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  • 101.
    Hugelius, Karin
    et al.
    Örebro University, School of Health Sciences.
    Adams, Mike
    First Response Radio, Frome, UK.
    Romo-Murphy, Eila
    Health Communication Resources (UK), UK.
    The Power of Radio to Promote Health and Resilience in Natural Disasters: A Review2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 14, article id E2526Article in journal (Refereed)
    Abstract [en]

    Humanitarian radio has been used in humanitarian aid efforts and after natural disasters over the last 15 years. However, the effects have barely been evaluated, and there are few scientific reports on the impact of radio as a disaster health response intervention. Therefore, this study aimed to provide an overview of the use and impact of humanitarian radio in natural disasters from a health perspective. A literature review of 13 scientific papers and grey literature resources was conducted. The results show that humanitarian radio could be used to promote both physical and psychosocial wellbeing by providing health-related information, advice and psychosocial support in natural disasters. Community resilience can be enhanced by the promotion of community engagement and can strengthen self-efficacy and community efficacy. Radio also has the potential to cost-effectively reach a large number of affected people in areas with severely damaged infrastructure. Radio could, therefore, contribute to health recovery and wellbeing from both individual and community perspectives. As such, health professionals; crises communication professionals, including radio journalists; and disaster-managing stakeholders should be prepared and trained to use humanitarian radio as an integrated part of the disaster health response in natural disasters.

  • 102.
    Hugelius, Karin
    et al.
    Örebro University, School of Health Sciences.
    Adolfsson, Annsofie
    Örebro University, School of Health Sciences.
    Gifford, Mervyn
    Örebro University, School of Health Sciences.
    Örtenwall, Per
    Sahlgrenska Akademin, Göteborgs universitet, Göteborg, Sweden.
    Social media can be used to recruit study participants in disaster research2016Conference paper (Refereed)
  • 103.
    Hugelius, Karin
    et al.
    Örebro University, School of Health Sciences. Karlskoga Hospital, Karlskoga, Sweden.
    Gifford, Mervyn
    Örebro University, School of Health Sciences.
    Örtenwall, Per
    Sahlgrenska Akademin, Gothenburg University, Gothenburg, Sweden.
    Adolfsson, Annsofie
    Örebro University, School of Health Sciences.
    Health among disaster survivors 30 months after Typhoon Haiyan, using a selfselected Internet sample in a web-based surveyManuscript (preprint) (Other academic)
  • 104.
    Islam, Farzana
    Örebro University, School of Health Sciences.
    Quality Improvement System for Maternal and Newborn Health Care Services at District and Sub-district Hospitals in Bangladesh2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In Bangladesh, research focusing on the quality of maternal and newborn health (MNH) services in hospitals remains neglected. There have only been a few studies conducted on quality issues and found the quality of MNH care provided at district and sub-district hospitals to be poor. The overall objective of this thesis was to develop, implement and evaluate a framework for quality improvement (QI) system for MNH care at the district and sub-district level government hospitals in Bangladesh. The thesis is comprised of four papers. Mixed methods were used in paper I and paper IV. In paper II quantitative methods were utilized, and to develop the “Model QI System”, exploratory methodological approaches were used and illustrated in paper III. Group discussions, focus group discussions, in-depth interviews, documents review and photography were utilised as qualitative data collection techniques. Through structured observation and exit interviews quantitative data were obtained. Findings of baseline survey identified several keyfactors that affected the quality of patient care: shortage of staff and logistics; lack of laboratory support; under useof patient-management protocols; lack of training; and insufficient supervision. The clinical performance of health care providers was found unsatisfactory. Utilizing the baseline survey findings and existing information on QI models, theories and QI intervention programmes implemented in defferent settings an adapted “Model QI System” and its implementation framework, guidelines and tools were developed. The key areas of this “Model QI System” included health system support, clinical service delivery, inter-departmental coordination; and utilization of services and client satisfaction. The adopted “Model QI System” was incorporated within the existing hospital management system and it was found that the quality of care improved. The evaluation of the study showed that the “Model QI System” was acceptable to the top health managers, health care providers and hospital support staff and feasible to implement in district and sub-district hospitals in Bangladesh.

    List of papers
    1. Perceptions of health care providers and patients on quality of care in maternal and neonatal health in fourteen Bangladesh government healthcare facilities: a mixed-method study
    Open this publication in new window or tab >>Perceptions of health care providers and patients on quality of care in maternal and neonatal health in fourteen Bangladesh government healthcare facilities: a mixed-method study
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    2015 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 15, article id 237Article in journal (Refereed) Published
    Abstract [en]

    Background: Bangladesh has achieved remarkable progress in healthcare with a steady decline in maternal and under-5 child mortality rates in efforts to achieve Millennium Development Goals 4 and 5. However, the mortality rates are still very high compared with high-income countries. The quality of healthcare needs improve to reduce mortality rates further. It is essential to investigate the current quality of healthcare before implementing any interventions. The study was conducted to explore the perception of healthcare providers about the quality of maternal and neonatal health (MNH) care. The study also investigated patient satisfaction with the MNH care received from district and sub-district hospitals.

    Methodology: Both qualitative and quantitative methods were used in the study. Two district and 12 sub-district hospitals in Thakurgaon and Jamalpur in Bangladesh were the study settings. Fourteen group discussions and 56 in-depth interviews were conducted among the healthcare providers. Client exit interviews were conducted with 112 patients and their attendants from maternity, labor, and neonatal wards before being discharged from the hospitals. Eight physicians and four anthropologists collected data between November and December 2011 using pretested guidelines.

    Results: The hospital staff identified several key factors that affected the quality of patient care: shortage of staff and logistics; lack of laboratory support; under use of patient-management protocols; a lack of training; and insufficient supervision. Doctors were unable to provide optimal care because of the high volume of patients. The exit interviews revealed that 85 % of respondents were satisfied with the hospital services received. Seven out of 14 respondents were satisfied with the cleanliness of the hospital facilities. More than half of the respondents were satisfied with the drugs they received. In half of the facilities, patients did not get an opportunity to ask the healthcare providers questions about their health conditions and treatments.

    Conclusion: The quality of healthcare is poor in district and sub-district hospitals in Bangladesh because of the lack of healthcare personnel and logistic support. An integrated quality improvement approach is needed to improve MNH care service in district and sub-district hospitals in Bangladesh.

    Place, publisher, year, edition, pages
    London, United Kingdom: BioMed Central, 2015
    Keywords
    Bangladesh, clients' satisfaction, healthcare providers' perception, maternal and neonatal health, quality of healthcare
    National Category
    Health Care Service and Management, Health Policy and Services and Health Economy
    Research subject
    Health and Medical Care Research
    Identifiers
    urn:nbn:se:oru:diva-45294 (URN)10.1186/s12913-015-0918-9 (DOI)000356584000001 ()26084893 (PubMedID)2-s2.0-84935856544 (Scopus ID)
    Available from: 2015-07-23 Created: 2015-07-20 Last updated: 2018-06-30Bibliographically approved
    2. Assessment of quality of infrastructure and clinical care performance of HCPs during MNH services at district and sub-district level government hospitals, Bangladesh
    Open this publication in new window or tab >>Assessment of quality of infrastructure and clinical care performance of HCPs during MNH services at district and sub-district level government hospitals, Bangladesh
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    2015 (English)In: HealthMed, ISSN 1840-2291, E-ISSN 1986-8103, Vol. 9, no 12, p. 500-510Article in journal (Refereed) Published
    Abstract [en]

    Background: Despite the progress towards the MDG4 and 5, compared to the developed world maternal and newborn deaths are still high in Bangladesh. Poor quality of maternal and newborn health care is often blamed for this high mortality. However, only few studies assessed the quality of health care of the facilities in Bangladesh. This study assessed the two important components of quality of maternal and newborn health care namely, infrastructure and performance of health care providers (HCPs) of three different levels of health facilities in Bangladesh.

    Methodology: A cross sectional survey including observation and document reviews conducted to measure the quality of infrastructures and to assess the clinical care performance of the health care providers related to maternal and newborn services. Two district hospitals, two maternal and child welfare centres, and 10 upazila (sub-district) health complexes were purposively selected from Thakurgaon and Jamalpur districts of Bangladesh to conduct the study. Six components including human resource, physical infrastructure, infection prevention, equipments/logistics/supplies, essential drugs and recordkeeping were assessed under infrastructure. Maternal and newborn care services provided by the health care providers were evaluated during antenatal care, postnatal care, conduction of delivery care and newborn care. Sixteen doctors using pre-tested infrastructure survey and observation checklists collected data between November and December 2011. The average of the sub-items of each item was calculated and then the mean average of the items were calculated and expressed in percentage. Ethical clearance was obtained from a competent authority and informed consent was obtained from the hospital authorities and the persons who participated in the study.

