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  • 1.
    Alexanderson, Kristina
    et al.
    Karolinska Institutet, Sektionen för försäkringsmedicin.
    Keller, Christina
    Jönköping University, Jönköping International Business School, JIBS, Informatics.
    von Knorring, Mia
    Karolinska Institutet, Sektionen för försäkringsmedicin.
    Paul, Ann-Sofi
    Karolinska Institutet, Sektionen för försäkringsmedicin.
    Ledning och styrning av hälso- och sjukvårdens arbete med patienters sjukskrivning: Resultat från 2013 och jämförelse med 20072013Report (Other academic)
    Abstract [sv]

    Hälso- och sjukvården är en av flera aktörer som är involverade i patienters sjukskrivning. År 2006 infördes den så kallade sjukskrivningsmiljarden för att stimulera landstingen i att förbättra kvaliteten i sjukskrivningshanteringen och att ge den ökad prioritet. Olika områden har betonats i sjukskrivningsmiljarderna, såsom kompetens, samverkan och jämställd sjukskrivning – samtliga har haft ett starkt fokus på att utveckla ledning och styrning av sjukskrivningsfrågan. 

    Syftet med den här studien var att få ökad kunskap om hur chefer på olika nivåer inom hälso- och sjukvården leder och styr arbetet med patienters sjukskrivning och om detta förändrats sedan 2007, då en motsvarande studie gjordes. 

    Metod: Kvalitativ och kvantitativ innehållsanalys har genomförts av semistrukturerade intervjuer med 72 chefer på tre nivåer inom hälso- och sjukvården; landstings- och regiondirektörer (nivå 1), chefer direkt underställda dessa och med övergripande ansvar för sjukhusvård respektive primärvård (nivå 2), samt strategiskt valda verksamhetschefer inom primärvård och sjukhusvård (nivå 3). Resultaten har jämförts med dem från 2007. 

    Resultat: Cheferna på samtliga tre nivåer såg nu ledning och styrning av sjukskrivningshantering som ett ansvar för cheferna i linjeorganisationen, vilket var en stor skillnad mot 2007. Det var stora variationer i hur ansvaret utövas, men analysen pekar på att frågan i högre utsträckning nu ägs och hanteras av cheferna, ofta med stöd av resurser utanför linjen. Frågan fanns också på agendan i högre utsträckning än tidigare på samtliga chefsnivåer – särskilt stor var förändringen på verksamhetsnivå. Många chefer beskrev att de nu leder och styr sjukskrivningsområdet på samma sätt som andra områden och att sjukskrivningsfrågan är införlivad med verksamhetens ordinarie ledningssystem. Chefernas kompetens i att leda och styra sjukskrivningsfrågan bedöms ha ökat sedan 2007. 

    Samverkan med Försäkringskassan har utvecklats. Etablerade former för samverkan finns på flera strukturella nivåer, och omfattar främst kompetensutveckling och hantering av specifika patientärenden och ibland projekt. Samverkan beskrevs generellt som positiv och ansågs ha lett till ökad förståelse för varandras uppdrag och roller. Samverkan med Arbetsförmedlingen och kommuner nämndes ibland; däremot nämndes samverkan med arbetsgivare eller företagshälsovård ytterst sällan. 

    Intern samverkan mellan kliniska verksamheter i sjukskrivningshanteringen har utvecklats men behöver förbättras ytterligare. I många verksamheter ingår flerprofessionellt samarbete i det patientnära arbetet med sjukskrivningar, som en del av överenskomna rutiner. Chefer beskriver att intern och extern samverkan underlättas av koordinatorer som organiserar och stöttar hanteringen av sjukskrivning och rehabilitering. 

    Kompetens och kompetensutveckling inom försäkringsmedicin framstod nu som ett relativt prioriterat område för cheferna, på samtliga nivåer och i betydligt högre utsträckning än 2007. Utbildningsinsatser har gjorts i samtliga landsting, dels som begränsad fortbildning,främst för läkare, dels som utbildning av expertresurser. Man lyfte behovet av kontinuerlig kompetensutveckling. Utbildningsinsatser uppfattas som nödvändiga men tidskrävande och att det är en utmaning att leda och styra detta då frågan sällan har hög prioritet bland läkare.

    Jämfört med 2007 har en tydlig förändring skett vad avser chefernas förhållningssätt till sjukskrivningsfrågan som blivit mer positiv. Sjukskrivning beskrevs nu som en del av vård och behandling. 

    Jämställd sjukskrivning är ett prioriterat område i sjukskrivningsmiljarden och finns nu på agendan i högre grad än 2007; få har dock vidtagit konkreta åtgärder. Ibland nämndes planer på åtgärder, och många hade tagit fram - eller planerade att ta fram - könsuppdelad sjukskrivningsstatistik. Området upplevdes som svårt och komplicerat att leda och styra, bland annat på grund av bristande kunskap inom området. 

    År 2007 framkom att kvalitetssäkring av arbetet med sjukskrivningar i princip inte förekom. Här har en utveckling skett. Uttalanden om kvalitet i och kvalitetssäkring av arbetet med sjukskrivningar handlade framför allt om uppföljning. Uppföljning begränsades i flera uttalanden till mätning av villkor som anges i sjukskrivningsmiljarden, så som andel läkarintyg som godkänts av Försäkringskassan. Mer sällan inbegrep uppföljning förbättringsarbete baserat på återkoppling eller analys av sjukskrivningsprocessen eller andra kvalitetsindikatorer. 

    Chefens ansvar för att skapa goda administrativa förutsättningar för arbetet med sjukskrivningar framhölls nu på samtliga tre nivåer; detta diskuterades endast i begränsad omfattning 2007. Administrativa förutsättningar som nämndes var riktlinjer och rutiner, tid för såväl patientarbete som för kompetensutveckling, tillgång till kompetensstöd från experter, lättillgänglig och korrekt information samt olika ”verktyg”. Resultatet pekar på att man i hög grad har infört rutiner för olika aspekter av sjukskrivningsarbetet, men det fanns fortsatt behov av effektivisering och kvalitetsförbättring, inte minst vad gäller IT- stöd. 

    Sjukskrivningsmiljarden bedöms ha haft mycket stor betydelse för att fokus har satts på sjukskrivningsfrågorna i landstingen. Många ansåg att sjukskrivningsmiljarden behövs ytterligare några år, även om det framkom en ambivalens till denna form av statlig styrning. Kortsiktigheten i överenskommelserna, att de kommer sent och att det nu finns fler miljardsatsningar ansågs göra verksamheten svårare att styra. 

    Slutsatser: Ledning och styrning av sjukskrivningshantering har i större utsträckning blivit en del av den ordinarie verksamheten inom sjukvården, och chefens roll i relation till sjukskrivningshanteringen har blivit tydligare jämfört med 2007. Sjukskrivningsmiljarden tycks ha haft en stor betydelse för att sätta sjukskrivningsfrågan på agendan på samtliga nivåer i hälso- och sjukvården. Sjukskrivning ses nu i stor utsträckning som en del av vård och behandling som skall ledas och styras på motsvarande sätt som annan verksamhet, till exempel vad gäller riktlinjer, rutiner och kvalitetssäkring. Sjukskrivningsfrågan är dock en fråga bland många andra, och det finns behov av särskilt stöd till linjen i att hantera den. Vi fann en stor förändring i chefernas syn på det egna ansvaret i sjukskrivningsfrågan, särskilt på verksamhetschefsnivå. Hälso- och sjukvården har med andra ord kommit en bra bit på väg i sjukskrivningsfrågan. 

