS-S) for persons with and without impaired time management skills.

    METHOD: A total of 238 persons participated in the study, of whom 94 had self-reported impaired time management skills due to mental disorders such as schizophrenic spectrum or neurodevelopmental disorders such as attention deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and mild intellectual disabilities, and 144 persons had no reported impaired time management skills. Rasch analysis was used to analyze data.

    RESULTS: Three subscales were detected: the time management subscale with 11 items, the organization & planning subscale with 11 items, and the subscale of regulation of emotions with 5 items, with excellent to acceptable psychometric properties. The conclusions were that: ATMS-S is a valid instrument for self-rating of time management, organization & planning and for the regulation of emotions. ATMS-S can be useful for persons with mental disorders including mild neurodevelopmental disorders.

  • 14.
    Lidström Holmqvist, Kajsa
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Occupational therapy practice for clients with cognitive impairments following aquired brain injury: occupational therapists' perspective2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to describe occupational therapy practice for clients with cognitive impairment following acquired brain injury (CIABI) from the perspective of practicing occupational therapists (OTs).

    To fulfill this aim, qualitative and quantitative approaches were used including interviews (Study I) and questionnaires (Studies II -IV). Based on the qualitative descriptions generated in Study I, a questionnaire was developed and evaluated for content validity and test-rest validity (Study II). The questionnaire was then used in a survey (Study III). The reactive Delphi technique was used to empirically define the aspects that OTs found to be consistent with the concept of therapeutic use of self (Study IV).

    The results showed that a predominant practice pattern was the use of ADL activities for intervention regardless of whether limitations in occupational performance or cognitive function were assessed, or whether the approach to therapy was remedial or compensatory. General ADL-instruments were used more than instruments focused on impairment level. Therapies covering a wide range of cognitive impairments, and abilities important to organizing and executing occupational performance were commonly targeted. Therapies targeting clients’ activity limitations were prioritized before remediating impairment. Therapeutic use of self was regarded as being important and the results identified clientspecific aims not earlier described in relation to therapeutic use of self. Another prominent practice pattern was the collaborative approach toward clients, relatives, and other staff. Theories used to support practice were primarily general. Occupational therapy practice for clients with CIABI was found to be complex, and the practice patterns were affected by circumstances such as the ‘hidden’ nature of the cognitive impairments, perceived lack of knowledge, and organizational issues. The results of this thesis can be used as a foundation for further research on practice patterns or the specific therapies used. It can facilitate discussions on strengths and weaknesses witcurrent practice, the need for development, and research utilization.

    List of papers
    1. Occupational therapists' descriptions of their work with persons suffering from cognitive impairment following acquired brain injury
    Open this publication in new window or tab >>Occupational therapists' descriptions of their work with persons suffering from cognitive impairment following acquired brain injury
    2009 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 16, no 1, p. 13-24Article in journal (Refereed) Published
    Abstract [en]

    The aim of the present study was to investigate how Swedish occupational therapists’ describe their work with persons suffering from cognitive impairment following acquired brain injury. A qualitative descriptive approach was used and interviews were conducted with 12 occupational therapists working in community and county council care. Qualitative content analysis was used and revealed three main themes: 1) “To make the invisible visible”, 2) “To collaborate- a prerequisite for success” and 3) “Dilemmas to handle”. The findings showed a complex scenario where the occupational therapists worked to make the cognitive impairments visible to themselves, the clients, and persons close to the client. Collaboration was perceived as a key factor. The dilemmas concerned different aspects in the rehabilitation process, which affected the occupational therapists’ work with the clients. Identified areas in need of improvement are prioritisations and additional education regarding both intervention methods and theory. A reluctance to use standardised assessments was expressed and research that identifies and overcomes those hindrances in clinical practice is needed. Therapeutic use of self was described as important. To understand and illuminate the occupational therapists’ comprehension of the concept further research is required.  