    Results: The percentage of mean average scores of all items of infrastructure for district hospitals, maternal and child welfare centres and upazila health complexes were 57.1%, 52.7% and 45.9% respectively, which were below the cut-off point (60.0%). None of the health care providers of three types of government hospitals obtained 100% score in any areas namely antenatal care, post-natal care, delivery care and newborn care.

    Conclusion: Quality of infrastructure of health facilities, and clinical care performance of the health care providers during discharging maternal and newborn health services were found poor in the selected three types of public hospitals.

    Place, publisher, year, edition, pages
    Sarajevo, Bosnia & Herzegovina: D R U N P P, 2015
    Keywords
    Health care providers, public hospital, infrastructure, maternal and newborn health, performance, quality improvement
    National Category
    Medical and Health Sciences Public Health, Global Health, Social Medicine and Epidemiology
    Research subject
    Public health
    Identifiers
    urn:nbn:se:oru:diva-47959 (URN)
    Available from: 2016-02-04 Created: 2016-02-04 Last updated: 2018-07-02Bibliographically approved
    3. A Model Quality Improvement System for Maternal and Newborn Health Services Applicable for District and Sub-district Level government hospitals in Bangladesh: Description of Model Development process
    Open this publication in new window or tab >>A Model Quality Improvement System for Maternal and Newborn Health Services Applicable for District and Sub-district Level government hospitals in Bangladesh: Description of Model Development process
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    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-48459 (URN)
    Available from: 2016-02-22 Created: 2016-02-22 Last updated: 2017-10-17Bibliographically approved
    4. Evaluation of a “Model Quality Improvement System" for MNH service for its acceptability and feasibility by the health care providers and patients in district and sub-district level government hospitals, Bangladesh
    Open this publication in new window or tab >>Evaluation of a “Model Quality Improvement System" for MNH service for its acceptability and feasibility by the health care providers and patients in district and sub-district level government hospitals, Bangladesh
    Show others...
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-48460 (URN)
    Available from: 2016-02-22 Created: 2016-02-22 Last updated: 2017-10-17Bibliographically approved
  • 105.
    Islam, Farzana
    et al.
    Örebro University, School of Medical Sciences. Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh.
    Rahman, Aminur
    Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh.
    Halim, Abdul
    Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh.
    Eriksson, Charli
    Örebro University, School of Health Sciences.
    Rahman, Fazlur
    Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh.
    Dalal, Koustuv
    Örebro University, School of Health Sciences.
    A Model Quality Improvement System for Maternal and Newborn Health Services Applicable for District and Sub-district Level government hospitals in Bangladesh: Description of Model Development processManuscript (preprint) (Other academic)
  • 106.
    Islam, Farzana
    et al.
    Örebro University, School of Medical Sciences. Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh.
    Rahman, Aminur
    Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh.
    Halim, Abdul
    Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh.
    Eriksson, Charli
    Örebro University, School of Health Sciences.
    Rahman, Fazlur
    Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh.
    Dalal, Koustuv
    Örebro University, School of Health Sciences.
    Evaluation of a “Model Quality Improvement System" for MNH service for its acceptability and feasibility by the health care providers and patients in district and sub-district level government hospitals, BangladeshManuscript (preprint) (Other academic)
  • 107.
    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.

  • 108.
    Jansson, Fredrik
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Valfridsson, Emil
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Enkätstudie om valet att genomföra eller integenomföra hörselgångs- och frifältsmätningar2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Audionomen har en viktig roll i att säkerställagod vård inom hörselrehabilitering. Hörselgångs- och frifältsmätningar är viktigautvärderingsmetoder. Konsekvenser av att inte genomföra dessa mätningar kaninnebära att hörapparatens inte ger optimal förbättring för patienten. Syftet med studien äratt undersöka i hur stor utsträckning audionomerna i Mellansverige utförobjektiva kvalitetssäkrande rehabiliterings- och utvärderingsmetoder i form avhörselgångs- och frifältsmätningar samt vilka faktorer som kan påverka i valetatt genomföra eller inte genomföra dessa mätmetoder. Detta gjordes genom en enkätstudie som innehöll 25 frågor och besvarades av 107 yrkesverksammaaudionomer i Mellansverige. Frekvens på genomförande samt faktorerna till valatt genomföra eller inte genomföra hörselgångs- och frifältsmätningarundersöktes. Bemästrande av utförandet var den variabel som samverkade starkastmed hur ofta audionomerna i stickprovet genomför hörselgångs- ochfrifältsmätningar. Bättre tillgång till teknisk utrustning innebär mer frekventgenomförande av mätningar. Inställningen till upplevd nytta har även den ettstatistiskt signifikant samband med hur ofta mätningar genomförs. Dock är intetidsbrist en statistiskt signifikant påverkande faktor. Tillsammans förklararupplevd nytta, bemästrande och tillgänglighet av teknisk utrustning 46 procentav variationen i hur ofta hörselgångsmätningar genomförs. Audionomer som angerkvalitetssäkring och rutin på klinik som anledning att genomföra mätningarna,utför dessa statistiskt signifikant oftare. Studien indikerar att hörselgångs- och frifältsmätningar genomförs iliten utsträckning inom hörselvården i Mellansverige. Studiens resultat antyderatt tydliga rutiner ökar frekvensen av genomförda mätningar. Vidare indikerarstudien att ett positivt samband mellan ökat bemästrande och antalet genomfördamätningar finns.

  • 109.
    Jansson-Fröjmark, Markus
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Linton, Steven J.
    Örebro University, School of Law, Psychology and Social Work.
    Flink, Ida K.
    Örebro University, School of Law, Psychology and Social Work.
    Granberg, Sarah
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Audiological Research Centre, Örebro University Hospital, Örebro, Sweden.
    Danermark, Berth
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Audiological Research Centre, Örebro University Hospital, Örebro, Sweden.
    Norell-Clarke, Annika
    Örebro University, School of Law, Psychology and Social Work.
    Cognitive-behavioral therapy for insomnia co-morbid with hearing impairment: a randomized controlled trial2012In: Journal of clinical psychology in medical settings, ISSN 1068-9583, E-ISSN 1573-3572, Vol. 19, no 2, p. 224-234Article in journal (Refereed)
    Abstract [en]

    The purpose of the current study was to examine the effects of cognitive behavior therapy (CBT-I) for insomnia on patients with insomnia co-morbid with hearing impairment. A randomized controlled design was used with a 3-month follow-up. Thirty-two patients with insomnia co-morbid with hearing impairment were randomized to either CBT-I or a waitlist condition (WLC). The primary outcome was insomnia severity. Secondary outcomes were sleep diary parameters, dysfunction, anxiety, and depression. Compared to WLC, CBT-I resulted in lower insomnia severity at post-treatment and at follow-up (d = 1.18–1.56). Relative to WLC, CBT-I also led, at both assessment points, to reduced total wake time (d = 1.39) and increased sleep restoration (d = 1.03–1.07) and sleep quality (d = 0.91–1.16). Both groups increased their total sleep time, but no significant group difference emerged. Compared to WLC, CBT-I resulted in higher function (d = 0.81–0.96) and lower anxiety (d = 1.29–1.30) at both assessment points. Neither CBT-I nor WLC led to improvement on depression. Based on the Insomnia Severity Index, more CBT-I (53–77%) than WLC participants (0–7%) were treatment responders. Also, more CBT-I (24%) than WLC participants (0%) remitted. In patients with insomnia co-morbid with hearing impairment, CBT-I was effective in decreasing insomnia severity, subjective sleep parameters, dysfunction, and anxiety. These findings are in line with previous results on the effects of CBT-I in other medical conditions.

  • 110.
    Jarl, Gustav
    et al.
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Prosthetics and Orthotics, Örebro University Hospital, Örebro, Sweden; University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Ramstrand, Nerrolyn
    CHILD research group, Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    A model to facilitate implementation of the International Classification of Functioning, Disability and Health into prosthetics and orthotics2018In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 42, no 5, p. 468-475Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The International Classification of Functioning, Disability and Health is a classification of human functioning and disability and is based on a biopsychosocial model of health. As such, International Classification of Functioning, Disability and Health seems suitable as a basis for constructing models defining the clinical P&O process. The aim was to use International Classification of Functioning, Disability and Health to facilitate development of such a model.

    Proposed model: A model, the Prosthetic and Orthotic Process (POP) model, is proposed. The Prosthetic and Orthotic Process model is based on the concepts of the International Classification of Functioning, Disability and Health and comprises four steps in a cycle: (1) Assessment, including the medical history and physical examination of the patient. (2) Goals, specified on four levels including those related to participation, activity, body functions and structures and technical requirements of the device. (3) Intervention, in which the appropriate course of action is determined based on the specified goal and evidence-based practice. (4) Evaluation of outcomes, where the outcomes are assessed and compared to the corresponding goals. After the evaluation of goal fulfilment, the first cycle in the process is complete, and a broad evaluation is now made including overriding questions about the patient's satisfaction with the outcomes and the process. This evaluation will determine if the process should be ended or if another cycle in the process should be initiated.

