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  • 1. Andersson, Åsa G.
    et al.
    Kamwendo, Kitty
    Örebro universitet, Hälsoakademin.
    Appelros, Peter
    Örebro universitet, Hälsoakademin.
    Fear of falling in stroke patients: relationship with previous falls and functional characteristics2008Inngår i: International Journal of Rehabilitation Research, ISSN 0342-5282, E-ISSN 1473-5660, Vol. 31, nr 3, s. 261-264Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The objectives of this study were to determine the relationship between fear of falling and functional characteristics of patients after stroke as well as to determine what characterizes fallers who score high fall-related self-efficacy, and nonfallers who score low fall-related self-efficacy. Patients (n=140) treated in a stroke unit during a 12-month period were included. On follow-up, fallers were identified and patients answered the questions in the Falls Efficacy Scale, Swedish version (FES-S). Assessments of motor capacity, functional mobility and balance were also made. In univariate analysis, low fall-related self-efficacy was significantly associated with increased age, female sex, earlier falls, visual and cognitive impairment, low mood and impaired physical function. In multivariate analysis, only earlier falls and physical function remained significant. Twenty percent of the patients scored low fall-related self-efficacy without having experienced a fall, and 11% who experienced a fall scored high fall-related self-efficacy. Impaired physical function was significantly associated with scoring low fall-related self-efficacy, for both fallers and nonfallers. Fear of falling is significantly associated with poor physical function and earlier falls. Falls Efficacy Scale, Swedish version could add useful information to a fall risk analysis. Patients scoring low fall-related self-efficacy should be offered fall prevention measures whether they have fallen or not.

  • 2. Andersson, Åsa G.
    et al.
    Kamwendo, Kitty
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Seiger, Åke
    Appelros, Peter
    Örebro universitet, Institutionen för klinisk medicin.
    How to identify potential fallers in a stroke unit: validity indexes of 4 test methods2006Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 38, nr 3, s. 186-191Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The aim of this study was to describe general characteristics of patients with stroke who have a tendency to fall and to determine whether certain test instruments can identify fallers. METHODS: Patients treated in a stroke unit during a 12-month period were included. At inclusion assessments were made with Berg Balance Scale Berg Balance Scale, Stops Walking When Talking, Timed Up & Go (TUG) and diffTUG. At follow-up 6 or 12 months later, patients who had fallen were identified. RESULTS: During the time from discharge to follow-up on 159 patients, 68 patients fell and 91 did not. Fallers fell more often during their initial hospital stay, used sedatives more often and were more visually impaired, compared with non-fallers. The Berg Balance Scale, Stops Walking When Talking and TUG results differed between fallers and non-fallers. The combined results of Berg Balance Scale and Stops Walking When Talking increased the possibility of identifying fallers. CONCLUSION: Berg Balance Scale, Stops Walking When Talking and TUG can be used to evaluate which patients have a tendency to fall in order to carry out preventive measures. Berg Balance Scale can be used in all patients. Stops Walking When Talking can give additional information if the patient is able to walk. TUG is a possible choice, but fewer patients can perform it.

