To Örebro University

PURPOSE: Time management is essential to handle daily life in today's society. This study aimed to evaluate the effectiveness of the Swedish version of the Let's Get Organised (LGO-S) intervention to improve time-management skills for adults with impaired time management due to attention deficit hyperactivity disorder (ADHD), autism or mental disorders compared to treatment as usual (TAU), which is individual occupational therapy.

MATERIALS AND METHODS: This was a multi-centre, open, two-armed pragmatic randomised controlled trial. The setting was out-patient adult habilitation centres and psychiatric clinics. At baseline the study had 75 participants aged 19-61 years (mean 32.3 years) whereof 44 were women.

RESULTS: Both intervention groups showed statistically significant improvements in time-management skills, organisation and planning, emotional regulation, general self-efficacy and satisfaction with activities at post-intervention test. Most of these within-group improvements were sustained after 3 months. Changes in time-management skills between LGO-S and TAU intervention were not statistically significant at post-intervention or after 3-months. Programme completers in LGO-S had significantly better time management skills at the 3-month follow-up than non-completers.

CONCLUSIONS: This pragmatic RCT, conducted in a clinical environment including participants with complex difficulties, showed that both LGO-S and individual occupational therapy are clinically useful/applicable interventions that effectively improve time-management skills.

People with cognitive disabilities are often excluded from research due to the inaccessibility of methods and assessment tools. Critical challenges include ensuring self-determination, developing inclusive recruitment methods, and enabling effective communication, all of which are essential to inclusive research. This article describes the use of graphic vignettes-illustrating various forms of violence-combined with semi-structured interviews as a multimodal approach to promote sensemaking and reflexivity related to violence against persons with cognitive disabilities. This methodological study is based on a reflexive thematic analysis conducted with 17 participants with cognitive disabilities (18 years or older). It describes the development of the vignettes and interview strategies designed to elicit participants' own understanding of violence while supporting their decision-making and sense of control over the interview process. The article also discusses the implications and value of using vignettes and interviews as a multimodal research approach that not only maximizes accessibility and flexibility but also enhances self-determination and actively builds trust; key aspects that support sense-making of sensitive topics, such as violence. In doing so, this study provides key methodological insights that uniquely facilitate reflection and the direct participation of this population in research about their lives.

Summary: Dialogues between professionals and clients in social work are central to identifying and providing support for violence in close relationships. How professionals approach dialogues about violence in close relationships with clients with cognitive disabilities, and associated challenges to making them accessible, are understudied. Semi-structured interviews with 18 professionals in disability services, domestic violence shelters, social services, and health services in Sweden were conducted. Previous findings and gaps in theory motivated an inductive content analysis which generated four categories that illustrate challenges to accessible violence in close relationship dialogues.

Findings: The four categories comprise challenges about : understanding and reasoning about violence; self-determination and protection; adapting assessment tools and approaches; and urgent and long-term approaches. These challenges entail difficulties in creating shared understandings and handling conflicting rights of clients. Furthermore, they included the need to adapt and maintain the validity of assessment tools, as well as organizational restrictions on the use of long-term approaches.

Applications: The findings shed light on how professionals must simultaneously handle various aspects of violence in close relationship dialogues. Verbally adhering to a given description of a situation was restricted by the need to maintain a professional-client relationship. When motivating the need to accept support, professionals had to avoid manipulating clients. Furthermore, the findings indicate several weaknesses in current practice that professionals struggle to address individually, such as, overly extensive assessment tools and little guidance on identifying less overt forms of violence in close relationships. Professional guidance is required in social work practice and related fields.

INTRODUCTION: Parents with intellectual and developmental disabilities (IDDs) often need parenting support, but there are few evidence-based programmes adapted to their cognitive needs. Parenting Young Children (PYC), a home-based programme for parents with IDDs, is perceived as beneficial by parents and practitioners, but it is unclear if PYC improves parenting. The purpose of the proposed mixed-methods study is therefore to evaluate the PYC programme for improved parenting in parents with IDDs.

METHODS AND ANALYSIS: The quantitative evaluation will have a multi-centre, pretest-posttest study design and include parents with IDDs (children aged 0-9) in need of adapted parenting support. Goal-attainment in parenting skills, parental self-efficacy and child mental health will be measured outcomes. Interviews will be used to explore the perspectives of parents and children on PYC.

ETHICS AND DISSEMINATION: Particpation is based on informed consent from parents and guardians of the participating children. Ethical approval was granted by the Swedish Ethical Review Authority.

Parents with intellectual and developmental disabilities (IDDs) often need parenting support, but there are few evidence-based support programs adapted to these parents’ cognitive needs. Parenting Young Children (PYC) is a home-based parenting support program developed for parents with IDDs in Australia and has then been implemented in Sweden. PYC emphasizes individualized goals, breaking down complex skills into smaller steps, and collaborating with the parents. To investigate the usefulness and acceptability of PYC, it is of vital importance to explore how the intervention is perceived by the parents.

The aim of the present study was to explore how PYC is perceived by Swedish parents with IDD, in need of adapted parenting support when there is a risk for neglect.

Parents' experiences of PYC were explored shortly after completing PYC, using individual, semi-structured interviews that are audio-recorded and transcribed. Data were analysed using reflexive thematic analysis. In total, 15 parents (8 mothers, 7 fathers) have been interviewed. Participating parents have mild ID or other cognitive difficulties (e.g., ASD) and have children between 0-9 years of age.