    CONCLUSION: The Prosthetic and Orthotic Process model can provide a common understanding of the P&O process. Concepts of International Classification of Functioning, Disability and Health have been incorporated into the model to facilitate communication with other rehabilitation professionals and encourage a holistic and patient-centred approach in clinical practice.

    Clinical relevance: The Prosthetic and Orthotic Process model can support the implementation of International Classification of Functioning, Disability and Health in P&O practice, thereby providing a common understanding of the P&O process and a common language to facilitate communication with other rehabilitation professionals.

  • 111.
    Kajbjer, Karin
    et al.
    Linköpings universitet, Linköping, Sweden.
    Nordberg, Ragnar
    JMP Research & Development AB, Mölndal, Sweden.
    Klein, Gunnar O
    Karolinska Institute, Stockholm, Sweden.
    Electronic Health Records in Sweden: From Administrative Management to Clinical Decision Support2011In: History Of Nordic Computing 3: Third IFIP WG 9.7 Conference, HiNC 3, Stockholm, Sweden, October 18-20, 2010, Revised Selected Papers / [ed] John Impagliazzo, Per Lundin, Benkt Wangler, Springer, 2011, Vol. 350, p. 74-82Conference paper (Refereed)
    Abstract [en]

    Computer support for health care started in Sweden in the mid-1960s, with a series of pilot tests using clinical records at the Karolinska Hospital. This had very little impact in health care due to its limited volume and scope. In addition, the first automation of chemistry laboratories that created many benefits in the form of increased efficiency from the early 1970s, rapid results delivery and the possibilities of quality control also occurred in the mid-1960s. The 1970s and first part of the 1980s saw the independent development of several patient administration systems, based on central mainframes in the counties, as well as a large number of dumb terminals in the hospitals and later also in the outpatient clinics. From the early 1990s, we saw an explosion of primary care electronic health records with twenty-seven different products in 1995.

  • 112.
    Katshiete Mbuisi Eale, Brigitte
    et al.
    Örebro University, School of Health Sciences.
    Andersson, Gunnel
    Örebro University, School of Health Sciences.
    Ntabe Namegabe, Edond
    Université libre des Pays des Grands Lacs, Goma, Democratic Republic of the Congo.
    Kaboru, Berthollet Bwira
    Adolfsson, Annsofie
    Örebro University, School of Health Sciences.
    Ordeals of sexually violated women and access to comprehensive healthcare: A case study of victims of sexual violence in North Kivu, Eastern Congo2018In: Journal of women´s reproductive health, ISSN 2381-862X, Vol. 2, no 1, p. 23-34Article in journal (Refereed)
    Abstract [en]

    Background: The impact of sexual violence in any community is extremely devastating and women in the Eastern part of the Congo are no exception. Sexual violence not only affects the health of women, but it impacts their social life within the community too.

    Objective: The study aims to investigate the experiences of female victims of sexual violence in accessing medical care in North Kivu.

    Design: An interpretive, phenomenological approach was used for this inductive and qualitative study. In-depth informant interviews were the main data collection tool. Open-ended questions were used during the interviews in order to garner more information from the interviewees. Heidegger’s approach was utilized in analyzing the collected data.

    Results: The analyzed and interpreted results of the data indicated that survivors of sexual violence are engaged in an ongoing struggle. The victims demonstrated immense resilience despite the lack of comprehensive medical care and have continued to reassemble their broken lives. In order to present the outcomes of the research in a succinct and coherent manner, the outcomes are categorized into five sub-themes: managing worries and shame; regaining happiness; healing and restoration; the need for professional assistance and struggles in daily life.

    Conclusion: The study provides an understanding of the recovery processes of survivors of sexual violence in North Kivu, with important insights into dimensions that rehabilitation programs should take into consideration.

  • 113.
    Klein, Gunnar O
    Center for health telematics, Karolinska institute, Stockholm, Sweden.
    Enabling health online: The case for standards2001In: MEDINFO 2001: PROCEEDINGS OF THE 10TH WORLD CONGRESS ON MEDICAL INFORMATICS, PTS 1 AND 2, Amsterdam: IOS Press, 2001, Vol. 84, p. 123-123Conference paper (Refereed)
    Abstract [en]

    Healthcare policies in many countries, in the European Union and of the United Nations stress the importance of using information and communications technology to achieve the goals of improving health for all while controlling accelerating costs. This paper reviews the major areas where standards actions are required on a national, European and global level.

  • 114.
    Klein, Gunnar O.
    Karolinska Institutet, Stockholm, Sweden.
    History of Electronic Prescriptions in Sweden: From Time-Sharing Systems via Smartcards to EDI2011In: History Of Nordic Computing 3: Third IFIP WG 9.7 Conference, HiNC 3, Stockholm, Sweden, October 18-20, 2010, Revised Selected Papers / [ed] John Impagliazzo, Per Lundin, Benkt Wangler, Springer, 2011, Vol. 350, p. 65-73Conference paper (Refereed)
    Abstract [en]

    Managing prescriptions for medication, using ICT support, started in the 1970s with the computerization of the pharmacy branch offices where local systems registered handwritten prescriptions and to print labels. In 1984, the first online prescribing started with physicians connected to their local pharmacy system in a pilot test. Then in 1987, the first pilot test started with an off-line system in which PC-based prescriber support systems transferred data to patient-held smart cards that were taken to the pharmacy. In the 1990s, we had the first use of messaging using EDIFACT syntax for prescriptions. These had a relatively small volume until 2000, when an XML version of a European standard based on object-oriented modeling became popular and made electronic prescribing the normal practice, which meant important quality gains.

  • 115.
    Klein, Gunnar O
    Örebro University, Örebro University School of Business.
    ISO and CEN standards for health informatics-synergy or competition.2003In: Advanced Health Telematics and Telemedicine: The Magdeburg Expert Summit Textbook / [ed] Blobel, Bernd; Pharow, Peter, Amsterdam: IOS Press, 2003, Vol. 96, p. 259-265Conference paper (Refereed)
    Abstract [en]

    The European standardisation of health informatics in CEN/TC 251 started in 1990 with the now twenty national standards bodies as members and a political mandate from the European Union and EFTA. The start of the international work in ISO/TC 215 has been welcomed by Europe and there is a lot of co-operation where European pre-standards have often been the basis for the start of international standards work, particularly in the area of medical device communication and for health cards. CEN and ISO also collaborate with other bodies in the field such as DICOM for imaging, IEEE for devices and the US based HL7 organisation for message development. It is important to find the right level of standards work for different aspects. The European CEN work will be maintained for issues like the electronic health record, some security aspects and medication related communication where there are common views and legislation makes European consensus necessary and achievable. The device market on the other hand requires global standards. In addition to multinational co-operation, it is important with a national strategy for the use of standards and adaptation and promotion of specific profiles to achieve interoperability in the still mainly national health systems.

  • 116.
    Klein, Gunnar O.
    Dept. of Microbiology, Tumour and Cell Biology, Karolinska Institutet, Sweden.
    Metadata: an international standard for clinical knowledge resources2011Conference paper (Refereed)
    Abstract [en]

    This paper describes a new European and International standard, ISO 13119 Health informatics - Clinical knowledge resources - Metadata that is intended for both health professionals and patients/citizens. This standard aims to facilitate two issues: 1) How to find relevant documents that are appropriate for the reader and situation and 2) How to ensure that the found knowledge documents have a sufficient or at least declared quality management? Example of use is provided from the European Centre for Disease Control and Prevention.

  • 117.
    Klein, Gunnar O.
    GKAB, Stockholm, Sweden.
    Smart cards: a security tool for Health Information Systems1994In: International Journal of Bio-medical Computing, ISSN 0020-7101, Vol. 35, no Suppl., p. 147-151Article in journal (Refereed)
    Abstract [en]

    Expanding use of information technology in health case, both within and between the institutions, leads to additional security demands. The role is discussed that can be played by smart cards for healthcare professionals.

  • 118.
    Klein, Gunnar O
    Centre for Health Telematics, Karolinska Institutet, Stockholm, Sweden.
    Standardization of health informatics - Results and challenges2002In: Methods of Information in Medicine, ISSN 0026-1270, Vol. 41, no 4, p. 261-270Article in journal (Refereed)
    Abstract [en]

    Objectives: This review article aims to highlight the importance of standards for effective communication and provides an overview of international standardization activities. Methods: This article is based on the experience of the author of European standardization in CEN, which he leads, and the global work of ISO, where he is leading the security working group, and an overview of the work of DICOM, IEEE and HL7, partly using their web presentations. Results: Health communication is highly dependent of the general development of information technology with standards coming from ISQ/IEC ITC1, ITU and several other organizations e.g. IETE, the World Wide Web consortium and Open group. A number of standardization initiatives have been in progress for more than ten years with the aim to facilitate different aspects of the exchange of health information. Electronic record architecture, Message structures, Concept representation, Device communication including imaging and Security are the main areas. Conclusions. Important results have been achieved, and in some fields and parts of the worked, standards are widely used today. Unfortunately, we are still facing the fact that most healthcare information systems cannot exchange information with all systems for which this would be desired. Either the existing standards are not sufficiently implemented, or the required standards and necessary national implementation guidelines do not yet exist. This causes unacceptable risks to patients, inefficient use of healthcare resources, and sub optimal development of medical knowledge. Fortunately, the different bodies are now largely co-operating to achieve global consensus.