  • 3.
    Fahlström, Gunilla
    et al.
    University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Kamwendo, Kitty
    College of Medicine, University of Malawi, Zomba, Malawi.
    Forsberg, Jenny
    Region Örebro County, Örebro, Sweden.
    Bodin, Lennart
    Örebro universitet, Handelshögskolan vid Örebro Universitet.
    Fall prevention by nursing assistants among community-living elderly people. A randomised controlled trial2018Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, nr 2, s. 575-585Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Falls among elderly are a major public health issue in Sweden. The aim was to determine whether nursing assistants can prevent falls by supervising community-living elderly individuals with a history of falling in performing individually designed home exercise programmes. A randomised controlled trial was performed in Sweden, in eight municipalities in the county of Örebro, during 2007-2009. Community-living persons 65 years or older having experienced at least one fall during the last 12 months were included. The intervention group consisted of 76 participants, and there were 72 in the control group. The interventions were free of charge and were shared between a physiotherapist and a nursing assistant. The former designed a programme aiming to improve balance, leg strength and walking ability. The nursing assistant supervised the performance of activities during eight home visits during a 5-month intervention period. The measures and instruments used were health-related quality of life (SF-36), activity of daily living (ADL-staircase), balance, (Falls Efficacy Scale, and Berg Balance Scale), walking ability (Timed Up and Go and the 3-metre walking test), leg strength, (chair stand test). All participants were asked to keep a structured calendar of their physical exercise, walks and occurrence of falls during their 12-month study period. Hospital healthcare consumption data were collected. Although the 5-month intervention did not significantly decrease the risk for days with falls, RR 1.10 (95% CI 0.58, 2.07), p = 0.77, significant changes in favour of the intervention group were noted for balance (p = 0.03), ADL (p = 0.035), bodily pain (p = 0.003) and reported health transition over time (p = 0.008) as well as less hospital care due to fractures (p = 0.025). Additional studies with more participants are needed to establish whether or not falls can be significantly prevented with this model which is workable in home-based fall prevention.

  • 4.
    Frisk, Margot
    et al.
    Örebro universitet, Hälsovetenskapliga institutionen.
    Arvidsson, Helena
    Arbets- och miljömed. kliniken, USÖ.
    Kiviloog, Jaak
    Lungkliniken, USÖ.
    Ivarsson, Ann-Britt
    Örebro universitet, Hälsovetenskapliga institutionen.
    Kamwendo, Kitty
    Örebro universitet, Hälsovetenskapliga institutionen.
    Stridh, Göran
    Örebro universitet, Institutionen för teknik.
    An investigation of the housing environment for persons with asthma and persons without asthma2006Inngår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 13, nr 1, s. 4-12Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Asthma is a chronic disease affected by environmental factors that may increase symptoms that impact on a persons' well-being. An important issue in occupational therapy is to improve the relationship between a person's functional capacity and the physical environment. The aim of the study was to compare the housing environment of persons with asthma (cases, n=49) and persons without asthma (controls, n=48), with regard to building construction and condition, physical, chemical and biological factors, and cleaning routines. A secondary aim was to compare different types of accommodation within cases and controls. A specialist team, including a construction engineer, a biological scientist, and an occupational therapist, conducted the study. Data were collected using protocols, as well as a number of established technical methods from the field of occupational and environmentsl medicine. The primary results showed no major differences in the housing environment between the two groups. However, in individual homes environmental factors at levels that could increase symptoms were identified. When single-familyhouses were compared with multi-family houses, significant differences were found indicating that preventive interventions may be needed in some single-family houses. Further studies are needed to clarify the person-environment relationship for persons with asthma, focusing on their ability to perform daily activities.

  • 5.
    Frisk, Margot L. A.
    et al.
    Örebro universitet, Hälsovetenskapliga institutionen.
    Magnuson, Anders
    Statistical and Epidemiological Unit, Center for Clinical Research, Örebro University Hospital.
    Kiviloog, Jaak
    Department of Respiratory Medicine, Örebro University Hospital.
    Ivarsson, Ann-Britt
    Örebro universitet, Hälsovetenskapliga institutionen.
    Kamwendo, Kitty
    Örebro universitet, Hälsovetenskapliga institutionen.
    Increased occurrence of respiratory symptoms is associated with indoor climate risk indicators: a cross-sectional study in a Swedish population2007Inngår i: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 101, nr 9, s. 2031-2035Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A basic assumption was that exposure to the indoor environment would increase the manifestation of respiratory symptoms in predisposed individuals. The aim was to investigate the proportion of perceived respiratory symptoms attributed to specific environmental exposures, and associations related to indoor climate risk indicators, i.e. occurrence of damp or mould, insufficient ventilation and condensation on windows.

    Method

    A questionnaire was mailed to a random sample of 8008 individuals, stratified for gender and age. The response rate was 84% (n=6732). Established criteria for current asthma were used to classify subjects into three subgroups: asthmatics, healthy and symptomatics (but without current asthma).