The parents experienced increased security in parenting, improvements in parenting skills, and strengthened self-confidence. PYC influenced parent-child relationships so that the child's needs were put in focus. The parents also emphasized that their parental competence developed in a trusting, participatory process in which it was important to feel included and treated positively. A prerequisite was that the PYC-social worker cooperates with the parent and is sensitive to the parent’s specific needs and wishes. According to the parents, the PYC-social worker should focus on the relationship between the parent and the PYC-social worker, and parents' knowledge and skills to increase the parent's competence. It was also of vital importance to include the needs of both the child and the parent.

AIM: To determine the relationship between the Assisting Hand Assessment (AHA), valid for children aged 18 months to 18 years with unilateral cerebral palsy (CP), and the Mini-Assisting Hand Assessment (Mini-AHA), valid for children aged 8 months to 18 months, so results from the two tests can be compared.

METHOD: This psychometric study used AHA data from 157 children and Mini-AHA data from 86 children. In addition, data from children who had undertaken both the AHA and Mini-AHA assessments within a fixed time frame were sought. A Rasch measurement model analysis was conducted using a concurrent test linking technique when both tests have been undertaken by the same (common) persons.

RESULTS: Data from 23 children who completed both assessments were added to previous AHA and Mini-AHA data. Using the combined data, the common person test linking Rasch analysis showed the AHA and Mini-AHA test results were not equivalent and a conversion table of Mini-AHA units to AHA units was needed.

INTERPRETATION: Information from the conversion table will allow clinicians and researchers to measure changes in use of the affected hand during bimanual performance in children with unilateral CP from 8 months to 18 years.

BACKGROUND: Research on how parents with intellectual and developmental disabilities perceive the Parenting Young Children (PTC) support program for the development of parenting skills is scarce. The study explored parents' experiences of PYC's methodology.

METHOD: Interviews were conducted with 15 Swedish parents (8 mothers, 7 fathers) at risk for child neglect who had received PYC for 6 months or longer. The interviews were analysed with reflexive thematic analysis.

RESULTS: Two main themes, with six subthemes, were identified: "Developing a trusting relationship with the PYC practitioner" and "Tailored support, planning, and training in collaboration." One overarching theme was also created: "The PYC methodology facilitates learning of parenting skills through a trusting and collaborative process guided by adapted support."

CONCLUSION: Parents with intellectual and developmental disabilities perceived the PYC methodology as helpful and well-adapted. The study highlights that learning parenting skills can be facilitated by a collaborative and tailored approach using behavioural teaching strategies.

BACKGROUND: Approximately 30% of older adults admitted to hospital in Sweden are readmitted within three months. Short hospital stays and readmission can lead to further functional decline, as recovery appears to be poor at home after discharge.

AIM: To explore healthcare professionals' experiences of transitional care in older adults in order to prevent readmission.

METHODS: Four focus group interviews were conducted with healthcare professionals (n = 29). Data were analyzed using a phenomenographic approach.

RESULTS: Healthcare professionals' perceptions were compiled into seven descriptive categories. Three of the categories, i.e., resources, interprofessional coordination, and advanced care needs can be difficult to meet, described healthcare professionals' perceptions of the current stage of older adults-the first-order perspective, i.e., what something is. The remaining categories described the meanings of the healthcare professionals' perceptions.

CONCLUSION: Several interacting structural issues cause readmissions. These include premature discharge from hospital, poor hand-over between healthcare professionals, and a lack of qualified staff in the home-setting. To prevent readmission, medical competence and interprofessional teamwork must be improved in the home setting.

Introduction Previous research has shown that nursing home applicants had negative experiences of living and receiving care in their ordinary housing due to several factors, such as difficulties in everyday activities and being depressed. However, whether these experiences stand solely for nursing home applicants, or are common in an older population in general needs to be investigated.

Aim of this study was to compare nursing home applicants with matched older adults with respect to difficulties in everyday life, life satisfaction and depressive mood.

Methods Using a case-control design, 34 participants (17 in each group) were compared using Wilcoxon signed rank test for continuous variables and McNemar test for binary variables. The magnitude of associations was explored using conditional logistic regression.

Results Nursing home applicants experienced more difficulties in daily life and were more depressed than their matched peers, and this difference between groups was significant. To experience several difficulties in everyday life and being depressed increased the odds for a nursing home application.

Conclusions As aging in place is the societal norm, older adults with increased likelihood of nursing home applications need to be identified and catered for in an early stage, to prevent nursing home admission.

Introduction: Relatives are important when older adults return home after a hospital stay. The aim of this study was to describe close relatives' perspectives of the everyday activities of older adults who are repeatedly readmitted to hospital and discharged to home.

Methods: A semi-structured interview was performed to collect data from twenty relatives (aged 45-82 years). Data were analysed using a deductive qualitative content analysis based on the results of a previous study within this field.

Results: The overall theme 'In need of support to manage an unpredictable everyday life' shows that the older adults often needed support in everyday activities. In the two categories 'Difficulties in dealing with an unstable day' and 'Managing an unstable day' and the 10 subcategories, close relatives described that the older adults needed support in various ways from relatives or other individuals. Close contact was important for how everyday activities worked at home and in maintaining social contacts and contact with healthcare.

Conclusion: It was found that social needs, such as social contacts/activities, are just as important to assess at discharge as medical and functional needs.