  • 119.
    Klein, Gunnar O.
    et al.
    NSEP, Norges teknisk-naturvitenskapelige universitet (NTNU),Trondheim, Norway; Karolinska Institutet, Stockholm, Sweden; Råcksta-Vällingby Närvård, Stockholm, Sweden.
    Andersson, Kjell
    Råcksta-Vällingby Närvård, Stockholm, Sweden.
    Patient empowerment in the process of sickness certificates2012In: Quality of Life through Quality of Information / [ed] John Mantas et al, Amsterdam, Netherlands: IOS Press, 2012, Vol. 180, p. 1174-6Chapter in book (Refereed)
    Abstract [en]

    A national patient portal for secure communication between the patients/citizens and primary care (Mina vårdkontakter) is available in Sweden. This system was used in a pilot project in the Stockholm County where patients were invited to prepare the visit to their physician for the discussion on the need for prolonged sickness leave by filling out a web based questionnaire on their current health status and working conditions. The opinions of the patients and their primary care physicians about the system were analyzed with positive feedback.

  • 120.
    Klein, Gunnar O.
    et al.
    Karolinska Institute, Stockholm, Sweden.
    Chen, Rong
    Translation of SNOMED CT: strategies and description of a pilot project2009In: Connecting Health and Humans: Proceedings of NI2009 – The 10th International Congress on Nursing Informatics / [ed] Kaija Saranto, Patricia Flatley Brennan, Hyeoun-Ae Park, Marianne Tallberg, Anneli Ensio, IOS Press, 2009, Vol. 146, p. 673-7Chapter in book (Refereed)
    Abstract [en]

    The translation and localization of SNOMED CT (Systematized Nomenclature of Medicine - Clinical Terms) have been initiated in a few countries. In Sweden, we conducted the first evaluation of this terminology in a project called REFTERM in which we also developed a software tool which could handle a large scale translation with a number of translators and reviewers in a web-based environment. The system makes use of existing authorized English-Swedish translations of medical terminologies such as ICD-10. The paper discusses possible strategies for a national project to translate and adapt this terminology.

  • 121.
    Klein, Gunnar O.
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Kajbjer, Karin
    eHealth tools for patients and professionals in a multicultural world2009In: Medical Informatics in a United and Healthy Europe: Proceedings of MIE 2009 – The XXIInd International Congress of the European Federation for Medical Informatics / [ed] Klaus-Peter Adlassnig, Bernd Blobel, John Mantas, Izet Masic, IOS Press, 2009, Vol. 150, p. 297-301Chapter in book (Refereed)
    Abstract [en]

    In many countries today, an important challenge for health care is the fact that the population is mixed as regards cultural background and not the least with regard to preferred language. In our country Sweden almost 20% of the population has some connection to another country and many patients seeking health care do not have sufficient mastering of the dominant Swedish language to get optimal care. We propose in this study a set of eHealth services that could be implemented within a country and in multinational co-operation to deal with some of these issues in an effective way which both empowers the citizens, improves patient safety and at the same time may offer cost savings for the publicly financed health care systems in the countries of the European Union. The basic idea is to use a set of people-people communication strategies using ICT tools combined with semantic tools for information sharing and conversion. This requires new and challenging organizational contexts.

  • 122.
    Klein, Gunnar O.
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Smith, Barry
    University at Buffalo part of State University of New York, NewYork, USA.
    Concept Systems and Ontologies: Recommendations for Basic Terminology2010In: Jinkou Chinou Gakkai rombunshi (Online), ISSN 1346-0714, E-ISSN 1346-8030, Vol. 25, no 3, p. 433-441Article in journal (Refereed)
    Abstract [en]

    This essay concerns the problems surrounding the use of the term "concept" in current ontology and terminology research. It is based on the constructive dialogue between realist ontology on the one hand and the world of formal standardization of health informatics on the other, but its conclusions are not restricted to the domain of medicine. The term "concept" is one of the most misused even in literature and technical standards which attempt to bring clarity. In this paper we propose to use the term "concept" in the context of producing defined professional terminologies with one specific and consistent meaning which we propose for adoption as the agreed meaning of the term in future terminological research, and specifically in the development of formal terminologies to be used in computer systems. We also discuss and propose new definitions of a set of cognate terms. We describe the relations governing the realm of concepts, and compare these to the richer and more complex set of relations obtaining between entities in the real world. On this basis we also summarize an associated terminology for ontologies as representations of the real world and a partial mapping between the world of concepts and the world of reality.

  • 123.
    Klein, Gunnar O.
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Sottile, Pier Angelo
    Endsleff, Frederik
    Another HISA - the new standard: health informatics - service architecture2007In: MEDINFO 2007: Proceedings of the 12th World Congress on Health (Medical) Informatics – Building Sustainable Health Systems / [ed] Klaus A. Kuhn, James R. Warren, Tze-Yun Leong, IOS Press, 2007, Vol. 129, no Pt 1, p. 478-82Chapter in book (Refereed)
    Abstract [en]

    In addition to the meaning as Health Informatics Society of Australia, HISA is the acronym used for the new European Standard: Health Informatics - Service Architecture.

    This EN 12967 standard has been developed by CEN - the federation of 29 national standards bodies in Europe. This standard defines the essential elements of a Service Oriented Architecture and a methodology for localization particularly useful for large healthcare organizations.

    It is based on the Open Distributed Processing (ODP) framework from ISO 10746 and contains the following parts:

    Part 1: Enterprise viewpoint.

    Part 2: Information viewpoint.

    Part 3: Computational viewpoint.

    This standard is now also the starting point for the consideration for an International standard in ISO/TC 215. The basic principles with a set of health specific middleware services as a common platform for various applications for regional health information systems, or large integrated hospital information systems, are well established following a previous prestandard. Examples of large scale deployments in Sweden, Denmark and Italy are described.

  • 124.
    Kristoffersson, Annica
    et al.
    Örebro University, School of Science and Technology.
    Ulfvarson, Johanna
    Karolinska institutet, Stockholm, Sweden.
    Loutfi, Amy
    Örebro University, School of Science and Technology.
    Teknik i hemmet - tekniska förutsättningar2019In: Hemsjukvård: olika perspektiv på trygg och säker vård / [ed] Mirjam Ekstedt & Maria Flink, Liber, 2019, 1, p. 396-421Chapter in book (Other (popular science, discussion, etc.))
    Abstract [sv]

    I och med den fjärde industriella revolutionen – Industri 4.0 – kommer en nygeneration av teknik att finnas tillgänglig. Det förutspås att robotik och virtualreality kommer att transformera inte bara arbetsplatser utan även utvecklaandra domäner, såsom smarta städer och möjligheten till livsstils- och hälsomonitoreringhemma.Antalet tillgängliga konsument- och medicintekniska produkter ökar irask takt. Hälso- och sjukvårdssystemet ställs inför utmaningar, såsom behovetav att utveckla verktyg för att hantera ny teknologi men också att förändraarbetsprocesser och anpassa organisationen för att kunna hantera teknologin.

    Det här kapitlet ger en översikt över kommande teknologier, förslag på hurteknologi kan användas i hemmiljöer, en översikt över hur sådan teknik utvärderatssamt inte minst en reflektion kring hur dessa teknologier kan harmoniseramed nuvarande organisatoriska processer.

  • 125. Krumlinde-Sundholm, Lena
    et al.
    Holmefur, Marie
    Eliasson, Ann-Christin
    Validitet, reliabilitet och känslighet för förändring hos Assisting Hand Assessment2005Conference paper (Refereed)
  • 126.
    Larsson Tholén, Susanna
    et al.
    Örebro University, School of Health Sciences.
    Danermark, Berth
    Örebro University, School of Health Sciences.
    "Hur vet vi att det blir bättre?": Utveckling av ett instrument för uppföljning av finansiell samordning av rehabiliteringsinsatser2016Report (Other academic)
  • 127.
    Ledenstam, Moa
    Örebro University, School of Health Sciences.
    Hyperacusis bland barn och ungdomar: - En litteraturöversikt med fokus på prevalens, diagnostik och behandling2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 128.
    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
  • 129.
    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.