    Results

    The proportion of symptoms attributed to specific environmental exposures increased in the total sample and in the three subgroups when indoor climate risk indicators, particularly damp or mould, were reported. Generally, the lowest proportions were found for healthy and the highest for asthmatics. Univariate analyses presented as relative risks (RR) (95% CI) showed significantly increased risks for perceived overall influence on airways for all groups, with RR ranging from 4.3 to 6.8. Although respiratory symptoms attributed to dust, environmental tobacco smoke (ETS) and strong scents increased when risk indicators were reported, RR were generally lower in all groups.

    Conclusion

    The high frequency of respiratory symptoms among asthmatics increased when occurrences of risk indicators were reported. Similarly, increased symptoms were found for healthy indicating that indoor climate risk indicators may affect both healthy and unhealthy individuals.

  • 6.
    Frisk, Margot L. A.
    et al.
    Örebro universitet, Hälsoakademin.
    Stridh, Göran
    Arbets- och miljömed. kliniken, USÖ.
    Ivarsson, Ann-Britt
    Örebro universitet, Hälsoakademin.
    Kamwendo, Kitty
    Örebro universitet, Hälsoakademin.
    Can a housing environmental index establish associations between indoor risk indicators and clinical tests in persons with asthma?2009Inngår i: International Journal of Environmental Health Research, ISSN 0960-3123, E-ISSN 1369-1619, Vol. 19, nr 6, s. 389-404Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim was to investigate the associations between indoor risk indicators, identified by a Housing Environmental index (HE-index), and clinical tests of lung function, allergy and bronchial hyper-responsiveness (BHR). Forty-nine eligible subjects participated in the investigation. The HE-index was based on national and international guidelines and related to measurements of humidity, temperature, carbon dioxide, formaldehyde, nitrogen dioxide, allergens and occurrence of tobacco smoke and pets. Only 18% of the investigated homes did not have any of the risk indicators. Statistically significant associations were found between exposure to mites and lung function, and to a lesser degree in BHR for subjects living in homes with pets. The cut-off levels in the HE-index were not specifically related to health effects and may therefore have been too high for sensitive persons. Further studies are needed to establish relevant guidelines for the identification of risk indicators in the housing environment for persons with asthma.

  • 7.
    Holmqvist, Kajsa
    et al.
    Örebro universitet, Hälsoakademin.
    Kamwendo, Kitty
    Örebro universitet, Hälsoakademin.
    Ivarsson, Ann-Britt
    Örebro universitet, Hälsoakademin.
    Occupational therapists' descriptions of their work with persons suffering from cognitive impairment following acquired brain injury2009Inngår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 16, nr 1, s. 13-24Artikkel i tidsskrift (Fagfellevurdert)
    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.  

  • 8.
    Holmqvist, Kajsa
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Kamwendo, Kitty
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Ivarsson, Ann-Britt
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Occupational therapists' practice patterns for clients with cognitive impairment following acquired brain injury: development of a questionnaire2012Inngår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 19, nr 2, s. 150-163Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 9.
    Lidström-Holmqvist, Kajsa
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Kamwendo, Kitty
    Örebro universitet, Hälsoakademin.
    Ivarsson, Ann-Britt
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Arbetsterapi för personer med kognitiva svårigheter efter förvärvad hjärnskada2007Konferansepaper (Fagfellevurdert)
  • 10.
    Tollén, Anita
    et al.
    Örebro universitet, Hälsovetenskapliga institutionen.
    Fredriksson, Carin
    Örebro universitet, Hälsovetenskapliga institutionen.
    Kamwendo, Kitty
    Örebro universitet, Hälsovetenskapliga institutionen.
    Elderly persons' expectations of day-care rehabilitation2007Inngår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 14, nr 3, s. 173-182Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to explore elderly persons' conceptions of what they expected to gain from attending day-care rehabilitation centres (DCR). A purposeful sampling procedure was employed. Interviews with 22 prospective elderly day-care patients were carried out and analysed according to a phenomenographic approach. The analysis yielded eight categories. Two categories, Social contact and Exercise, described what the elderly persons expected to encounter. The remaining categories, A change from the monotony of everyday life, An opportunity to be yourself, A balm for the body, A safety net, A mastery of everyday activities, and An energizing spark, described the meanings of the encounters. Two categories were attributed to the elderly persons' physical presence at the centre and the gains were expected to end when the programme ended. In three categories the expected improvements were projected into the future and were expected to last. The findings imply that follow-up home visits and suggestions for alternative social activities in order to provide stimulation and social equality would be a valuable complement to the DCR programme. Rehabilitation personnel need to consider the ambivalent view on assistive devices as well as the elderly person's need for continuity when setting goals and planning individual programmes.