    Mycket återstår dock att göra för att säkra ledningssystem, rutiner, och tillräckliga administrativa förutsättningar för ett optimalt arbete med hantering av patienters sjukskrivning. Särskilt gäller detta kvalitetssäkring, jämställd sjukskrivning, administrativa förutsättningar och den interna samverkan mellan olika kliniker.

  • 2.
    Alfredsson, Anette
    Jönköping University, School of Health Science, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Samma arbete, med mer samarbete: En fallstudie om hur Kundcentrerad planering kan tillämpas i syfte att öka patientdelaktighet inom kommunal hemsjukvård2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 3.
    Andersson, Sofia
    et al.
    Jönköping University, School of Engineering, JTH, Industrial Engineering and Management.
    Egger, Amanda
    Jönköping University, School of Engineering, JTH, Industrial Engineering and Management.
    Kartläggning av sjukfrånvaro på en distributionscentral2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose – The purpose of this study is to identify patterns in the absence due to illness at a distribution center with higher absence due to illness compared to other companies in the same industry, and to investigate how managers work with routines for absence due to illness. To achieve the purpose, it has been divided into two research questions:

    1. Which patterns in absence due to illness can be found at a distribution center with higher sick leave compared to other companies in the same industry?

    2. How do managers work with routines regarding the absence due to illness at a distribution center with higher sick leave compared to other companies in the same industry?

    Method – Theories about sick leave, work environment, psychosocial health, motivation, organization and leadership were collected to fulfil the purpose of the study. A case study was carried out to collect empirical data on the basis of interviews and document studies which then were compared with the theory for further analysis.

    Findings – The study identifies patterns that were found after mapping the statistics of the absence due to illness on the case company. The result shows that women have higher absence due to illness than men, mostly younger women and older men. Permanent and temporary employees have more absence due to illness than workers on deputy posts and that employees who have worked one to three years have more absence due to illness than other groups. The mapping also shows that employees have the highest sick leave in the fall, on Mondays and only one day is most prevalent. There are clear routines regarding sick leave and rehabilitation at the case company. Improvements can be made with the documentation in the web-portal for sick leave, how the first day reporting sick should be done, and that a comprehensive action plan could be designed for managers to use. The study shows that the managers who are committed and have a higher focus on creating a good group dynamic through activities generally have lower absence due to illness. By creating a satisfying work environment where employees have the opportunity to participate, influence, take responsibility, develop and be seen and heard can therefore improve productivity, motivation and workplace health.

    Implications – A mapping of absence due to illness can improve the same work on other companies and create a greater understanding of why some groups have higher absence due to illness in the workplace than others. This case study also shows that the work environment, motivation and leadership are essential to encourage health in the workplace which can be applied on companies in several sectors.

    Limitations – Deviation may have occurred as a large amount of data during the study was processed. To do a mapping is considered generalizable but the result may differ between companies, therefore is the study not applicable in all contexts. The authors consider however that the study could be applied in general to other businesses as work environment and absence due to illness is an issue in all industries. 

  • 4.
    Axelsson, Anna Karin
    Jönköping University, School of Health Science, HHJ. CHILD.
    Children with profound intellectual and multiple disabilities and their participation in family activities2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background. Families are essential parts of any community and throughout childhood one’s family serves as the central setting wherein opportunities for participation are offered. There is a lack of knowledge about participation of children with profound intellectual and multiple disabilities (PIMD) in family activities and how improved participation can be reached. Gathering such knowledge could enable an improvement in child functioning and wellbeing and also ease everyday life for families of a child with PIMD.

    Aim. The overall aim of this thesis was to explore participation seen as presence and engagement in family activities in children with PIMD and to find strategies that might facilitate this participation.

    Material and Methods. The research was cross-sectional and conducted with descriptive, explorative designs. First a quantitative, comparative design was used including questionnaire data from 60 families with a child with PIMD and 107 families with children with typical development (TD) (I, II). Following that, a qualitative, inductive design was used with data from individual interviews with parents of 11 children with PIMD and nine hired external personal assistants (III). Finally a mixed method design was conducted where collected quantitative data was combined with the qualitative data from the previous studies (IV).

    Results. It was found that children with PIMD participated less often, compared to children with TD, in a large number of family activities, however they participated more often in four physically less demanding activities. Children with PIMD also participated in a less diverse set of activities. Additionally, they overall had a lower level of engagement in the activities; however, both groups of children showed higher engagement in enjoyable, child-driven activities and lower engagement in routine activities. The motor ability of the child with PIMD was found to be the main child characteristic that affected their presence in the family activities negatively and child cognition was found to be the personal characteristic that affected their engagement in the activities. The child’s presence and engagement were influenced to a lesser extent by family socio-economic factors when compared to families with children with TD. Parents and hired external personal assistants described several strategies to be used to improve participation of the children with PIMD, such as by showing engagement in the activities oneself and by giving the child opportunities to influence the activities. The role of the hired external personal assistant, often considered as a family member for the child, was described as twofold: one supporting or reinforcing role in relation to the child and one balancing role in relation to the parents/the rest of the family, including reducing the experience of being burdened and showing sensitivity to family life and privacy.

    Conclusion. A child with PIMD affects the family’s functioning and the family’s functioning affects the child. Child and environmental factors can act as barriers that have the result that children with PIMD may experience fewer and less varied activities that can generate engaged interaction within family activities than children with TD do. Accordingly, an awareness and knowledge of facilitating strategies for improved participation in family activities is imperative. There needs to be someone in the child’s environment who sets the scene/stage and facilitates the activity so as to increase presence and engagement in proximal processes based on the child’s needs. The family, in turn, needs someone who can provide respite to obtain balance in the family system. External personal assistance includes these dual roles and is of importance in families with a child with PIMD.

  • 5.
    Beckhusen, Benedict
    Jönköping University, Jönköping International Business School, JIBS, Informatics.
    Mobile Apps and the ultimate addiction to the Smartphone: A comprehensive study on the consequences of society’s mobile needs2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The smartphone is omnipresent and is cherished and held close by people. It allows for constant connection within a digitally connected society, as well as for many other purposes such as leisure activity or informational purpose. Within the Information Systems studies deeper investigation is required as to what impact this “taken – for – granted” mobile access to information and mobile apps has for individuals and society and if a “technological addiction”can be developed when using the smartphone for everything during the day on such a constant basis.

    The aim of this study was to understand the role of the smartphone in society and to shed light on this unclear relationship between the constant use of a smartphone and its development towards an addictive quality. To reach a conclusion, in depth – interviews were conducted with participants about their relationship to the smartphone and their smartphone use based on questions derived from literature on mobile communication technologies and the types of digital addictions existing.

    The results are that the smartphone is a device that seamlessly integrates into our daily lives in that we unconsciously use it as a tool to make our daily tasks more manageable, and enjoyable. It also supports us in getting better organized, to be in constant touch with family and friends remotely, and to be more mobile which is a useful ability in today’s mobility driven society.

    Smartphones have been found to inhabit a relatively low potential to addiction. Traits of voluntary behaviour, habitual behaviour, and mandatory behaviour of smartphone use have been found. All of these behaviours are not considered a true addiction. In the end, it seems that the increase of smartphone use is mainly due to the way we communicate nowadays digitally,and the shift in how we relate to our social peers using digital means.