  • 130.
    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)
  • 131.
    Lindner, Helen Y.
    et al.
    Örebro University, School of Health Sciences.
    Hiyoshi, Ayako
    Örebro University, School of Medical Sciences.
    Hermansson, Liselotte
    Region Örebro County, Örebro, Sweden.
    Relation between capacity and performance in paediatric myoelectric prosthesis users2017Conference paper (Refereed)
  • 132.
    Linton, Ann-Charlotte
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. The Swedish Institute for Disability Research, Linköping, Sweden; The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden; Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    Per, Germundsson
    Department of Health and Welfare Studies, Malmö University, Malmö, Sweden.
    Mikael, Heimann
    The Swedish Institute for Disability Research, Linköping, Sweden; The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden; Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    Danermark, Berth
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. The Swedish Institute for Disability Research, Linköping, Sweden; The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
    The role of experience in teachers´social representation of students with autism spectrum diagnosis (Aspberger)2015In: Cogent Education, ISSN 2331-186X, Vol. 2, no 1Article in journal (Refereed)
    Abstract [en]

    Support from teachers is a key strategy for accommodating students with Asperger syndrome (AS) diagnosis in the mainstream classroom. Teachers’ understanding and expectations of students, i.e. their social representations (SR), have a bearing on how they interact and accommodate, but little is known about why. Therefore, the current study examined the idea that teachers’ SR of these students are influenced by their previous experience with AS. To this end, Swedish mainstream teachers were invited to anonymously answer a web-based questionnaire (N = 153). An association task was used to obtain data on teachers’ SR and the content and structure of the SR were explored. Our results suggest that work-related experience of AS and/or private experience shape teachers’ SR of these students relative to teachers with no experience. Moreover, teachers with previous experience had more SR elements related to environment and learning factors while teachers without previous experience had more elements related to the individual’s behavior. Teachers with private experience produced fewer positive elements compared to those with work-related experience only. These results highlight the role of contextual factors and prior experience in forming SR. We conclude that contact with students with AS, e.g. during teacher training, could facilitate accommodation in mainstream schools.

  • 133.
    Luhr, Kristina
    Örebro University, School of Health Sciences.
    Patient participation from the patient's preferences, that's what counts2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Patient participation is a core element in legislation in most western countries today. From the patient’s perspective, patient participation includes respect, equality, sharing of knowledge, joint planning, and self-management. However, participation is not always experienced, and the patient’s experiences and preferences are seldom mapped.

    The general aim of this thesis was to enhance the knowledge on patient participation from the preferences of patients with long-term conditions in outpatient healthcare by evaluating a measure (The Patient Preferences for Patient Participation: the 4Ps) on patient participation and by investigating a self-management programme’s impact on patient participation.

    Qualitative evaluations of the 4Ps included Think Aloud interviews with patient experts (n = 11) and research experts (n = 10) in Study I. Psychometric evaluations were performed in Study II (n = 108) and after amendments in Study III (n = 150). Effects of the self-management programme on patient participation were investigated in a randomised controlled trial with the 4Ps as the outcome measure in Study III (n = 118), and in Study IV were influences investigated qualitatively in nine focus group interviews (n = 36).

    The 4Ps was found to be sufficiently valid and reliable. As measured with the 4Ps, patients with long-term conditions had both set preferences in and experiences of patient participation, regardless of randomised to a self-management programme or not. Qualitatively the programme was found to include patient participation and to influence self-management.

    The use of diverse methods was beneficial and complementary. The sufficiently valid and reliable 4Ps can fil the gap of a measure to map preferences for and experiences of patient participation. Patients with long-term conditions have set preferences for participation. The self-management programme can be applied to influence participation and future responsibilities.

    List of papers
    1. The development and initial validation of a clinical tool for patients' preferences on patient participation: The 4Ps
    Open this publication in new window or tab >>The development and initial validation of a clinical tool for patients' preferences on patient participation: The 4Ps
    2015 (English)In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 18, no 6, p. 2522-2535Article in journal (Refereed) Published
    Abstract [en]

    Aims: To report on the development and initial testing of a clinical tool, The Patient Preferences for Patient Participation tool (The 4Ps), which will allow patients to depict, prioritize, and evaluate their participation in health care.

    Background: While patient participation is vital for high quality health care, a common definition incorporating all stakeholders' experience is pending. In order to support participation in health care, a tool for determining patients' preferences on participation is proposed, including opportunities to evaluate participation while considering patient preferences.

    Methods: Exploratory mixed methods studies informed the development of the tool, and descriptive design guided its initial testing. The 4Ps tool was tested with 21 Swedish researcher experts (REs) and patient experts (PEs) with experience of patient participation. Individual Think Aloud interviews were employed to capture experiences of content, response process, and acceptability.

    Results: 'The 4Ps' included three sections for the patient to depict, prioritize, and evaluate participation using 12 items corresponding to 'Having Dialogue', 'Sharing Knowledge', 'Planning', and 'Managing Self-care'. The REs and PEs considered 'The 4Ps' comprehensible, and that all items corresponded to the concept of patient participation. The tool was perceived to facilitate patient participation whilst requiring amendments to content and layout.

    Conclusions: A tool like The 4Ps provides opportunities for patients to depict participation, and thus supports communication and collaboration. Further patient evaluation is needed to understand the conditions for patient participation. While The 4Ps is promising, revision and testing in clinical practice is required.

    Place, publisher, year, edition, pages
    Wiley-Blackwell, 2015
    Keywords
    clinical tool, content validity, instrument development, patient participation, qualitative analysis
    National Category
    Nursing
    Research subject
    Caring sciences
    Identifiers
    urn:nbn:se:oru:diva-41155 (URN)10.1111/hex.12221 (DOI)000368250300058 ()24938672 (PubMedID)2-s2.0-84955180179 (Scopus ID)
    Note

    Funding Agencies:

    Capio Research Fund, Sweden

    Family Medicine Research Centre, Örebro county council 

    Available from: 2015-01-14 Created: 2015-01-13 Last updated: 2018-09-05Bibliographically approved
    2. Patient preferences for patient participation: Psychometric evaluation of The 4Ps tool in patients with chronic heart or lung disorders
    Open this publication in new window or tab >>Patient preferences for patient participation: Psychometric evaluation of The 4Ps tool in patients with chronic heart or lung disorders
    2018 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 38, no 2, p. 68-76Article in journal (Refereed) Published
    Abstract [en]

    The Patient Preferences for Patient Participation tool (The 4Ps) was developed to aid clinical dialogue and to help patients to 1) depict, 2) prioritise, and 3) evaluate patient participation with 12 pre-set items reiterated in the three sections. An earlier qualitative evaluation of The 4Ps showed promising results. The present study is a psychometric evaluation of The 4Ps in patients with chronic heart or lung disease (n¼108) in primary and outpatient care. Internal scale validity was evaluated using Rasch analysis, and two weeks test–retest reliability of the three sections using kappa/weighted kappa and a prevalence- and bias-adjusted kappa. The 4Ps tool was found to be reasonably valid with a varied reliability. Proposed amendments are rephrasing of two items, and modifications of the rating scale in Section 2. The 4Ps is suggested for use to increase general knowledge of patient participation, but further studies are needed with regards to its implementation.

    Place, publisher, year, edition, pages
    Sage Publications, 2018
    Keywords
    Chronic heart failure, chronic obstructive pulmonary disease, clinical tool, instrument testing, patient participation
    National Category
    Health Sciences Nursing Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-66035 (URN)10.1177/2057158517713156 (DOI)
    Available from: 2018-03-23 Created: 2018-03-23 Last updated: 2018-09-07Bibliographically approved
    3. Effects of a self-management program on patient participation in patients with chronic heart failure or chronic obstructive pulmonary disease: a randomised controlled trial
    Open this publication in new window or tab >>Effects of a self-management program on patient participation in patients with chronic heart failure or chronic obstructive pulmonary disease: a randomised controlled trial
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-66492 (URN)
    Available from: 2018-04-10 Created: 2018-04-10 Last updated: 2018-04-10Bibliographically approved
    4. Patient participation during and after a self-management programme in primary healthcare: The experience of patients with chronic obstructive pulmonary disease or chronic heart failure
    Open this publication in new window or tab >>Patient participation during and after a self-management programme in primary healthcare: The experience of patients with chronic obstructive pulmonary disease or chronic heart failure
    2018 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 101, no 6, p. 1137-1142Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVE: Patient participation is facilitated by patients' ability to take responsibility for and engage in health issues. Yet, there is limited research as to the promotion of these aspects of patient participation in long-term healthcare interactions. This paper describes patient participation as experienced by patients with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF); the aim was to describe if and how a self-management programme in primary healthcare influenced patient participation.

    METHODS: Patients who had participated in a self-management programme were interviewed in nine focus groups (36 patients). Data was analysed using qualitative content analysis.

    RESULTS: Patients described equality in personal interactions, opportunities to share and discuss, and a willingness to share and learn to facilitate patient participation in a self-management programme. Consequently, patient participation was promoted by a match between the individuals' personal traits and the context.