  • 11.
    Tollén, Anita
    et al.
    Örebro universitet, Hälsoakademin.
    Fredriksson, Carin
    Örebro universitet, Hälsoakademin.
    Kamwendo, Kitty
    Örebro universitet, Hälsoakademin.
    Elderly persons with disabilities in Sweden: their experiences of everyday life2008Inngår i: Occupational therapy international, ISSN 0966-7903, Vol. 15, nr 3, s. 133-149Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to describe the everyday life experiences of 22 elderly persons with physical disabilities in Sweden. The participants were aged between 65 and 91 years. Interviews were conducted and analysed according to a qualitative research approach. Disengagement in activities and social contacts resulted in feelings of resignation and dejection for some participants, while others delegated tasks as a satisfactory alternative. Participants also described how activities and social contacts continued, albeit in a different way, and being active and socializing gave feelings of pleasure and a sense of belonging. While receiving help was experienced as valuable, it also increased the fear of becoming dependent. Occupational therapy intervention should be directed at increasing social contacts and engagements in meaningful activities, as well as strengthening the individual's autonomy. The transferability of the study can be questioned as the sample only included elderly persons with physical disabilities from urban areas. Further research is needed to address the impact of occupational therapy interventions on life satisfaction.

  • 12.
    Tollén, Anita
    et al.
    Örebro universitet, Hälsoakademin.
    Kamwendo, Kitty
    Örebro universitet, Hälsoakademin.
    Ivarsson, Ann-Britt
    Örebro universitet, Hälsoakademin.
    Changes in everyday life after discharge from day care rehabilitation2011Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, nr 1, s. 5753-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Community-based day care that provides rehabilitation (DCR) targets elderly people with physical disabilities. The goal of these programmes is mainly to improve physical ability in order to enable participants to remain in their ordinary homes. Knowledge of the outcomes of DCR is limited as well as knowledge of what it is that makes a difference for the individual. The aim of this study was to describe what changes in everyday life elderly persons experienced after discharge from a community-based day care rehabilitation centre and to give possible explanations for these changes. Fifteen elderly people were interviewed after that they had been discharged from DCR. A narrative approach was used for analysing the interview data. Four case stories constitute the findings, each of them with unique descriptions of changes in everyday life as well as possible explanations for these changes. The first case story described resumption of daily activities that made the days more eventful and meaningful. The second described how everyday life became an arena for exercising, which create confidence for the future. The third described how an increased sense of certainty and security in the movements led to an increased appetite for life. Finally, the fourth case story described both the stay at the DCR centre and the promise of a new period there as uplifting that made the days easier. Concerning possible explanations for these changes, the findings indicate that it was a combination of several events that together contributed to the changes. Examples were physical training, counselling about how to live in an active and healthy lifestyle, and socialisation with other patients in formal as well as in informal sessions.

  • 13.
    Tollén, Anita
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Kamwendo, Kitty
    Örebro universitet, Hälsoakademin.
    Ivarsson, Ann-Britt
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Förändringar i vardagen efter utskrivning från dagrehabilitering och möjliga förklaringar till dessa2011Konferansepaper (Fagfellevurdert)
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