  • 6.
    Bergerum, Carolina
    Jönköping University, School of Health Science, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Quality Improvement in a Maternity Ward and Neonatal Intensive Care Unit. What are staff and patients' experiences of Experience-based Co-design?: Part 1: A qualitative study2012Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: Recent focus on quality and patient safety has underlined the need to involve patients in improving healthcare. “Experience-based Co-design” (EBCD) is an approach to capture and understand patient and staff (i. e. users) experiences, identifying so called “touch points” and then working together equally in improvement efforts.

    Purpose:This article elucidates patient (defined as the mother-newborn couple with next of kin) and staff experiences following improvement work carried out according to EBCD in a maternity ward and neonatal intensive care unit (NICU) in a small, acute hospital in Sweden.

    Method: An experience questionnaire, derived from the EBCD approach tool set, was used for continuously evaluating each event of the EBCD improvement project. Furthermore, a focus group interview with staff and in-depth interviews with mother-father couples were held in order to collect and understand the experiences of working together according to EBCD. The analysis and interpretation of the interview data was carried through using qualitative, problem-driven content analysis. Themes, categories and sub-categories presented in this study constitute the manifest and latent content of the participants’ experiences of Experience-based Co-design.

    Results:The analysis of the experience questionnaires, prior to the interviews, revealed mostly positive experiences of the participation. Both staff and patient participants stated generally happy, involved, safe, good and comfortable experiences following each event of the improvement project so far.

    Two themes emerged during the analysis of the interviews. For staff participants the improvement project was a matter of learning within the microsystem through managing practical issues, moving beyond assumptions of improvement work and gaining a new way of thinking. For patients, taking part of the improvement project was expressed as the experience of involvement in healthcare through their participation and through a sense of improving for the future.

    Discussion: This study confirms that, despite practical obstacles for participants, the EBCD approach to improvement work provided an opportunity for maternity ward /NICU care being explored respectfully at the experience level, by assuring the sincere sharing of useful information within the microsystem continuously, and by encouraging and supporting the equal involvement of both staff and patients. Staff and patients wanted and were able to contribute to the EBCD process of gathering information about their experiences, analyzing and responding to collected data, and engaging themselves in improving the same. Furthermore, the EBCD approach provided staff and patients the opportunity of learning within the microsystem. Nevertheless, the responsibility of the improvement work remained the responsibility of the healthcare professionals.

  • 7.
    Björklund, Anita
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. HHJ. Quality improvements, innovations and leadership in health care and social work. AFR.
    Arbetsterapeuternas 'hälsa'2006In: Vetenskapens dag 8 oktober, 2006Conference paper (Other (popular scientific, debate etc.))
  • 8.
    Björklund, Anita
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Arbetsterapeutparadigm1988Report (Other academic)
  • 9.
    Björklund, Anita
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Arbetsterapeutparadigm: Uttryck, mening och referens1994In: Arbetsterapeuten, ISSN 0345-0988, no 10, p. 21-25Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Professor Håkan Törnebohms paradigmteori.

  • 10.
    Björklund, Anita
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. HHJ. Quality improvements, innovations and leadership in health care and social work. AFR.
    Att studera Arbetsterapeutparadigm: Rapport från ett avhandlingsarbete1999In: Program för At-forum 25-26 mars, 1999Conference paper (Refereed)
  • 11.
    Björklund, Anita
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. CHILD.
    Berättelsen om "den obente" soldaten.1998In: Arbetsterapeuten, ISSN 0345-0988, no 13, p. 14-18Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Ett försök att reda ut begreppen med anknytning till ett arbetsterapeutiskt perspektiv.

  • 12.
    Björklund, Anita
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. AFR. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Focus on Occupational Therapists' Paradigms1999In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 13, no 3, p. 165-170Article in journal (Refereed)
    Abstract [en]

    The present study has an explorative design with its starting point in Törnebohm´s theory of paradigms. The primary aim of the study was to identify and characterize seven experienced occupational therapists´ perceptions of their profession, especially regarding world view and field of action view. The secondary aim was to find out if there were similarities among the respondents´ personal paradigms that could constitute a potential, local ideology for the group. Qualitative data were collected using audio- and video-taped, thematic discussions which involved focus groups on three occasions during the autumn of 1996. Within the two paradigm components world view and field of action view the data were analysed qualitatively. The results show several unifying factors and dissimilarities were limited to specifications within the unifying factors, with regard to the respondents´ notions. The unifying factors could be described as a potential, local ideology for the group.

  • 13.
    Björklund, Anita
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work. AFR.
    Function, action and/or well-being as health constituents in occupational therapy2006In: 5th Occupation UK and Ireland symposium in Occupational science 11-12 september: Health through occupation - the evidence, 2006Conference paper (Refereed)
  • 14.
    Björklund, Anita
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. HHJ. Quality improvements, innovations and leadership in health care and social work. AFR.
    Hälsa, kropp och arbetsterapi i ett professionsperspektiv2004In: At-forum 21-22 april, 2004Conference paper (Refereed)
  • 15.
    Björklund, Anita
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. HHJ. Quality improvements, innovations and leadership in health care and social work. AFR.
    Kunskapsmöte inom arbetsterapi.2001In: Vetenskapens dag 3 oktober, 2001Conference paper (Other (popular scientific, debate etc.))
  • 16.
    Björklund, Anita
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    'Occupation': Fokus för yrkesutövningen arbetsterapi.1999In: Arbetsterapeuten, ISSN 0345-0988, no 1, p. 4-9Article in journal (Other academic)
  • 17.
    Björklund, Anita
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. AFR. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Occupational therapy students' paradigms: A passage from beholder to practitioner.2000In: Australian Occupational Therapy Journal, ISSN 0045-0766, E-ISSN 1440-1630, Vol. 47, no 3, p. 97-109Article in journal (Refereed)
    Abstract [en]

    The present study has an explorative, comparative design with its starting point in Törnebohm´s theory of paradigms. The aim of the study was to identify and describe how qualified OT students perceived their future profession, especially regarding world view and field of action view, and to compare their conceptions with those of newly enrolled OT students in order to find out the differences and similarities between the two aggregations of paradigms. Data were collected in writing, using essay questions. Data analysis/synthesis was accomplished qualitatively. The comparision between the two groups was carried out through the structure of three themes with appurtenant categories. The qualified occupational therapist students´ notions gave expression to a constant application of a holistic health perspective which in contrast to those of the newly enrolled occupational therapist students resulted in numerous examples of interrelations between themes belonging to different paradigm components. In line with Törnebohm (1987) this is characteristic for paradigms.

  • 18.
    Björklund, Anita
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. HHJ. Quality improvements, innovations and leadership in health care and social work. AFR.
    Om arbetsterapeutstudenters och arbetsterapeuters syn på arbetsterapi2000In: Vetenskapens dag 3 oktober, 2000Conference paper (Other (popular scientific, debate etc.))
    Abstract [en]

    OBJECTIVES:

    To study quality of life and subjective post-concussion symptoms in adults (16-60 years) with a mild traumatic brain injury (MTBI) 3 months and 1 year after injury.

    METHODS:

    Of a total of 489 patients 173 responded to questionnaires at 3 months and at 1 year, including the SF-36 health-related quality of life survey, which is a standardized measure validated for Swedish conditions. Post-concussion symptoms were rated as either existing or non-existing in a 21-item checklist [a modified version of Comprehensive Psychopathological Rating Scale (CPRS)].