    CONCLUSION: Features facilitating patient participation by means of sharing and assimilating knowledge and insights should be included in self-management programmes and in the care for patients with COPD and CHF.

    PRACTICE IMPLICATIONS: A self-management programme can complement regular primary care regarding enhanced understanding of one's disease and support patient participation and the patient's own resources in self-management.

    Place, publisher, year, edition, pages
    Elsevier, 2018
    Keywords
    Chronic heart failure, Chronic obstructive pulmonary disease, Person-centered care, Patient participation, Self-management programme
    National Category
    Nursing
    Identifiers
    urn:nbn:se:oru:diva-64005 (URN)10.1016/j.pec.2017.12.020 (DOI)000432345000019 ()29290329 (PubMedID)2-s2.0-85039553404 (Scopus ID)
    Note

    Funding Agencies:

    Region Örebro County  

    Uppsala-Örebro Regional Research Council 

    Available from: 2018-01-12 Created: 2018-01-12 Last updated: 2018-09-07Bibliographically approved
  • 134.
    Luhr, Kristina
    et al.
    Örebro University, School of Health Sciences. University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Eldh, Ann Catrine
    School of Education, Health and Social Studies, Dalarna University, Falun, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Nilsson, Ulrica
    Örebro University, School of Health Sciences.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Patient preferences for patient participation: Psychometric evaluation of The 4Ps tool in patients with chronic heart or lung disorders2018In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 38, no 2, p. 68-76Article in journal (Refereed)
    Abstract [en]

    The Patient Preferences for Patient Participation tool (The 4Ps) was developed to aid clinical dialogue and to help patients to 1) depict, 2) prioritise, and 3) evaluate patient participation with 12 pre-set items reiterated in the three sections. An earlier qualitative evaluation of The 4Ps showed promising results. The present study is a psychometric evaluation of The 4Ps in patients with chronic heart or lung disease (n¼108) in primary and outpatient care. Internal scale validity was evaluated using Rasch analysis, and two weeks test–retest reliability of the three sections using kappa/weighted kappa and a prevalence- and bias-adjusted kappa. The 4Ps tool was found to be reasonably valid with a varied reliability. Proposed amendments are rephrasing of two items, and modifications of the rating scale in Section 2. The 4Ps is suggested for use to increase general knowledge of patient participation, but further studies are needed with regards to its implementation.

  • 135.
    Luhr, Kristina
    et al.
    Örebro University, School of Health Sciences.
    Eldh, Ann Catrine
    Linköping University, Sweden; Uppsala University, Uppsala, Sweden.
    Theander, Kersti
    Centre for Clinical Research, County Council of Värmland, Karlstad, Sweden.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Effects of a self-management program on patient participation in patients with chronic heart failure or chronic obstructive pulmonary disease: a randomised controlled trialManuscript (preprint) (Other academic)
  • 136.
    Lundqvist, Lars-Olov
    et al.
    Örebro University, School of Health Sciences.
    Ivarsson, Ann-Britt
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Rask, Mikael
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Brunt, David
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Schröder, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Nursing, Faculty of Health, Care and Nursing, Norwegian University of Science and Technology (NTNU), Gjövik, Norway.
    The attendees' view of quality in community-based day centre services for people with psychiatric disabilities2018In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 25, no 3, p. 162-171Article in journal (Refereed)
    Abstract [en]

    Background/Aims: Community-based day centres in Sweden are well-established arenas for psychiatric rehabilitation, but little is known of the attendees' perception of the quality of the service provided. The aim of the study was thus to describe and investigate the quality of the services in community-based day centre for people with psychiatric disabilities.

    Methods: A sample of 218 attendees in 14 community-based day centre services in Sweden completed the Quality in Psychiatric Care - Daily Activities (QPC-DA).

    Results: The results showed that people with psychiatric disabilities perceived the quality of community-based day centre services as high. Most notably, quality of service was rated higher by those with lower educational level, had waited shorter time to attend the centre, and had better mental and physical health. However, particularly aspects of a secluded environment and participation (information) may be areas with potential for improvement.

    Conclusion/Significance: From an occupational science perspective, the results adhere to the importance of occupational balance, with periods of rest/privacy during the time at the centre.

  • 137.
    Löfqvist, C.
    et al.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Pettersson, Cecilia
    Department of Health Sciences, Lund University, Lund, Sweden.
    Iwarsson, S.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Brandt, A.
    Department of Research and Development, Danish Centre for Assistive Technology, Aarhus, Denmark.
    Mobility and mobility-related participation outcomes of powered wheelchair and scooter interventions after 4-months and 1-year use2012In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 7, no 3, p. 211-218Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim was to investigate outcomes of powered wheelchair and scooter interventions after 4-months and 1-year use regarding need for assistance when moving around, frequency of mobility-related participation, easiness/difficulty in mobility during participation, and number of participation aspects performed in everyday life.

    METHOD: The study was a prospective cohort study, using an instrument focusing on mobility-related participation outcomes of mobility device interventions (NOMO 1.0), at baseline, after 4-months and 1-year use.

    RESULTS: The results show that the outcomes in terms of participation frequency and easiness in mobility occur in a short time perspective, and that the effects remained stable at 1-year follow-up. The frequency of going for a walk increased most prominently (26%). Even though the majority of the participation aspects were not performed, more often they became easier to perform: 56-91% found that shopping, walking and visiting family/friends were easier. Moreover, independence outdoors and indoors increased.

    CONCLUSIONS: This small study provides knowledge about the outcomes of powered wheelchairs and scooters in terms of mobility and mobility-related participation in real-life situations. The study supports results from former studies, but even so, larger studies are required in order to provide evidence for the effectiveness of powered wheelchairs and scooters. [Box: see text].

  • 138.
    Magnusson, Björn
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Svensson, Pontus
    Gymnasieungdomars attityder till stark musik2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 139.
    Manchaiah, Vinaya
    et al.
    Department of Speech and Hearing Sciences, Lamar University, Beaumont TX, USA; Linnaeus Centre Head, Swedish Institute for Disability Research, Department of Behavioral Science and Learning, Linköping University, Linköping, Sweden; Audiology India, Mysore, India; Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipala, India.
    Beukes, Eldré W.
    Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, United Kingdom.
    Granberg, Sarah
    Örebro University, School of Health Sciences. Audiological Research Center, Örebro University Hospital, Örebro, Sweden.
    Durisala, Naresh
    GN Hearing Pte Ltd, CT Hub, Singapore, Singapore.
    Baguley, David M.
    Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, United Kingdom; National Institute for Health Research - Nottingham, Hearing Biomedical Research Unit, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom; Otology and Hearing Group, Division of Clinical Neurosciences, Faculty of Medicine, University of Nottingham, Nottingham, United Kingdom.
    Allen, Peter M.
    Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, United Kingdom; Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, United Kingdom.
    Andersson, Gerhard
    Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden; Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institute, Stockholm, Sweden.
    Problems and Life Effects Experienced by Tinnitus Research Study Volunteers: An Exploratory Study Using the ICF Classification2018In: Journal of american academy of audiology, ISSN 1050-0545, E-ISSN 2157-3107, Vol. 29, no 10, p. 936-947Article in journal (Refereed)
    Abstract [en]

    Background: Tinnitus is one of the most distressing hearing-related symptoms. It is often associated with a range of physiological and psychological complications, such as depression, anxiety, and insomnia. Hence, approaching tinnitus from a biopsychological perspective may be more appropriate than from purely a biomedical model.

    Objective: The present studywas aimed at determining the relationship between tinnitus and the problems and life effects experienced by UK-based tinnitus research study volunteers. Open-ended questions were used. Responses were classified using the International Classification of Functioning, Disability and Health (ICF) framework to understand the impact of tinnitus in a multidimensional manner using a biopsychosocial perspective.

    Research Design: A cross-sectional survey design was used.

    Study Sample: Study sample included a sample of 240 adults with tinnitus who were interested in undertaking an Internet-based intervention for tinnitus.

    Data Collection and Analysis: The data were collated using two open-ended questions. The first focused on problems related to having tinnitus and the second to life effects as a result of tinnitus. Responses were analyzed using a simplified content analysis approach to link concepts to ICF categories in accordance with established linking rules. A Wilcoxon signed-rank test was performed to compare the number of responses between the two questions. The most frequent responses related to body function involved ‘‘emotional functions’’ (b152), ‘‘sleep functions’’ (b134), ‘‘hearing functions’’ (b230), ‘‘sustaining attention’’ (b1400), and ‘‘energy level’’ (b1300). For activity limitations and participation restrictions they were ‘‘communicating with—receiving—spokenmessages’’ (d310), ‘‘socialization’’ (d9205), ‘‘handling stress and other psychological demands’’ (d240), and ‘‘recreation and leisure’’ (d920). The most frequently occurring responses related to environmental factors were ‘‘sound intensity’’ (e2500), ‘‘sound quality’’ (e2501), and ‘‘general products and technology for communication’’ (e1250). ‘‘Coping styles’’ was the most frequently occurring personal factor.