    Place, publisher, year, edition, pages
    London, UK: Informa Healthcare, 2009
    Keywords
    brain injury, cognition, occupational therapy, qualitative content analysis, rehabilitation, stroke
    National Category
    Nursing Occupational Therapy
    Research subject
    Nursing Science; Nursing Science w. Occupational Therapy Focus
    Identifiers
    urn:nbn:se:oru:diva-7995 (URN)10.1080/11038120802123520 (DOI)000264692800002 ()18609240 (PubMedID)2-s2.0-61549101770 (Scopus ID)
    Available from: 2009-09-23 Created: 2009-09-23 Last updated: 2017-12-13Bibliographically approved
    2. Occupational therapists' practice patterns for clients with cognitive impairment following acquired brain injury: development of a questionnaire
    Open this publication in new window or tab >>Occupational therapists' practice patterns for clients with cognitive impairment following acquired brain injury: development of a questionnaire
    2012 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 19, no 2, p. 150-163Article in journal (Refereed) Published
    Abstract [en]

    Clients with cognitive impairment following acquired brain injury (CIABI) are a common group to receive occupational therapy services. Research has shown that occupational therapy has a positive effect on occupational performance for these clients, but the exact nature of the interventions is not clearly described and needs to be better understood and defined. The aim of this study was to develop and evaluate an empirically derived questionnaire for the purpose of surveying occupational therapists' (OTs') practice patterns in relation to CIABI. The questionnaire was developed from the results of a former qualitative study. It was evaluated for content validity by a group of six OT researchers with experience in CIABI, using the content validity index (CVI). Reliability was evaluated by a test-retest design with a group of 51 OTs. Data were analysed by non-parametric statistical methods. Initially the questionnaire consisted of 90 items dealing with OT practice and nine demographic questions. After the reliability and content validity process the OT practice items were reduced to 44. The revised questionnaire will be used to survey and explicitly describe occupational therapy practice for clients with CIABI.

    Place, publisher, year, edition, pages
    London, United Kingdom: Informa Healthcare, 2012
    Keywords
    Content validity, instrument development, psychometrics, reliability
    National Category
    Occupational Therapy Other Health Sciences
    Research subject
    Nursing Science w. Occupational Therapy Focus
    Identifiers
    urn:nbn:se:oru:diva-22123 (URN)10.3109/11038128.2011.576428 (DOI)000300557000005 ()21631175 (PubMedID)2-s2.0-84857587229 (Scopus ID)
    Note

    Funding Agencies:

    Örebro University, School of Health and Medical Sciences 

    Swedish Association of Occupational Therapists 

    Available from: 2012-03-16 Created: 2012-03-16 Last updated: 2017-12-07Bibliographically approved
    3. Occupational therapist practice patterns in relation to clients with cognitive impairment following acquired brain injury
    Open this publication in new window or tab >>Occupational therapist practice patterns in relation to clients with cognitive impairment following acquired brain injury
    2014 (English)In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 28, no 11, p. 1365-1373Article in journal (Refereed) Published
    Abstract [en]

    Primary objective: To describe Swedish occupational therapist practice patterns for clients with cognitive impairment following acquired brain injury.

    Research design: A cross-sectional stratified random sample of 462 occupational therapists.

    Methods: An online questionnaire was used to collect data.

    Main results: The predominant practice pattern was the use of ADL-activities for assessment and therapy regardless of whether limitations in occupational performance or cognitive function were assessed or whether the approach was remedial or compensatory. For assessment, general ADL-instruments were used more often than instruments that assessed cognitive function. Instruments were used less often within municipal rehabilitation facilities compared to regional, county and primary care facilities. The most common focus of the therapies was in regard to abilities related to executive functioning. Another prominent practice pattern was a collaborative approach involving clients, relatives and other staff. The theories used in practice were, to a large extent, general in nature and did not focus specifically on cognitive functioning.

    Conclusions: Swedish occupational therapy practice for clients with cognitive impairments following acquired brain injury focuses highly on occupational performance. Therapies targeting executive functioning seem particularly important in practice and a collaborative approach involving clients, relatives and other staff is a prominent feature in practice.

    Place, publisher, year, edition, pages
    Informa Healthcare, 2014
    Keywords
    assessment, intervention, occupational therapy cognition
    National Category
    Neurosciences
    Research subject
    Occupational therapy
    Identifiers
    urn:nbn:se:oru:diva-26099 (URN)10.3109/02699052.2014.919529 (DOI)000341969200002 ()24911987 (PubMedID)2-s2.0-84907043606 (Scopus ID)
    Note

    Funding Agencies:

    Örebro University

    Swedish Association of Occupational Therapists

    Available from: 2012-10-04 Created: 2012-10-04 Last updated: 2018-01-12Bibliographically approved
    4. Therapeutic use of self as defined by Swedish occupational therapists working with clients with cognitive impairment following acquired brain injury: a Delphi study
    Open this publication in new window or tab >>Therapeutic use of self as defined by Swedish occupational therapists working with clients with cognitive impairment following acquired brain injury: a Delphi study
    2013 (English)In: Australian Occupational Therapy Journal, ISSN 0045-0766, E-ISSN 1440-1630, Vol. 60, no 1, p. 48-55Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUND/AIM: The concept therapeutic use of self has mainly been described theoretically. Empirical descriptions are few and empirical validation is needed to make the concept more useful for informing practice and explaining what occupational therapists do in the interaction with their clients to facilitate successful outcomes. The aim of this study was to empirically define the aspects that occupational therapists working with clients with cognitive impairments following acquired brain injury find are consistent with the concept of therapeutic use of self.

    METHOD: Thirteen expert occupational therapists participated. Reactive Delphi technique in three rounds was used where each round built on the results of the previous one. A questionnaire based on current literature was developed for the first round.

    RESULTS: Twenty of 33 statements reached a consensus level of 75% or more. These statements reflected the therapists' consciousness, self-awareness and use of personal characteristics. The statements also concerned the intentions of therapeutic use of self, including client group-specific intentions such as enhancing self-awareness. The results indicate that the content of the concept may be defined differently depending on the client group.

    CONCLUSIONS: The empirical descriptions generated from this study may help occupational therapists working with clients with cognitive impairments following acquired brain injury to describe how and with what intention they use themselves therapeutically in the rehabilitation process. In occupational therapy education, the results may be used to highlight how the concept may be understood in practice and to discuss it in relation to different client groups.

    Place, publisher, year, edition, pages
    Wiley-Blackwell, 2013
    Keywords
    Concept, development, occupational therapy
    National Category
    Medical and Health Sciences
    Research subject
    Occupational therapy
    Identifiers
    urn:nbn:se:oru:diva-26098 (URN)10.1111/1440-1630.12001 (DOI)000315101000006 ()23414189 (PubMedID)2-s2.0-84874017526 (Scopus ID)
    Available from: 2012-10-04 Created: 2012-10-04 Last updated: 2017-12-07Bibliographically approved
  • 15.
    Lidström Holmqvist, Kajsa
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Holmefur, Marie
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ivarsson, Ann-Britt
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Therapeutic use of self as defined by Swedish occupational therapists working with clients with cognitive impairment following acquired brain injury: a Delphi study2013In: Australian Occupational Therapy Journal, ISSN 0045-0766, E-ISSN 1440-1630, Vol. 60, no 1, p. 48-55Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/AIM: The concept therapeutic use of self has mainly been described theoretically. Empirical descriptions are few and empirical validation is needed to make the concept more useful for informing practice and explaining what occupational therapists do in the interaction with their clients to facilitate successful outcomes. The aim of this study was to empirically define the aspects that occupational therapists working with clients with cognitive impairments following acquired brain injury find are consistent with the concept of therapeutic use of self.

    METHOD: Thirteen expert occupational therapists participated. Reactive Delphi technique in three rounds was used where each round built on the results of the previous one. A questionnaire based on current literature was developed for the first round.

    RESULTS: Twenty of 33 statements reached a consensus level of 75% or more. These statements reflected the therapists' consciousness, self-awareness and use of personal characteristics. The statements also concerned the intentions of therapeutic use of self, including client group-specific intentions such as enhancing self-awareness. The results indicate that the content of the concept may be defined differently depending on the client group.

    CONCLUSIONS: The empirical descriptions generated from this study may help occupational therapists working with clients with cognitive impairments following acquired brain injury to describe how and with what intention they use themselves therapeutically in the rehabilitation process. In occupational therapy education, the results may be used to highlight how the concept may be understood in practice and to discuss it in relation to different client groups.

  • 16.
    Lidström Holmqvist, Kajsa
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ivarsson, Ann-Britt
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Holmefur, Marie
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Occupational therapist practice patterns in relation to clients with cognitive impairment following acquired brain injury2014In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 28, no 11, p. 1365-1373Article in journal (Refereed)
    Abstract [en]

    Primary objective: To describe Swedish occupational therapist practice patterns for clients with cognitive impairment following acquired brain injury.

    Research design: A cross-sectional stratified random sample of 462 occupational therapists.

    Methods: An online questionnaire was used to collect data.

