To Örebro University

BACKGROUND: The implementation of interventions in clinical practices is a challenge in healthcare settings, particularly in the field of habilitation. Although research on interventions in this area has increased, research on the implementation of these interventions has been slow. Exploring staff experience of implementation is therefore crucial to optimize the likelihood that interventions will be adopted and sustained in habilitation settings. The purpose of this systematic review is to synthesize the experiences of staff in implementing interventions for adults with congenital disabilities into a comprehensive overview.

METHODS: Studies were included if they provided empirical data on staff experiences of implementing interventions for adults with congenital disabilities in health and social care settings, regardless of study design. Non-empirical studies and grey literature were excluded. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, we conducted a search using the Medline, CINAHL, PsycInfo, Sociological Abstract, Applied Social Sciences Index and Abstracts (ASSIA), and Web of Science databases. The last search update was conducted in February 2024. The Critical Appraisal Skills Program (CASP) tool was used for qualitative studies, and the Mixed-Method Assessment Tool (MMAT) for the quantitative and mixed-method studies. The Convergent Integrated Approach (CIA) was employed to synthesize the data.

RESULTS: Of the 5855 studies initially retrieved, eight met the inclusion criteria. The analysis and integration of all included studies were categorized into three themes: (1) conditions for implementation, (2) acceptability of the intervention, and (3) approaches for change. The results underscore the importance of organizational resources, vision, and collaboration in successful implementation.

CONCLUSIONS: Active participation of professionals and alignment of interventions with existing practices were identified as key factors for success. The consideration of external factors that can influence the implementation of interventions is also important. In general, these findings provide information to guide future planning and implementation of interventions within habilitation settings.

SYSTEMATIC REVIEW REGISTRATION: Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/SBV9E.

This article directs attention to theory in academic writing. The empirical material analysed consists of 52 Swedish doctoral dissertations on social work in healthcare, published between 2008 and 2019. The aim of the study is to describe and suggest a framework for analysing the use of theories in research work. The results suggest that the field is characterised by an intersection of sciences, mirrored by two overarching ways of understanding theory. One approach, less frequently drawn upon, is analysed as influenced by the health sciences, understanding theory as a means of predicting outcomes by using different variables, without defining them within a broader theoretical framework. Theorising is here analysed as the enabling of predicting outcomes, by generalisations. The more common approach to theory is analysed as influenced by the social sciences, understanding theory as a way of understanding society and social relations, explicitly defining and referencing the concepts used. Within this second approach, theorising is done differently and, drawing on Wolcott<acute accent>s descriptions of ways of doing analysis in ethnography, we propose three ways of understanding this theorising, conceptualised as Description, Analyses and Interpretation. In the article we outline how different understandings of theory and theorising allow for different kinds of knowledge to be gained. The framework presented can be useful for students and researchers when planning research and writing academic texts, clarifying different ways of understanding theory and the potential use of variables and theoretical concepts: from aim, to analysis and implications.

INTRODUCTION: Traumatic brain injury (TBI) is a global health issue and a leading cause of long-term disabilities and mortality worldwide. There is growing evidence that TBI rehabilitation should be differentiated and individualised according to gender to provide more effective healthcare and rehabilitation. However, there is a lack of reviews focusing on the rehabilitation for women with TBI and there is a need to summarise existing knowledge to guide and individualise their rehabilitation. This scoping review aims to identify and map evidence on content and outcome of non-pharmacological rehabilitation for women with TBI aged below 65 years.

METHODS AND ANALYSIS: This scoping review will follow the methodological guidelines of the Joanna Briggs Institute (JBI) and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). The databases searched will be PubMed, CINAHL and PsycINFO. The following inclusion criteria will be applied: peer-reviewed studies published in English over the years 2000-2024 including description of content and outcomes of non-pharmacological TBI rehabilitation for women aged between 16 and 65 years in both inpatient and outpatient contexts. All severities of TBI ranging from concussion through to extremely severe will be included. Text and opinion papers, conference abstracts and grey literature will be excluded. Studies fulfilling the inclusion criteria will be independently reviewed by three researchers. A data extraction form will be used including specific details about the participants, concept, context, study methods and key findings. The results will be presented in tabular format accompanied by a narrative summary.

ETHICS AND DISSEMINATION: Due to the nature of data, no approval from an ethics committee is required. Dissemination of results are planned in an open-access peer-reviewed journal and in professional networks.

REVIEW REGISTRATION NUMBER: OSF, https://doi.org/10.17605/OSF.IO/QUY3T.

BACKGROUND: Coping with disabilities after stroke in midlife can be challenging, with potential gender differences that may have implications for quality of life (QoL) and support. This study aimed to explore QoL and resilience among midlife stroke survivors from a gender perspective.

METHODS: Quantitative questionnaire data related to demographics, function, service, resilience and QoL were gathered from a stroke register including 51 individuals (of whom 29 were men) aged 40-64 years. Results of gender were compared using two-sided t-tests and chi-square tests. Additionally, eight semi-structured telephone interviews were conducted, with equal representation of men and women. Qualitative content analysis was used to explore deeper and capture nuanced insights.