    Conclusions: The study highlights the use of open-ended questions in gathering useful information about the impact of tinnitus. The responses coded to ICF show that tinnitus impacts many domains, not only particularly body function, but also activity limitations and participation restrictions. The results demonstrate the heterogeneous nature of the impact of tinnitus on people affected.

    Results: There were 764 responses related to problems identified, 797 responses associated with life effects due to tinnitus, and 37 responses that did not fit into any ICF category. No significant differences were observed in the number of responses between the two questions. In addition, no significant association between the number of responses reported and demographic variables was found. Most of the problems and life effects experienced by tinnitus sufferers were related to body function, followed by activity limitations, and participation restrictions. Only a few responses were related to environmental and personal factors.

  • 140.
    Matérne, Marie
    Örebro University, School of Health Sciences.
    Återgång i arbete efter förvärvad hjärnskada: livskvalitet, möjligheter och hinder2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In Sweden, about 35–40 percent of people who acquire a brain injury can return to work. To be able to help people with acquired brain injury to return to work, it is important to know about experiences and factors that facilitate return to work and how they affect quality of life. The overall aim of this thesis is to investigate the opportunities and barriers for people with acquired brain injury to return to work, as well as the importance of returning to work for their quality of life. Four studies were conducted: two interview studies and two register studies, giving qualitative and quantitative data.The major finding in this thesis was that people with acquired brain injury who could return to work had high functioning in all levels of the biopsychosocial model. The opportunities increased if the return to work was individually adapted in all phases of the process and if the person was motivated and supported by support persons with commitment, cooperation and adaptation. Those who had a university education, got their driver’s license reinstated, had high motor function and could return towork showed the greatest increase in their quality of life.Return to work is a complex process for people with acquired brain injury that could be successful if they are motivated, can balance the internal and external demands to return to work, get individual adaptation, and receive committed support. Their quality of life also increased more if theywere able to return to work.

    List of papers
    1. Opportunities and barriers for successful return to work after acquired brain injury: A patient perspective
    Open this publication in new window or tab >>Opportunities and barriers for successful return to work after acquired brain injury: A patient perspective
    2017 (English)In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 56, no 1, p. 125-134Article in journal (Refereed) Published
    Abstract [en]

    Background: Many people who suffer an acquired brain injury (ABI) are of working age. There are benefits, for the patient, the workplace, and society, to finding factors that facilitate successful return to work (RTW).

    Objective: The aim was to increase knowledge of opportunities and barriers for a successful RTW in patients with ABI.

    Method: Five men and five women with ABI participated. All had successfully returned to work at least 20 hours a week. Their experiences were gathered by semi-structured interviews, which were subsequently subjected to qualitative content analysis.

    Results: Three themes that influenced RTW were identified: individually adapted rehabilitation; motivation for RTW; and cognitive and social abilities. An individually adapted rehabilitation was judged important because the patients were involved in their own rehabilitation and required individually adapted support from rehabilitation specialists, employers, and colleagues. A moderate level of motivation for RTW was needed. Awareness of the person's cognitive and social abilities is essential, in finding compensatory strategies and adaptations.

    Conclusions: It seems that the vocational rehabilitation process is a balancing act in individualized planning and support, as a partnership with the employer needs to be developed, motivation needs to be generated, and awareness built of abilities that facilitate or hinder RTW.

    Place, publisher, year, edition, pages
    Amsterdam, The Netherlands: IOS Press, 2017
    Keywords
    Content analysis, vocational rehabilitation, qualitative interviews
    National Category
    Occupational Therapy Other Medical Sciences
    Research subject
    Disability Science
    Identifiers
    urn:nbn:se:oru:diva-54393 (URN)10.3233/WOR-162468 (DOI)000396547500014 ()28035941 (PubMedID)2-s2.0-85012225058 (Scopus ID)
    Note

    Funding Agencies:

    University Health Care Research Center

    Region Örebro County Sweden

    Swedish Association of Brain Injured and Families

    Available from: 2017-02-07 Created: 2017-01-10 Last updated: 2018-11-19Bibliographically approved
    2. Support Persons' Perceptions of Giving Vocational Rehabilitation Support to Clients With Acquired Brain Injury in Sweden
    Open this publication in new window or tab >>Support Persons' Perceptions of Giving Vocational Rehabilitation Support to Clients With Acquired Brain Injury in Sweden
    2016 (English)In: Journal of Social Work in Disability & Rehabilitation, ISSN 1536-710X, E-ISSN 1536-7118, Vol. 15, no 3-4, p. 351-369Article in journal (Refereed) Published
    Abstract [en]

    The aim is to explore the perception of being a support person for clients with acquired brain injury undergoing vocational rehabilitation. Nine support persons, identified by clients with brain injury, were interviewed. Interviews were analyzed using qualitative content analysis, resulting in three themes for assisting the client: (i) commitment; (ii) adaptation; and (iii) cooperation. Within each theme, multiple dimensions were identified, reflecting the complexity of vocational rehabilitation following acquired brain injury. Commitment built on social relations is linked to sustainability of support. The included support persons' role was especially valuable in contexts where adaptation and cooperation were required.

    Place, publisher, year, edition, pages
    Routledge, 2016
    Keywords
    Acquired brain injury, content analysis, empathy and support, inclusion, rehabilitation, return to work, support person, vocational rehabilitation
    National Category
    Social Work Other Health Sciences
    Research subject
    Social Work; Disability Science
    Identifiers
    urn:nbn:se:oru:diva-51616 (URN)10.1080/1536710X.2016.1220880 (DOI)000387348600010 ()27494552 (PubMedID)2-s2.0-84987662485 (Scopus ID)
    Available from: 2016-08-09 Created: 2016-08-09 Last updated: 2019-03-26Bibliographically approved
    3. Change in quality of life in relation to returning to work after acquired brain injury: a population-based register study
    Open this publication in new window or tab >>Change in quality of life in relation to returning to work after acquired brain injury: a population-based register study
    2018 (English)In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 32, no 13-14, p. 1731-1739Article in journal (Refereed) Published
    Abstract [en]

    PURPOSE: This study investigated changes in quality of life (QoL) in relation to return to work among patients with acquired brain injury (ABI).

    METHOD: The sample consisted of 1487 patients with ABI (63% men) aged 18-66 years (mean age 52) from the WebRehab Sweden national quality register database. Only patients who worked at least 50% at admission to hospital and were on full sick leave at discharge from hospital were included. QoL was measured by the EuroQol EQ-5D questionnaire.

    RESULTS: Patients who returned to work perceived a larger improvement in QoL from discharge to follow-up one year after injury compared to patients who had not returned to work. This difference remained after adjustment for other factors associated with improved QoL, such as having a university education, increased Extended Glasgow Outcome Scale scores and getting one's driving licence reinstated.

    CONCLUSION: Return to work is an important factor for change in QoL among patients with ABI, even after adjusting for other factors related to QoL. This is consistent with the hypothesis that having employment is meaningful, increases self-esteem and fosters participation in society. Thus, helping patients with ABI return to work has a positive influence on QoL.

    Place, publisher, year, edition, pages
    Taylor & Francis Group, 2018
    Keywords
    Stroke, life satisfaction, rehabilitation, traumatic brain injury, vocational rehabilitation
    National Category
    Neurology Occupational Therapy
    Identifiers
    urn:nbn:se:oru:diva-69466 (URN)10.1080/02699052.2018.1517224 (DOI)000453393600016 ()30296173 (PubMedID)2-s2.0-85054574457 (Scopus ID)
    Note

    Funding Agency:

    University Health Care Research Centre, Region Örebro County, Sweden

    Available from: 2018-10-09 Created: 2018-10-09 Last updated: 2019-01-08Bibliographically approved
    4. Risk markers for not returning to work among patients with acquired brain injury: a population-based register study
    Open this publication in new window or tab >>Risk markers for not returning to work among patients with acquired brain injury: a population-based register study
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-70255 (URN)
    Available from: 2018-11-19 Created: 2018-11-19 Last updated: 2018-11-20Bibliographically approved
  • 141.
    Matérne, Marie
    et al.
    Örebro University, School of Health Sciences.
    Lundqvist, Lars-Olov
    Örebro University, School of Law, Psychology and Social Work.
    Strandberg, Thomas
    Örebro University, School of Law, Psychology and Social Work.
    Support Persons’ Perceptions of Giving Vocational Rehabilitation Support to Clients With Acquired Brain Injury in Sweden: 2018In: Contemporary Perspectives on Social Work in Acquired Brain Injury / [ed] Grahame K. Simpson, Francis K. Yuen, Routledge , 2018, 1, p. 183-201Chapter in book (Refereed)
  • 142.
    Matérne, Marie
    et al.
    Örebro University, School of Health Sciences. University Health Care Research Center, Faculty of Medicine and Health, The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
    Lundqvist, Lars-Olov
    Örebro University, School of Health Sciences. The Swedish Institute for Disability Research.
    Strandberg, Thomas
    Örebro University, School of Law, Psychology and Social Work. The Swedish Institute for Disability Research.
    Support Persons' Perceptions of Giving Vocational Rehabilitation Support to Clients With Acquired Brain Injury in Sweden2016In: Journal of Social Work in Disability & Rehabilitation, ISSN 1536-710X, E-ISSN 1536-7118, Vol. 15, no 3-4, p. 351-369Article in journal (Refereed)
    Abstract [en]

    The aim is to explore the perception of being a support person for clients with acquired brain injury undergoing vocational rehabilitation. Nine support persons, identified by clients with brain injury, were interviewed. Interviews were analyzed using qualitative content analysis, resulting in three themes for assisting the client: (i) commitment; (ii) adaptation; and (iii) cooperation. Within each theme, multiple dimensions were identified, reflecting the complexity of vocational rehabilitation following acquired brain injury. Commitment built on social relations is linked to sustainability of support. The included support persons' role was especially valuable in contexts where adaptation and cooperation were required.