    RESULTS:

    SF-36 showed impaired scores in all dimensions. Existing post-concussion symptoms were reported by 1545%. Significantly, more symptoms were present at 3 months than at 3 weeks after injury. Furthermore, a significant correlation between higher rates of post-concussion symptoms and lower SF-36 scores was found. CONCLUSIONS:

    The SF-36 results were significantly impaired compared with an age- and gender-matched normative control group and the rate of post-concussion symptoms was significantly higher at 3 months than at 3 weeks after injury. As a significant correlation between higher rates of symptoms and low SF-36 scores was also found we assume SF-36 to be a sensitive enough measure of MTBI-related effects.

  • 19.
    Björklund, Anita
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. HHJ. Quality improvements, innovations and leadership in health care and social work. AFR.
    Om arbetsterapeutstudenters och arbetsterapeuters syn på arbetsterapi2001In: At-forum 17-18 maj, 2001Conference paper (Refereed)
  • 20.
    Björklund, Anita
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. HHJ. Quality improvements, innovations and leadership in health care and social work. AFR.
    Paradigmatik inom arbetsterapi.1998In: Vetenskapens dag 22 september, 1998Conference paper (Other (popular scientific, debate etc.))
  • 21.
    Björklund, Anita
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. HHJ. Quality improvements, innovations and leadership in health care and social work. AFR.
    Tematiska diskussioner med fokus på arbetsterapeuters verksamhet.1997In: Program för At-forum 13-14 mars, 1997Conference paper (Refereed)
  • 22.
    Björklund, Anita
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. AFR. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Borell, Lena
    Svensson, Tommy
    What Occupational Therapists Consider to be Worth Knowing: An Analysis of Swedish Occupational Therapists' Examination Papers 1984-96.1999In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 6, no 3, p. 127-133Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine and characterize an aggregation of experienced occupational therapists´ exam papers with regard to the occupational therapists´ research interests, concerning especially ontological and strategical matters, during the time period 1984-1996. The title pages, summaries and results discussions of 84 papers were analyzed qualitatively and quantitatively with the starting point in two of the components from Törnebohm´s structure of paradigms: the world view- and the field of action view-component. The occupational therapists´ interest in research subjects related to the field of action view component of paradigms, and applied research on strategical matters, dominates throughout the material. The interest in research subjects related to the world view component of paradigms, and basic research on ontological matters, increases in the last five year period. The increasing interest in more ontological matters seems as a natural and necessary progress for a profession which is deeply involved in knowledge aquired by experience. Only by the development of a “double-edged” knowledge, the profession has the possibility of developing and adapting to future demands.

  • 23.
    Björklund, Anita
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Svensson, Tommy
    A Longitudinal Study on the Transformation of Fifteen Occupational Therapist Students' Paradigms into Occupational Therapists' Paradigms.2006In: Australian Occupational Therapy Journal, ISSN 0045-0766, E-ISSN 1440-1630, Vol. 53, no 2, p. 87-97Article in journal (Refereed)
    Abstract [en]

    This study describes the transformation of 15 occupational therapist students’ paradigms into occupational therapists’ paradigms according to Törnebohm’s theory of paradigms, over a period of six years. This research particularly considers the paradigm components world view and field of action view in Törnbohm’s sense. Qualitative data were collected using essay-questions on three occasions: first week, and last semester, at the Occupational Therapy Programme at the School of Health Sciences, Jönköping, Sweden, and after three years of occupational therapy practice. A content-analysis of the collected materials was performed and the transformation of the informants’ views could be characterized as comprising three different perspectives: a ‘public’ view in 1995, a ‘theoretical’ view in 1998 and an ‘experiential/contextual’ view in 2001.

  • 24.
    Björklund, Anita
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Svensson, Tommy
    Begreppet 'Hälsa' som vägvisare för arbetsterapeuter.2005In: Arbetsterapeuten, ISSN 0345-0988, no 9, p. 10-14Article in journal (Other (popular science, discussion, etc.))
  • 25.
    Björklund, Anita
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Svensson, Tommy
    Femton arbetsterapeutstudenters paradigmutveckling genom utbildning och yrkespraktik: en sexårsstudie2007Conference paper (Refereed)
    Abstract [en]

    Studien handlar om paradigmutveckling hos arbetsterapeutstudenter, senare arbetsterapeuter, under en sexårsperiod. Speciellt studeras deras världsbild och verksamhetssyn enligt Törnebohms paradigmteori. Kvalitativ data samlades in genom essäfrågor, första veckan och sista terminen på arbetsterapeutprogrammet vid Hälsohögskolan i Jönköping, samt efter tre års yrkespraktik. Genom kvalitativ innehållsanalys framträdde informanternas syn på arbetsterapi vilken kan karaktäriseras som "allmänhetens syn" 1995, "teoretisk syn" 1998 och en "erfarenhetsbaserad/kontextuell syn" 2001.

  • 26.
    Björklund, Anita
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation.
    Svensson, Tommy
    Health, the Body and Occupational Therapy2000In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 7, no 1, p. 26-32Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to identify and characterise conceptions of health in a group of experienced occupational therapists. Data-collection involved the occupational therapists´ personal accounts of the meaning of health and data analysis was accomplished qualitatively. The material was found to comprise 52 distinguishable articulations of the meaning of health, which were categorized under three main themes: 22 articulations of Health as “feeling fine“; 20 articulations of Health as ability to act; and 10 articulations of Health as an objective state of body and/or mind. The results show a very strong tendency towards holistic health conceptions and also toward a phenomenological view on the body. If this tendency should be taken to reflect current basic views within the profession this would indicate a movement away from biomedical frames of reference on the theoretical level. This would seem to imply consequent movements on the practice level away from organ focused interventions to the benefit of interventions in the person/context dimension of occupational performance. Studies of processes of change seem to be needed and we suggest that a paradigm theory approach probably be most pertinent.

  • 27.
    Björklund, Anita
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Svensson, Tommy
    Read, Sanna
    Holistic and biomedical concepts of health: A study of health notions among Swedish occupational therapists and a suggestion for developing an instrument for comparative studies.2006In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 13, no 3, p. 141-150Article in journal (Refereed)
    Abstract [en]

    The objectives of this study were to inquire into notions of health among a group of 439 Swedish occupational therapists and to test a model derived from a qualitative study by Björklund and Svensson in a representative sample of occupational therapists in Sweden. The data were collected through a questionnaire and were analyzed using descriptive statistics, cluster analysis and confirmatory factor analysis. The means and ranking of the health notions showed that the Swedish occupational therapists most frequently hold holistic notions of health, and to a smaller extent biostatistical ones. Most Swedish occupational therapists indicate that being clearly conscious of one’s health notions is important both to themselves and to their profession. The test of the model provides a step towards developing an instrument for measuring notions of health that clearly distinguishes between holistic and biomedical ones and that could possibly be used for comparative studies.