    Main results: The predominant practice pattern was the use of ADL-activities for assessment and therapy regardless of whether limitations in occupational performance or cognitive function were assessed or whether the approach was remedial or compensatory. For assessment, general ADL-instruments were used more often than instruments that assessed cognitive function. Instruments were used less often within municipal rehabilitation facilities compared to regional, county and primary care facilities. The most common focus of the therapies was in regard to abilities related to executive functioning. Another prominent practice pattern was a collaborative approach involving clients, relatives and other staff. The theories used in practice were, to a large extent, general in nature and did not focus specifically on cognitive functioning.

    Conclusions: Swedish occupational therapy practice for clients with cognitive impairments following acquired brain injury focuses highly on occupational performance. Therapies targeting executive functioning seem particularly important in practice and a collaborative approach involving clients, relatives and other staff is a prominent feature in practice.

  • 17.
    Lidström-Holmqvist, Kajsa
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    The ADL taxonomy for persons with mental disorders: adaptation and evaluation2019In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 26, no 7, p. 524-534Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is a lack of occupation-focused instruments to assess Activities of Daily Living (ADL) that are intended for persons with mental disorders. The ADL Taxonomy is an instrument that is widely-used within clinical practice for persons with physical impairment. The aim of this study was to adapt the ADL Taxonomy for persons with mental disorders and evaluate its validity.

    METHODS: An expert group of Occupational Therapists (OTs) from psychiatric care adapted the ADL Taxonomy to fit the client group, including creating three new items. OTs in psychiatric care collected client data and evaluated the instrument for usability. Rasch analysis was used to evaluate the contruct validity of 16 activities separately.

    RESULTS: The OTs collected 123 assessments from clients with various mental disorders. Ten activities had excellent, and four had acceptable, psychometric properties with regard to item and person fit and unidimensionality. The activity managing the day/time gave complex results and would benefit from further development. The OTs found the test version intelligible, relevant and easy to use.

    CONCLUSIONS: The ADL Taxonomy for persons with mental disorders has 16 activities with three to six actions each, and is now ready for clinical use.

  • 18.
    Lidström-Holmqvist, Kajsa
    et al.
    Örebro University, School of Health Sciences.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Arvidsson, Patrik
    Reliabilitetsprövning av Weekly Calendar Planning Activity (WCPA): ett instrument för att mäta exekutiva funktioner2015Conference paper (Refereed)
  • 19.
    Lidström-Holmqvist, Kajsa
    et al.
    Örebro University, School of Health Sciences. University Health Care Research Center .
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Arvidsson, Patrik
    CHILD, Swedish Institute for Disability Research, Jönköping University, Sweden; Centre for Research & Development, Region Gävleborg, Uppsala University, Sweden.
    Test-retest reliability of the Swedish version of the Weekly Calendar Planning Activity: a performance-based test of executive functioning2019In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, p. 1-6Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The Weekly Calendar Planning Activity is a performance test aiming to examine how subtle problems with executive functioning influence the performance of multi-step activities in daily life. The purpose of this study was to explore the Swedish version of the Weekly Calendar Planning Activity, regarding test-retest reliability and possible learning effects.

    MATERIAL AND METHODS: Twenty-four adults with psychiatric, neurodevelopmental or mild intellectual disorders and with difficulties in executive functioning performed the test on three separate occasions, with two weeks apart. Test-retest reliability was determined using intraclass correlation coefficients. Possible learning effects were evaluated. The smallest detectable change was calculated to determine the precision of individual scores.

    RESULTS AND CONCLUSION: The intraclass correlation coefficients between the first two test occasions were weak (0.42-0.66), but were acceptable to excellent (0.65-0.91) between test occasions 2 and 3. There was a considerable amount of random variation in the results, but little systematic variation, indicating no or possibly a small learning effect in the total number of accurately recorded appointments. This variation indicates a need to use two consecutive baseline measurements when the Swedish version of the Weelky Calendar Planning Acitivity is used as an outcome measure. Together, our results suggest that the Swedish version of the Weelky Calendar Planning Acitivity is a useful performance-based measure of how subtle problems in executive functioning affects activity performance. Implications for rehabilitation Executive functioning is crucial for managing daily life, and ecologically valid tests are needed to measure such functioning. The Weekly Calendar Planning Activity is a new performance-based test using a task that is relevant to daily life. The outcomes obtained in the Weekly Calendar Planning Activity are highly useful in clinical practice. The day-to-day variation in the Weekly Calendar Planning Activity results warrants the need for two consecutive baseline measurements when it is used to measure change.