  • 143.
    Matérne, Marie
    et al.
    Örebro University, School of Health Sciences. University Health Care Research Center.
    Strandberg, Thomas
    Örebro University, School of Law, Psychology and Social Work. University Health Care Research Center.
    Lundqvist, Lars-Olov
    Örebro University, School of Health Sciences. 1University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
    Risk markers for not returning to work among patients with acquired brain injury: a population-based register studyManuscript (preprint) (Other academic)
  • 144.
    Matérne, Marie
    et al.
    Örebro University, School of Health Sciences. University Health Care Research Center, Faculty of Medicine and Health.
    Strandberg, Thomas
    Örebro University, School of Law, Psychology and Social Work.
    Lundqvist, Lars-Olov
    Örebro University, School of Health Sciences. University Health Care Research Center.
    Risk Markers for Not Returning to Work Among Patients with Acquired Brain Injury: A Population-Based Register Study2019In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study is to investigate person-related, injury-related, activity-related and rehabilitation-related risk markers for not return to work among patients with acquired brain injury (ABI).

    Methods: Retrospective data from the Quality register, WebRehab Sweden, on an ABI cohort of 2008 patients, was divided into two groups: those who had returned to work (n = 690) and those who had not returned to work (n = 1318) within a year of the injury.

    Results: Risk ratio analyses showed that several factors were risk markers for not returning to work: personal factors, including being a woman, being born outside of Sweden, having a low education level, and not having children in the household; injury-related factors, including long hospital stay (over 2 months), aphasia, low motor function, low cognitive function, high pain/discomfort, and high anxiety/depression; activity-related factors, including low function in self-care, inability to perform usual activities, and not having a driver's license; and rehabilitation-related factors, including being dissatisfied with the rehabilitation process and the attentiveness of the staff having limited influence over the rehabilitation plan, or not having a rehabilitation plan at all. Conclusion Several factors in different aspects of life were risk markers for not returning to work among patients with ABI. This suggests that rehabilitation and interventions need to address not only direct injury-related issues, but also person-related, activity-related, and rehabilitation-related factors in order to increase the patient's opportunities to return to work.

  • 145.
    Molin, Lisette
    et al.
    Örebro University, School of Health Sciences.
    Nilsson, Hanna
    Örebro University, School of Health Sciences.
    Tillgänglighet för alla – förlåt, vad sa du?: En enkätstudie om tillgänglighet på vårdcentraler för personer med hörselnedsättning inom region Örebro län2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 146.
    Müllerdorf, Maria
    et al.
    Mälardalen Univiversity, Eskilstuna, Sweden.
    Ivarsson, Ann-Britt
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    The use of creative activities in occupational therapy practice in Sweden2012In: Occupational Therapy International, ISSN 0966-7903, E-ISSN 1557-0703, Vol. 19, no 3, p. 127-134Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe the prevalence of creative activities in occupational therapy in Sweden and how often Swedish occupational therapists use creative activities as a means of intervention. A web-mail survey was sent to 2975 Swedish occupational therapists working in health care at regional, county council or primary health care level, and those working in vocational rehabilitation. A total of 1867 (63%) answered the questionnaire and showed that 44% did use creative activities as a means of intervention and most often by practitioners working in psychiatric health care. The most commonly used form of creative activity was arts and crafts followed by gardening. This web-mail survey was based on a limited amount of items regarding creative activities. Further research should focus on in-depth inquiries about how occupational therapists and their patients perceive the use of creative activities as a means of treatment in occupational therapy.

  • 147.
    Müllersdorf, Maria
    et al.
    Mälardalen University, Västerås, Sweden.
    Ivarsson, Ann-Britt
    Örebro University, School of Health Sciences.
    What, Why, How: Creative Activities in Occupational Therapy Practice in Sweden2016In: Occupational Therapy International, ISSN 0966-7903, E-ISSN 1557-0703, Vol. 23, no 4, p. 369-378Article in journal (Refereed)
    Abstract [en]

    Creative activities have historically been used in occupational therapy, and although their usage has declined in recent decades, they are still used in Swedish practice. The aim of this study was to better understand how occupational therapists use creative activities in practice. A web-based survey was sent to 520 occupational therapists, of which 304 (58.5%) responded. The main reason identified for using creative activities was to strengthen the client's occupational performance, well-being and self-esteem. The expected outcomes of applying creative activities were to support the client in self-expression and experiencing joy and desire. More than half of the occupational therapist respondents did not use creative activities to the extent they desired. Creative activities in occupational therapy are still used as a vital treatment to strengthen the clients' occupational performance abilities. The survey has looked at only a professional perspective on effectiveness of applying creative activities in occupational therapy. More research is needed to evaluate how occupational therapists internationally apply creative activities. There is also a need to gain information from the client's perspective on the therapeutic value of creative activities.

  • 148.
    Nilsson, Mats T
    et al.
    Karolinska Institutet, Department of Tumor Biology, Stockholm, Sweden.
    Klein, Gunnar O
    Karolinska Institutet, Department of Tumor Biology, Stockholm, Sweden.
    SEQ-ED - AN INTERACTIVE COMPUTER-PROGRAM FOR EDITING, ANALYSIS AND STORAGE OF LONG DNA-SEQUENCES1985In: COMPUTER APPLICATIONS IN THE BIOSCIENCES, ISSN 0266-7061, Vol. 1, no 1, p. 29-34Article in journal (Refereed)
    Abstract [en]

    The rapidly growing body of sequenced DNA demands efficient computer programs for its analysis and storage. The program described in this paper, SEQ-ED, has been designed to handle a large number of DNA sequences up to 200 kilobases [kb] long stored in a sequence library. In order to minimize the required storage space, the sequences are stored in a compressed format using three binary digits per base. In the development of this program, special care has been given to make it easy to use for molecular biologists without any previous computer experience.

  • 149.
    Nordstrand, Linda
    et al.
    Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden.
    Holmefur, Marie
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Kits, Annika
    Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden.
    Eliasson, Ann-Christin
    Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden.
    Improvements in bimanual hand function after baby-CIMT in two-year old children with unilateral cerebral palsy: a retrospective study2015In: Research in Developmental Disabilities, ISSN 0891-4222, E-ISSN 1873-3379, Vol. 41-42, p. 86-93Article in journal (Refereed)
    Abstract [en]

    The common assumption that early-onset intensive intervention positively affects motor development has rarely been investigated for hand function in children with unilateral cerebral palsy (CP). This retrospective study explored the possible impact of baby constraint-induced movement therapy (baby-CIMT) on hand function at two years of age. We hypothesized that baby-CIMT in the first year of life would lead to better bimanual hand use at two years of age than would not receiving baby-CIMT. The Assisting Hand Assessment (AHA) was administered at age 21 months (SD 2.4 months) in 72 children with unilateral CP, 31 of who received baby-CIMT. When dividing the children into four functional levels based on AHA, the proportional distribution differed between the groups in favour of baby-CIMT. Logistic regression analysis indicated that children in the baby-CIMT group were more likely than were children in the no baby-CIMT group to have a high functional level, even when controlling for the effect of brain lesion type (OR 5.83, 95% CI 1.44-23.56, p = 0.001). However, no difference was found between groups in the odds of having a very low functional level (OR 0.31, 95% CI 0.08-1.17, p = 0.084). The result shows that baby-CIMT at early age can have a positive effect. Children who received baby-CIMT were six times more likely to have a high functional level at two years of age than were children in the no baby-CIMT group.

  • 150.
    Norlén, Tobias
    et al.
    Örebro University, School of Health Sciences.
    Stridsman, Andrea
    Örebro University, School of Health Sciences.
    Orsaker till ljudkänslighet hos personer med autism - en systematisk litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
1234 101 - 150 of 196
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