  • 28.
    Bölte, S.
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Mahdi, S.
    Karolinska Institutet, Stockholm, Sweden.
    Coghill, D.
    University of Melbourne, Melbourne, Australia.
    Gau, S. S. -F
    National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Holtmann, M.
    University Bochum, Hamm, Germany.
    Karande, S.
    Seth G.S. Medical College and K.E.M. Hospital, Mumbai, India.
    Levy, F.
    University of New South Wales, Sydney, Australia.
    Rohde, L. A.
    Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
    Segerer, W.
    Swiss Paraplegic Research, Nottwil, Switzerland.
    de Vries, P. J.
    University of Cape Town, Cape Town, South Africa.
    Selb, M.
    ICF Research Branch a cooperation partner within the WHO Collaborating Center for the Family of International Classifcations in Germany (at DIMDI), Nottwil, Switzerland.
    Standardised assessment of functioning in ADHD: consensus on the ICF Core Sets for ADHD2018In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, p. 1-21Article in journal (Refereed)
    Abstract [en]

    Attention-deficit/hyperactivity disorder (ADHD) is associated with significant impairments in social, educational, and occupational functioning, as well as specific strengths. Currently, there is no internationally accepted standard to assess the functioning of individuals with ADHD. WHO’s International Classification of Functioning, Disability and Health—child and youth version (ICF) can serve as a conceptual basis for such a standard. The objective of this study is to develop a comprehensive, a common brief, and three age-appropriate brief ICF Core Sets for ADHD. Using a standardised methodology, four international preparatory studies generated 132 second-level ICF candidate categories that served as the basis for developing ADHD Core Sets. Using these categories and following an iterative consensus process, 20 ADHD experts from nine professional disciplines and representing all six WHO regions selected the most relevant categories to constitute the ADHD Core Sets. The consensus process resulted in 72 second-level ICF categories forming the comprehensive ICF Core Set—these represented 8 body functions, 35 activities and participation, and 29 environmental categories. A Common Brief Core Set that included 38 categories was also defined. Age-specific brief Core Sets included a 47 category preschool version for 0–5 years old, a 55 category school-age version for 6–16 years old, and a 52 category version for older adolescents and adults 17 years old and above. The ICF Core Sets for ADHD mark a milestone toward an internationally standardised functional assessment of ADHD across the lifespan, and across educational, administrative, clinical, and research settings. © 2018 The Author(s)

  • 29.
    Czarnecka, Anna
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Uppsökande tandvård och upplevelser om dess effekt på oral hälsa hos beroende äldre2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med studien var att undersöka tandhygienisters erfarenheter av uppsökande tandvård och deras upplevelser om dess effekt på oral hälsa hos beroende äldre.

    Metod: Studien bygger på en kvalitativ metod med en induktiv ansats. Nio legitimerade tandhygienister som arbetar med uppsökande tandvård inkluderades i studien. Inklusionskriterier var tandhygienister som arbetade med uppsökande tandvård i minst sex månader och minst två år som tandhygienist. Exklusionskriterien var tandhygienister som arbetade mindre än tre dagar i veckan med uppsökande tandvård. Intervjuer utfördes och analyserades med hjälp av kvalitativ innehållsanalys.

    Resultat: Uppsökande tandvård upplevdes höja engagemanget hos vårdpersonalen gällande den orala hälsan. En tanke har väckts att den orala hälsan tillhör resten av kroppen. Okunskap och attityder kunde dock begränsa effekten av arbetet med munvård. Känsla av frihet samt meningsfullhet nämndes som fördelar med arbetet med uppsökande tandvård. Faktorer som behövde förändras för att arbetet med uppsökande tandvård skulle vara mer effektivt och den orala hälsan bättre hos de äldre var större samverkan mellan professioner, bättre ergonomiskt stöd samt stöd till vårdpersonal som upplevdes för stressad.

    Slutsats: Äldre individer på vårdboende upplevs fortfarande ha en eftersatt munhygien. Uppsökande tandvård uppfattas vara en insats som sätter den orala hälsan i fokus, men det finns faktorer som försvårar arbetet med munvård på vårdboenden, främst på organisationsnivå. Trots detta finns möjligheter för att kunna erbjuda en mer adekvat munvård. 

  • 30.
    Deramore Denver, Belinda
    et al.
    Australian Catholic University, Australia.
    Adolfsson, Margareta
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Froude, Elspeth
    Australian Catholic University, Australia.
    Rosenbaum, Peter
    McMaster University, Canada.
    Imms, Christine
    Australian Catholic University, Australia.
    Methods for conceptualising ‘visual ability’ as a measurable construct in children with cerebral palsy2017In: BMC Medical Research Methodology, ISSN 1471-2288, E-ISSN 1471-2288, Vol. 17, no 46Article in journal (Refereed)
    Abstract [en]

    Background: Vision influences functioning and disability of children with cerebral palsy, so there is a growing need for psychometrically robust tools to advance assessment of children’s vision abilities in clinical practice and research. Vision is a complex construct, and in the absence of clarity about this construct it is challenging to know whether valid, reliable measures exist. This study reports a method for conceptualising ‘visual ability’ as a measurable construct. Methods: Using the items from 19 assessment tools previously identified in a systematic review, this study used a two-phase process: first, deductive content analysis linked items to the International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY), and second, vision-specific ‘Activity’-level items were explored using inductive thematic analysis. Results: The linking and content analysis identified that existing assessment tools are measuring vision across the ICF-CY domains of Body Functions, Activities and Participation, and Environmental and Personal Factors. Items specifically coded to vision at the Activity level were defined as measuring ‘how vision is used’, and these items form the basis of the conceptualisation that ‘visual ability’ is measurable as a single construct. The thematic analysis led to the identification of 3 categories containing 13 themes that reflect a child’s observable visual behaviours. Seven abilities reflect how a child uses vision: responds or reacts, initiates, maintains or sustains looking, changes or shifts looking, searches, locates or finds, and follows. Four interactions reflect the contexts in which a child uses their vision to purposefully interact: watches and visually interacts with people and faces, objects, over distance, and with hands. Finally, two themes reflect a child’s overall use of vision in daily activities: frequency of use, and efficiency of use. Conclusions: This study demonstrates an approach to exploring and explaining a complex topic utilising World Health Organization language and building on existing research. Despite the complexity of vision, the concept of ‘how vision is used’ can be clearly defined as a measurable construct at the Activity level of the ICF-CY. This study has identified observable visual behaviours that may be developed into items assessing how vision is used in daily activities.

  • 31.
    Edholm, Sigurd
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Alinder, Rasmus
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    En ny modell för att beskriva den posturala kontrollen hos underbensamputerade2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: För att minska risken för fallrelaterade skador hos amputerade är envaliderad modell som beskriver och undersöker balans viktigt. The invertedpendulum model (IPM) är en validerad modell som beskriver människans posturalakontroll vid stående. Validiteten är ifrågasättbar för transtibialtamputerade då desaknar aktiv plantarflektion i ankelleden. Därför hypotiserade Rusaw och Ramstrand(2016) att en ny modell krävdes.Metod: Protesanvändare (n = 8) och en kontrollgrupp (n = 7) utförde tre tester,stående på två kraftplattor, under tre olika villkor (totalt 9 tester). Villkoren var ögonöppna, ögon stängda samt feedback på viktfördelning. Data samlades in ochkorrelationskoefficienterna beräknades för att undersöka skillnaderna mellangruppernas medelvärden. För att validera modellen kinetiskt använde Alinder ochEdholm mekaniska begränsningar på kontrollgruppen. Detta i form av en anordningsom låste centre of pressure till en specifik punkt.Resultat: Som hypotiserat blev korrelationen mellan vänster sida för kontrollgruppen(r = -0.557) och den intakta sidan för protesbrukarna (r = -0.423) negativ. Dessutomvar korrelationen och för både protesanvändarna (r = 0.024) och kontrollgruppen (r= 0,207) nära 0 på högersida.Slutsats: Rusaw och Ramstrands (2016) nya modell kunde valideras utifrån resultatetpå denna studie.