  • 20.
    Lidström-Holmqvist, Kajsa
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Ivarsson, Ann-Britt
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Arbetsterapeuters praxismönster i relation till klienter med kognitiva nedsättningar efter förvärvad hjärnskada2017Conference paper (Refereed)
  • 21.
    Lidström-Holmqvist, Kajsa
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital.
    James, Inger
    Örebro University, School of Health Sciences.
    Patient participation in municipal elderly care from the perspective of nurses and occupational therapists2019In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 3, p. 1171-1179Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to describe how nurses and occupational therapists in municipal care of older people define and implement patient participation in their daily work.

    Design: This study had a cross-sectional design. Data were collected using an online questionnaire.

    Methods: The questionnaire had both closed and open-ended questions. One-hundred and fourteen nurses and occupational therapists responded. Data were analysed with descriptive statistics and thematic analysis.

    Results: Two main themes were identified as follows: "The professionals' perspective at the centre - Patient participation to enhance compliance" and "The patients' perspective at the centre - Patient participation as an ongoing process." The themes covered a continuum. On one extreme, patient participation was equated with making the patient comply with what the professionals wanted to do. On the other extreme, all power was transferred to the patient. The first theme was restricted to the decision-making process. The second theme covered the entire care or, rehabilitation, process.

  • 22.
    Lidström-Holmqvist, Kajsa
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Kamwendo, Kitty
    Örebro University, School of Health and Medical Sciences.
    Ivarsson, Ann-Britt
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Arbetsterapi för personer med kognitiva svårigheter efter förvärvad hjärnskada2007Conference paper (Refereed)
  • 23.
    Lidström-Holmqvist, Kajsa
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital. Universitetssjukvårdens forskningscentrum.
    Tollén, Anita
    Örebro University, School of Health Sciences.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Erfarenheter av att delta i gruppinterventionen Ha Koll! för personer med nedsatt tidshanteringsförmåga2019Conference paper (Refereed)
  • 24.
    Roshanai, A.
    et al.
    Department of Public Health and Caring Sciences, Disability and Habilitation, Uppsala University, Sweden.
    Janeslätt, G.
    Centre for Clinical Research, Dalarna County Council,, Falun, Sweden.
    White, S.
    State University of New York Downstate Medical Centre, Brooklyn NY, USA.
    Lidström-Holmqvist, Kajsa
    Örebro University, School of Health Sciences.
    TIME MANAGEMENT SKILLS IN RELATION TO GENERAL SELF-EFFICACY AND PARENTAL SENSE OF COMPETENCE IN INDIVIDUALS WITH AND WITHOUT COGNITIVE DISABILITIES2019In: Journal of Intellectual Disability Research, ISSN 0964-2633, E-ISSN 1365-2788, Vol. 63, no 7, p. 757-757Article in journal (Other academic)
  • 25. Roshanay, Afsaneh
    et al.
    Janeslätt, Gunnel
    White, Suzanne
    Lidström Holmqvist, Kajsa
    Örebro University, School of Health Sciences.
    Time Management, Organization skills, self-efficacy and self-rated Parental competence in individuals with and without disabilities2018Conference paper (Refereed)
  • 26.
    Spang, Lisa
    et al.
    Örebro University, School of Health Sciences.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Hermansson, Liselotte
    Örebro University, School of Health Sciences.
    Lidström-Holmqvist, Kajsa
    Örebro University Hospital. Örebro University, School of Health Sciences.
    Factors in daily life leading to the need for moving to a nursing home: Experiences from nursing home applicants2019Conference paper (Other academic)
    Abstract [en]

    Background/Aim In Sweden, most people age in ordinary housing, called aging in place. To support aging in place, older people can apply for home-based care such as Meals on Wheels or response alarm .Despite this support, the municipalities receive applications to nursing homes on a daily basis, which indicates that aging in place does not fill everyone’s needs. The aim of this study was to describe what experiences in daily life that make older people aging in place apply for a nursing home.

    Method This study has a descriptive design. Face to face interviews were conducted with older people with declining physical health who had a granted application for a place in a nursing home and were waiting for a placement. Some waited in their homes with or without home-based care and some waited in a short-term facility run by the municipality. Interviews were analyzed by qualitative content analysis according to Elo and Kyngäs.