RESULTS: The quantitative analysis revealed no statistically significant gender differences. However, the qualitative data revealed three central themes: (1) "A Forced Lifestyle Change," (2) "Lack of Understanding and Support," and (3) "Importance of Independence and Coping Strategies." Men talked about feelings of being restricted in their post-stroke lives and expressed a greater need for support from healthcare providers, family, and friends. In contrast, women described having more well-developed coping strategies and reported a higher perceived QoL.

CONCLUSION: Qualitative findings suggest men may face greater challenges in adapting to post stroke life. The result suggests that men struggle with accepting limitations that prevent them from participating in social contexts and require more support from healthcare services. These difficulties, potentially due to less effective coping mechanisms, may result in a lower QoL. Gender-sensitive interventions addressing these needs could improve QoL and adaptation.

Health social work is often described as a blurred profession, as a work area based on an interdisciplinary field of science with an unclear knowledge foundation of its own. This study describes and analyses the knowledge production in Swedish doctoral dissertations in health social work, authored by social workers, from 2008 to 2019, and focuses on the differences between dissertations published by faculties of health and those in the social sciences. Descriptive statistical and content analysis was carried out on the 52 dissertations identified. Dissertations in the health sciences were often about specific patient groups within adult somatic care. They predominantly used mixed methods and psychological and psychosocial theories and models. Dissertations in the social sciences more often concerned adults in psychiatric or addiction care and the organization of social work. A majority used qualitative research methods, organization and profession theories, as well as interactionist and critical theories. The differences are discussed as being associated with different research ideals and traditions in the scientific disciplines. The findings raise questions about the core components of health social work and how a knowledge foundation and its development can enhance the professional development of social workers and their contribution to healthcare and patients.

BACKGROUND: People with disabilities experience significant health inequities compared with the general population. Addressing these inequities requires the development and implementation of tailored interventions, but a gap often exists between recommended best practices and the actual care provided. Successful implementation is complex, involving multiple organizational factors. Assessing organizational readiness for change is crucial to overcome barriers and improve health outcomes for people with disabilities. This study aims to examine managers' perceptions of their organization's readiness for change regarding the implementation of interventions within disability healthcare in Sweden.

METHODS: This descriptive cross-sectional study employs an embedded mixed-methods approach. The primary approach for the overall study is based on quantitative data, while qualitative data is analyzed to provide supplementary deepened information. Both types of data were collected simultaneously through a web-based survey. The data analysis involves various statistical techniques for the quantitative data and inductive content analysis for the qualitative data.

RESULTS: Several key factors influence managers' perceptions of their organization's readiness for change, including gender, age, tenure, organizational type, managerial level, and experience. Enabling factors for implementation include trust-based leadership, staff involvement, motivation, and engagement. Barriers include complex processes, lack of support, resistance and fear, and insufficient time and resources.

CONCLUSIONS: This study highlights the complexity of organizational readiness for disability healthcare interventions, shaped by both individual and organizational factors. In particular, managerial characteristics, organizational dynamics, and resource availability play key roles. These findings suggest that a comprehensive strategy can strengthen healthcare organizations' ability to navigate implementation challenges effectively.

BACKGROUND: Post-stroke fatigue (PSF) is a common complication following stroke that affects approximately 50% of stroke survivors.

PURPOSE: The purpose of this study was to investigate the role of comorbidities in PSF and the impact of PSF on Quality of Life (QoL). To achieve this, residual stroke symptoms have also been considered.

METHODS: The participants were stroke survivors living in a Swedish municipality. Self-reported data were collected via the Fatigue Assessment Scale (FAS), the Riksstroke questionnaire, and the Short Form Health Survey 36 (SF-36). Linear multiple regression and Spearman's correlation coefficient were used to analyze the data.

RESULTS: A total of 142 participants (83 men) with a mean age of 74.8 (SD 9.7) years were included in the study. Fatigue levels were classified as normal (FAS 10-21) for 70 (49.3%) individuals, mild-to-moderate (FAS 22-34) for 56 (39.4%) individuals, and severe (FAS 35-50) for 16 (11.3%) individuals. The mean FAS score was 23.3 (SD 8.2). Multiple regression analysis indicated that the presence of vertigo (β = 0.24, p = 0.004), chronic pulmonary disorders (β = 0.29, p = 0.003), and hemiparesis (β = 0.18, p = 0.05) were associated with more severe PSF. The model explained 19.2% of the variance in PSF. A higher level of PSF was associated with worse QoL in all eight SF-36 domains (r = -0.38 to -0.67).

CONCLUSIONS: Vertigo, chronic pulmonary disorders, and hemiparesis were significantly associated with more severe PSF. Additionally, higher levels of fatigue were associated with a worse QoL. These findings confirm that PSF is a multifaceted phenomenon, underscoring the importance of addressing PSF in rehabilitation to improve outcomes for stroke survivors.