  • 32.
    Eivarsson, Marie
    Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Ett tryggare och säkrare överflyttningssätt från intensivvård till vårdavdelning.: Ett förbättringsarbete med fokus på övervakningsutrustning och läkemedelslistor.2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 33.
    Falkenström, Caroline
    Jönköping University, School of Health and Welfare, HHJ. Oral health. Kvinna.
    Tidens tand: Äldre individers upplevelse kring användandet av ett tekniskt hjälpmedel som påminnelse för tandborstning2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The ability to perform oral self-care can be affected by frailty in the elderly.

    Aim: To analyze the experience of using assistive technology, a so called trigger, as a reminder of tooth brushing, for the home dwelling elderly.

    Method: The recruitment was done in collaboration with the public Dental service and the Institute of Gerontology at HHJ. Seven informants tested the trigger for a week. Two interviews regarding their life situation/oral hygiene and the experience around the trigger was performed.A qualitative inductive content analysis was performed.

    Result: The main category "use", was linked to the subcategory "approaches and habits", here the value of the use was linked to if the capacity to maintain oral hygiene was impaired. In "everyday structure" a need to adapt the trigger to a changing schedule was experienced.  The main category ”function” and the subcategory "unreliable" referred to the parts that malfunctioned. “Improvement opportunities” regarded the need to develop the signal system.

    Conclusion: The informants perceived themselves as too healthy in relation to "use". In “function” this can be perceived as a strength. It resulted in improvement suggestions, such as sound-developments for attention, that should be taken into account before further studies are performed.

  • 34.
    Fried-Oken, Melanie
    et al.
    Oregon Health & Science University, Portland, Oregon, USA.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Guest editorial: AAC and ICF: A Good Fit to Emphasize Outcomes2012In: Augmentative and Alternative Communication: AAC, ISSN 0743-4618, E-ISSN 1477-3848, Vol. 28, no 1, p. 1-2Article in journal (Other academic)
  • 35.
    Fristedt, Sofi
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Dahl, Anna
    Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Wretstrand, Anders
    Lunds universitet.
    Björklund, Anita
    Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Community mobility in older men and women - a cross-sectional and 13 years prospective perspective2014In: Sharing traditions Creating futures, 2014Conference paper (Refereed)
  • 36.
    Gashi, Fitnete
    Jönköping University, School of Health Science, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Evidensbaserad praktik i socialt arbete: En fallstudie av ett förbättringsarbete om hur ESL kan bidra till ökat brukarinflytande och delaktighet inom socialpsykiatri2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 37.
    Hallstedt, Karin
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Runesson, Jessika
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Kinetisk validering av den inverterade pendelmodellen för transfemoralt amputerade2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: It is known that transfemoral prosthesis users lack normal balance control and are more likely to fall. Research on this topic is insufficient. The Inverted Pendulum Model (IPM) is a commonly used biomechanical model for assessment of balance and postural control for healthy individuals based on an assumption that Center of Pressure (CoP) and Center of Mass (CoM) are inter-dependent. The aim of the study is to validate IPM kinetically for transfemoral prosthesis users.

    Method: Amputees (n=5) and a control group (n=5) participated. During data collection, participants stood on two force plates with eyes open, eyes closed and with weight-bearing feedback. Correlation of the distance CoP-CoM and CoMacc were calculated for anteroposterior and mediolateral directions and evaluated with three-way ANOVA.

    Result: Results showed significant interaction effects between condition and position plus group and position in anteroposterior direction and condition and group in mediolateral direction.

    Conclusion: Results indicate kinetic validity of IPM for transfemoral amputees when looking at the whole body but not at the amputated side in the A/P direction. Kinetic validity of IPM for the intact leg is questionable.

  • 38.
    Hjálmarsson, Bjarki
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Can an insole measure torsion in two different types of prosthetic feet?2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

     

     

    Introduction: There have not been any prosthetic feet available that can match an intact foot in functionality. Little focus has been on research on prosthetic foot performance in frontal plane motions and while most have investigated sagittal plane motions.

    Background: Normal gait is an artform of falling, thus the intact anatomical foot needs to be capable of handling a wide-range of environments. A prosthesis is an external helping aid for amputees, therefore they lack the ability to adapt to different environments. Most of the researches on prosthetic feet have focused on the sagittal plane, which has limited understanding and literature towards frontal plane motions. In this study a relatively new insole measuring system was used, Vebitosolution. The Vebitosolution insole has five separate sensors. It’s made from a flexible, specially shaped material to allow the sensors to measure independently, and measures both bending and torsional moments.

    Aim: The aim of the study to investigate if the Vebitosolution system is capable of measure torsional moments in frontal plane during straight line walk in two different types of prosthetic feet.

    Method: The participants were two transtibial amputees of that used the same size and category foot. They walked in a straight line with two different prosthetic feet.

    Results: There was a statistical significant difference (P < 0,05) for all measurements except for one (P > 0,05).

    Discussion: The results give indications that the Vebitosolution system is capable in differentiating between two different types of prosthetic feet. There are also indications of both product and gait specific gait pattern, but further researches are needed.  This research is limited by its sample size and amount of measurements performed.

    Conclusion: The take-away from this research is that the Vebitosolution system might be capable of measuring differences in frontal plane moments in two different types of prosthetic feet.

  • 39.
    Jarl, Gustav
    et al.
    Örebro University, Sweden.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    A model to facilitate implementation of the International Classification of Functioning, Disability and Health into prosthetics and orthotics2017In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553Article 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.

  • 40.
    Jensen, Anne-Mette
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Effekten af Silversplints til personer med Ehlers-Danlos syndrom og hypermobilitet målt på håndfunktion og mentalt arbejde. Et crossover kontrolleret pilotstudie.2018Independent thesis Basic level (degree of Bachelor), 10 HE creditsStudent thesis
    Abstract [da]

    Introduktion: Silversplints til personer med hypermobil Ehlers-Danlos syndrom er blevet udbredt i Danmark, men der findes ingen dokumenteret evidens for fingerortoserne til denne målgruppe. Hypermobilitet gør simple greb krævende og indikerer, at personer med EDS bruger væsentligt mere mental opmærksomhed på simple håndbevægelser sammenlignet med raske personer.

    Formål: Formålet med studiet var at undersøge effekten af silversplints til personer med EDS og hypermobilitet målt på henholdsvis håndfunktion og den mentale arbejdsbyrde præfrontalt.

    Metode: 5 deltagere med EDS samt 5 matchede kontrolpersoner blev rekrutteret. Den relative koncentration af O2Hb og HHb præfrontalt blev målt med fNIRS under Box and Block testen samt 3 øvrige modificerede håndfunktionstest. Målinger af deltagerne med EDS blev foretaget under to konditioner; uden og med silversplints.

    Resultat: fNIRS målingerne viste en signifikant reducering af den relative O2Hb koncentration og en tilsvarende signifikant øgning af den relative HHb koncentration ved anvendelsen af silversplints kontra ingen ortoser. Box and Block testen viste en signifikant forskel ved de to konditioner, og mens skrivetesten demonstrerede en signifikant forskel mellem deltagerne med EDS og kontrolgruppen.