    Preliminary findings One main category emerged - “To move to a nursing home- a way to regain control over my life”. It was characterized by a feeling of decreasing level of independence which led to experiences of lack of social context or being in a state of dependence where someone else controlled decisions of their lives.  The participants had reached a point where they strongly felt that something has to be done to change their situation. This was usually associated with a critical event such as a hospitalization or after been informed of a cancer diagnosis. These experiences are described by three generic categories with seven subcategories.  The generic categories are “The opportunity to belong to a context”, “A state of dependence” and “Reaching a turning point”.

    Conclusions The findings show that a feeling of lost control due to perceived dependence, falling health or critical everyday life events may lead to a nursing home application. Therefore, in order to enhance aging in place it is important to enable older people to be socially involved, get support to stay as independent as possible in their daily activities and to handle critical events such as hospitalization.

  • 27.
    Spang, Lisa
    et al.
    Örebro Municipality, Örebro, Sweden.
    Holmqvist, Kajsa
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Occupational therapy practice in emergency care: occupational therapists' perspectives2015In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 22, no 5, p. 345-354Article in journal (Refereed)
    Abstract [en]

    Objective: Emergency care takes place in a complex work environment that is characterized by critically ill patients, short hospital stays, and a wide variety of different healthcare professionals. Studies of occupational therapists’ (OTs) experiences of working within emergency care have shown that they often experience difficulties in explaining the essence of occupational therapy and have to justify their approaches. Much effort has been made in Sweden to help OTs dispel the notion that occupational therapy is difficult to explain, and the aim of this study was to describe how Swedish OTs perceive their work in emergency care.

    Method: A qualitative descriptive approach was taken, and 14 interviews were conducted with OTs working in emergency care. Qualitative content analysis was used to analyse the data.

    Results: The overall theme that emerged was “Feeling established through deliberate occupation-based work”. The underlying categories showed different strategies used by the OTs to provide occupational therapy in an emergency care context. Deliberate strategies were used to demonstrate the effectiveness of occupational therapy and its approaches to patients and other health care professionals, and this resulted in the OTs feeling both established and needed. Unlike the OTs in previous studies, the Swedish OTs experienced no difficulties in explaining occupational therapy and could make convincing arguments for their interventions. Parallel to their clinical work, the OTs worked with on-going development to find ways to improve their approaches.

    Conclusions: In summary, these Swedish OTs seem to have been provided with a professional language and the knowledge required to establish themselves in an emergency care setting.

  • 28.
    White, Suzanne M:
    et al.
    SUNY Downstate Medical Center, Brooklyn, NY, USA.
    Janeslätt, Gunnel
    Centre for Clinical Research Dalarna, Falun, Sweden.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Lidström-Holmqvist, Kajsa
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Assessment of Time Management Skills: Psychometric Properties of the Swedish Version (ATMS-S)2017Conference paper (Other academic)
  • 29.
    Widehammar, Cathrine
    et al.
    Örebro University, School of Health Sciences. Department of Paediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden.
    Lidström-Holmqvist, Kajsa
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Centre.
    Pettersson, Ingvor
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Hermansson, Liselotte
    Örebro University, School of Health Sciences. Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden; Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Attitudes is the most important environmental factor for use of powered mobility devices - users' perspectives2019In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014Article in journal (Refereed)
    Abstract [en]

    Introduction: Different factors in the environment influence the use of powered wheelchairs or powered scooters, i.e. powered mobility devices (PMDs), but there is limited knowledge about how these factors interact and if any factor has a greater impact. According to the ICF the environment consists of five areas.

    Aim: To describe users' experiences of how environmental factors from all ICF areas influence the use of PMDs.

    Methods: Descriptive qualitative design including 14 interviews with PMD users, analyzed using inductive qualitative content analysis.

    Findings: Use of PMDs means a conditional freedom depending on the interaction of several environmental factors. Regardless of environmental factor the societal attitudes were always present, directly or indirectly, and influenced the participants' feeling of being included and involved in society. The environmental factors and how they influence PMD use are described in four categories, comprising the following subjects: societal attitudes, the service delivery process, accessibility to the physical environment and financial resources.

    Conclusion: The findings show that societal attitudes influence all other factors, directly by others people's attitudes, or indirectly by how legislation and guidelines are formulated, interpreted and applied. Therefore, a change of societal attitudes seems necessary to increase accessibility and participation for PMD users.

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