    Konklusion: Silversplints reducerer den mentale arbejdsbyrde ved personer med EDS.

  • 41.
    Johansson, Ann
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Björklund, Anita
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Rehabilitera mera: En kartläggning av äldrerehabilitering i Jönköpings län2004Report (Other academic)
  • 42.
    Johansson, Yvonne A
    et al.
    Skaraborgs Sjukhus.
    Kenne Sarenmalm, Elisabeth
    Skaraborgs Sjukhus. Centrum för Forskning och Utveckling.
    Böl, Inger
    Skaraborgs Sjukhus. Utvecklingsenheten.
    Hospital transition to person-centered care - a culture journey in practice2017In: 30th World Congress on Advanced Nursing Practice September 04-06, 2017 | Edinburgh, Scotland: Exploring Latest Innovations and Advances in Nursing Practice, 2017, Vol. 2, p. 1-Conference paper (Refereed)
    Abstract [en]

    This action research project started in 2015 with the aim to achieve an overall sustainable hospital transition to person-centered care. In the first wave of change towards an overall hospital transition to person-centered care, hospital managers were invited to work-shops and discussions. Eight hospital units were nominated as pilot units. Specific acilitators/change leaders were educated in the philosophy of person-centered care. A learning network was created including the project managers, project unit managers and facilitators/change leaders. Based on the theory of person-centered care, and the importance of focusing soft skills and learning skills and not just technical skills, as well as experiences and reflections during this action research project, a general model for transition to person-centered care was developed. Steps included in the model: 1) Introduction; 2) V alues linked to person-centered care; 3) Multidisciplinary teams including/involving patients and/or next of kin; 4) Communication skills, and in-depth knowledge about person-centered care, 5) Practical application of the person-centered approach into clinical practice.

  • 43.
    Josephson, Iréne
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work.
    Bülow, Pia
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Hedberg, Berith
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Physiotherapists’ clinical reasoning about patients with non-specific low back pain, as described by the International Classification of Functioning, Disability and Health2011In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, no 23-24, p. 2217-2228Article in journal (Refereed)
    Abstract [en]

    Purpose: To explore and describe what physiotherapists experience they need to know about patients with non-specific low back pain (NSLBP) to make decisions about intervention.

    Method: Four focus groups containing a total of 21 physiotherapists were carried out in Sweden. Interviews were transcribed and qualitative content analysis performed. The manifest content was coded and categorised, and a theme emerged. Extracted symptoms and signs were linked to ICF codes.

    Result: Physiotherapists’ clinical reasoning represented a broad view on low back pain (LBP) including codes from all ICF components. The participants argued for individualisation of intervention to a specific patient’s problems. A theme of case complexity emerged, involving three levels: easy case, characterised by impairment in body function with close relation to specific body structures; complex case, characterised by impairments in body function, particular mental functions, activity limitations and participation restrictions, particular management of activity level and very complex case, characterised by impairments in body function, activity limitations and participation restrictions, and contextual factors, with help-seeking behaviour as a particular feature.

    Conclusion: The physiotherapists’ clinical reasoning reflected a broad view on patients with NSLBP, with variations related to case complexity. The use of ICF codes contributed to understanding that the physiotherapists applied a broad perspective on NSLBP as a health condition as well as to knowledge about how physiotherapists’ understand patients with NSLBP.

    Physiotherapists’ use of the ICF in clinical practice might facilitate identification and assessment of specific patient’s back pain problem as they occur in daily life and therefore be helpful in rehabilitation planning. Findings might also have an educational value.

  • 44.
    Kammerlind, A-S
    et al.
    Linköpings universitet.
    Fristedt, Sofi
    Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Ernsth Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Fransson, Eleonor
    Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Test-retest reliability of the Swedish version of the Life-Space Assessment Questionnaire among community-dwelling older adults2014In: Age well: Challenges for individual and society, 2014Conference paper (Refereed)
    Abstract [en]

    Background: Mobility is a vitally important activity throughout life. Advanced age carries increased risk of experiencing decreased mobility, with associated activity limitations and participation restrictions in social events. The Life-Space Assessment (LSA), originally developed by Sawyer Baker and colleagues in the U.S.A., has been used to measure mobility in community dwelling older adults. The LSA includes six levels of life-space, ranging from the person's bedroom to places beyond the person's hometown. A total LSA score is obtained by multiplying the life-space level reached by a value for independence and a value for the frequency of transportations. Three additional measures of life-space levels can be calculated: the independent life-space level; the assistive life-space level; and the maximal life-space level. Objective: To examine the test-retest reliability of the Swedish version of the Life-Space Assessment Questionnaire. Methods: At two test sessions, two weeks apart, 298 community-dwelling subjects between 75 and 90 years of age were asked about their life-space mobility during the past four weeks, and how often and whether they were independent from another person or equipment to reach different life-space levels. Results: None of the four scoring methods showed significant differences between test sessions. The mean total scores were 65 out of the maximum possible score of 120 at both test sessions. High levels were also found for independent, assisted, and maximal life-space at both sessions. ICC coefficients and weighted Kappa values between 0.84-0.94 were found for the total score, the independent and the assisted life-space levels indicating good to excellent reliability. The method error values showed that a change of 10 in the total score and a change of one level in any of the three life-space levels can be considered to indicate a real change in clinical practice. Conclusion: The Swedish version of the Life-Space Assessment Questionnaire can be reliably used among community-dwelling older adults.

  • 45.
    Kjellström, Sofia
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Status and trends of research ethics in Swedish nurses' dissertations2010In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 17, no 3, p. 383-392Article in journal (Refereed)
    Abstract [en]

    Research ethics is increasingly formally regulated, but little is known about how ethical considerations are reported in dissertations. The aim of this literature study was to describe the status and trends of ethical considerations in Swedish doctoral dissertations written by registerednurses. A total of 77 dissertations from 1987, 1997, and 2007 met the inclusion criteria and were analyzed by descriptive statistics. Ethical considerations were mostly overlooked in 1987, but almost ubiquitous by 2007. All dissertations in 2007, except one, had a section on ethical considerations; however, these were short, lacking in references, and short on content. The most common topic was informed consent and approval from research ethics review boards, followed by confidentiality and ethical aspects of methodological issues. Our results imply that the quantity and quality of ethical considerations must be improved in order to assure ethical soundness for participants, patients, researchers, and society.

  • 46. Lager, Ida
    et al.
    Lundahl, Ida
    Patienters personliga upplevelser av mikroprocessorstyrda protesknäleder: En kvalitativ studie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Objective: A lot of quantitative research has been performed on the differences between mechanical and microprocessor-controlled prosthetic knees. Limited research is availed on personal experiences of using different types of prosthetic knees. The aim of this study is to examine how three people using a transfemoral prosthetis have experienced the change from a mechanical prosthetic knee to a microprocessor-controlled prosthetic knee.

    Method: Three participants using transfemoral prostheses who have used both mechanical and microprocsessor-controlled prosthetic knees have been interviewed. The interviews have been transcribed and analyzed with an interpretative phenomenological method. To clarify the results interesting phenomena have been coded using ICF.

    Results: The participants experienced a greater sense of security with microprocessor-controlled prosthetic knee. This primarily affected the ability to walk down slopes. The participants also feel that walking is easier and the gait more symmetrical. There are however differences in how the participants feel these improvements have affected them and which aspects of their lives are changed.

    Conclusions: Participants experiences vary. In order to decide which prosthetic knee joint is most suited for an individual the clinical practicioner should get to know the person and identify their needs.

  • 47.
    Lenrick, Raymond
    Jönköping University, School of Health Science, HHJ, Quality Improvement and Leadership in Health and Welfare. Jönköping University, The Jönköping Academy for Improvement of Health and Welfare.
    A potential for further enhancing obstetrical safety: Patient harm measurement with the global trigger tool in the south-east health-care region of Sweden2012Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    A decade of heightened awareness concerning safety issues in healthcare since the Institute of Medicine’s awakening call has resulted in a string of counteroffensive measures. The pace of improvement has been slow and not altogether clear. Rates of patient harm are in general now measured by voluntary reporting and indicator measurements. The use of triggers or clues in random nurse-based reviews to enable identification of patient harm is a more effective method for measuring the overall rate of harm in a health care organisation. Measured actual overall rates of patient harm, their variations and patterns during delivery in the south-east health-care region of Sweden are not previously known. Measurement is important to patient safety improvement, as a foundation for accountability, effort selection and keeping track of results. The patient’s voice must also be much clearer in quality and safety improvement efforts in healthcare. The Institute of Healthcare Improvements Global Trigger Tool for measuring adverse events was used to review 1137 deliveries during 2011 in the seven departments (10% of all cases). Mother and new-born were both evaluated. Thirty eight patient harm events per 1000 patient days were identified, correlating to 13% of admissions. Presupposed rates among staff were double this value. Current patient safety indicators are half this value. One third of patient harm events at birth affected the new-born. Twenty different categories of harm were found. This study shows significantly higher rates of patient harm than previously reported. The nurse reviewers defined the method as valuable and a useful method for measuring harm at delivery. Limitations at this stage are no observed changes in health care delivery or clinical outcomes and that value assessment is based entirely on the judgement of the data-abstractors.

     

  • 48.
    Lindmark, Ulrika
    Jönköping University, School of Health and Welfare, HHJ. Oral health. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Resursrikedom och balans i livet ger god munhälsa hos 19-åringar2013Conference paper (Other academic)
    Abstract [sv]

    Syftet var att undersöka hälsoorienterade resurser bland 19-åringar och hur dessa interagerar med orala hälsorelaterade attityder och beteenden.Deltagare, 19-åringar som bor i Jönköping, var strategiskt utvalda i samband med den årliga undersökningen på Folktandvården. En strukturerad enkät besvarades innehållande bakgrundsfaktorer och Antonovskys livsfrågeformulär som mäter "känsla av sammanhang" (KASAM), följt av en tematiserad djupintervju. Den kvalitativa analysmetoden var Grounded Theory. Nio informanter (fyra kvinnor) har hittills tagits med i studien.Den preliminära analysen visar en kärnkategori, "Resursrikedom och balans i livet", som tycks vara avgörande för hälsosamma val som påverkar orala hälsorelaterade attityder och beteenden. Denna kärnkategori bygger på fem inbördes relaterade teman som beskriver olika dimensioner av hälsorelaterade resurser. Trygghet och stöd från familj och vänner, interna resurser såsom självtillit men också olika strategier för att hantera vardagen lyftes fram som centrala resurser. Värderingar och förväntningar, egen erfarenhet och behov, men också tankar om framtida orala hälsotillstånd, var viktiga för motivation till hälsosamma val. Dessutom ansågs tillgången till samhällets resurser såsom stormarknader, möjlighet till självhushåll, en hälsosam kost,  men också hälsobudskap från media, skola och tandvård samt den psykosociala miljön som påverkande faktorer för hälsosamma val.Slutsats: Samspelet mellan olika externa och interna resurser beskrevs som avgörande för hälsosamma val och oral hälsa. Fokus på individens resurser kan vara en framgångsfaktor i förebyggande och munhälsofrämjande åtgärder.

  • 49.
    Lindmark, Ulrika
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Oral health. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Abrahamsson, Kajsa H.
    Göteborgs Universitet.
    Oral health-related resources - a salutogenic perspective on Swedish 19-year-olds2015In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 13, no 1, p. 56-64Article in journal (Refereed)
    Abstract [en]

    The aim was to explore health-oriented resources among 19-year-olds and, specifically, how these resources interact with oral health-related attitudes and behaviour. To represent individuals with various psychosocial environments and socioeconomic areas, the participants were selected from different geographical locations of the Public Dental Service clinics in the county of Jönköping, Sweden. A structured questionnaire was distributed, including the instrument ‘sense of coherence’, for description of the study group, followed by a semi-structured thematized interview. The qualitative method used for sampling and analyses was grounded theory. Data sampling and analysis were performed in parallel procedures and ended up in a sample of ten informants (five women). In the analysis of interview data, a core category was identified, ‘Resources of Wealth and Balance in Life – a Foundation for Healthy Choices’, describing the central meaning of the informants’ perceptions of resources with an essential beneficial impact on oral health. The core category was built on five themes, which in turn had various subthemes, describing different dimensions of resources interacting with beneficial oral health-related attitudes and behaviour: ‘Security-building Resources and Support’, ‘Driving force and Motivation’,Maturity and Insight’,Health Awareness’ and ‘Environmental influences.’ The results elucidate personal and environmental health-oriented resources with influence on oral health-related attitudes and behaviours of young individuals. Such beneficial recourses should be recognized by dental personnel to promote oral health.

  • 50.
    Lindmark, Ulrika
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    H Abrahamsson, Kajsa
    Odontologiska fakulteten, Sahlgrenska Akademin, Göteborgs Universitet.
    Resources of Wealth and Balance in life – Essential for Oral health among Swedish 19-year olds2013In: International Journal of Dental Hygiene: Abstracts for the International Symposium on Dental Hygiene, Cape Town, South Africa, August 14–17, 2013 / [ed] Öhrn, Kerstin, 2013, Vol. 11, p. 163-164Conference paper (Other academic)
    Abstract [en]

    Objectives: The aim was to explore health oriented resources among 19-year olds and in specific how these health oriented recourses interacts with oral health related attitudes and behaviors.Methods: Participants, 19-year olds living in Jönköping, were strategically selected in connection with the annual examination at the Public Dental Service. A structured questionnaire included background factors and Antonovsky´s 13-items Life-orientation questionnaire measuring ‘Sense of coherence’ (SOC), followed by a thematized in-depth interview. The qualitative method chosen was Grounded Theory (GT). In accordance with GT, datasampling and analyses is performed in a parallel procedure that continues until new data do not bring anything vital into the analysis model. Nine informants (four women) have so far been included in the study.

    Preliminary results: The preliminary analysis model suggests a core category labeled ‘Resources of Wealth and Balance in Life’ which seemed to be essential for healthy choices influencing oral health related attitudes and behaviors. This core category is built on five interrelated themes describing different dimensions of health related recourses. Security and support from family and friends, internal resources such as self-efficacy but also different strategies to coop with everyday life were highlighted as central resources.  Values and expectation within life context, your own experience and needs but also thoughts about future oral health conditions, were important for motivation towards healthy choices. Moreover, availability to community resources such as supermarkets, opportunity for self-cooking and a healthy diet, but also health messages from media, school and dental care as well as the psychosocial environment were described as influencing factors for healthy choices.  Conclusions: The interplay between different external and internal resources were described as essential for healthy choices and oral health. Focusing on such beneficial resources could be a success factor in prevention and oral health promotion strategies. 

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