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• 1.
Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Uppsala universitet.
Professionals' views of children's everyday life situations and the relation to participation2012Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, nr 7, s. 581-592Artikkel i tidsskrift (Fagfellevurdert)

Purpose: The aim was to determine professionals’ views of everyday life situations (ELS) of importance for children and to explore how ELS correlate with the construct ‘Participation’. This study was part of a larger work to develop a structured tool with code sets to identify child participation and support children with disabilities to describe what matters most for them in intervention planning.

Method: The study had a concurrent mixed methods design. Information from one open-ended question and questionnaires were linked to the ICF-CY component Activities and Participation. Two concurrent data sets were compared.

Results: Proposed ELS were distributed across ICF-CY categories from low to high level of complexity and context specificity. The correlation with participation became stronger for the later chapters of the component (d7-d9). Differences between respondents due to working field, country, and children’s ages were explored. Acts and tasks seemed most important for the youngest children whereas ELS shifted towards societal involvement for adolescents.

Conclusion: Eleven categories related to ICF-CY chapters d3-d9 emerged as ELS. Two age groups (infants/preschoolers and adolescents) are required to develop code sets for the new tool. The results need triangulation with other concurrent studies to provide corroborating evidence and add a family perspective.

• 2.
Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. University of Gothenburg, Sweden.
Pain management for children with cerebral palsy in school settings in two cultures: Action and reaction approaches2018Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, nr 18, s. 2152-2162Artikkel i tidsskrift (Fagfellevurdert)

Background: Children with cerebral palsy (CP) face particular challenges, e.g. daily pain that threaten their participation in school activities. This study focuses on how teachers, personal assistants, and clinicians in two countries with different cultural prerequisites, Sweden and South Africa, manage the pain of children in school settings.

Method: Participants’ statements collected in focus groups were analysed using a directed qualitative content analysis framed by a Frequency of attendance-Intensity of involvement model, which was modified into a Knowing-Doing model.

Results: Findings indicated that pain management focused more on children’s attendance in the classroom than on their involvement, and a difference between countries in terms of action-versus-reaction approaches. Swedish participants reported action strategies to prevent pain whereas South African participants primarily discussed interventions when observing a child in pain.

Conclusion: Differences might be due to school- and healthcare systems. To provide effective support when children with CP are in pain in school settings, an action-and-reaction approach would be optimal and the use of alternative and augmentative communication strategies would help to communicate children’s pain. As prevention of pain is desired, structured surveillance and treatment programs are recommended along with trustful collaboration with parents and access to “hands-on” pain management when needed.

• 3.
Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Uppsala universitet. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för beteendevetenskap och socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
Identifying Child Functioning from an ICF-CY Perspective: Everyday Life Situations Explored in Measures of Participation2011Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, nr 13-14, s. 1230-1244Artikkel i tidsskrift (Fagfellevurdert)

Purpose. This study was part of a larger work to develop an authentic measure consisting of code sets for self- or proxy-report of child participation. The aim was to identify common everyday life situations of children and youth based on measures of participation.

Method. The study was descriptive in nature and involved several stages: systematic search of literature to find articles presenting measures for children and youth with disabilities, identifying measures in selected articles, linking items in included measures to the ICF-CY, analysing content in measures presented as performance and participation and identifying aggregations of ICF-CY codes across these measures.

Results. A large number of measures for children and youth with disabilities were identified but only 12 fulfilled the inclusion criteria. A slight distinction in content and age appropriateness appeared. Measures presented as performance covered all the ICF-CY Activities and Participation chapters, whereas measures presented as participation covered five of nine chapters. Three common everyday life situations emerged from the measures: Moving around, Engagement in play and Recreation and leisure.

Conclusion. Only a small number of life situations for children and youth emerged from items in selected measures, thus, other sources are needed to identify more everyday life situations.

• 4.
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. AIR/Rheumatology Unit, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University Hospital, Linköping, Sweden. Rehabilitation Medicine, IKE, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. School of Occupational Therapy, La Trobe University, Melbourne, VIC, Australia.
Pain and Daily Activities in Rheumatoid Arthritis2012Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, nr 15, s. 1245-1253Artikkel i tidsskrift (Fagfellevurdert)

The aim of this study was to describe experiences of pain and its relationship to daily activities in people with rheumatoid arthritis (RA). Method. Seven semi-structured focus group discussions were conducted with 33 men and women of different ages with RA. Data were analysed with content analysis. Results. Pain affected everyday life and may be a barrier to perform valued activities. Regarding the impact of pain on participation and independence, personal factors and the social environment were found to be important. It could be a struggle to find the right activity balance, since it was easy to be overactive, triggering subsequent elevation of pain levels. However, the participants also described activities as a mediator of pain and a distraction from it.Conclusion. The relationship between pain and daily activities in RA was complex. Pain as an impairment was expressed to be related to activity limitations and participation restrictions, as well as to contextual factors. These findings highlight the clinical importance of paying attention to the complexity of pain and its relation to daily activities and participation.

• 5.
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
Disability and quality of life in individuals with postpolio syndrome.2000Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 22, nr 9, s. 416-422Artikkel i tidsskrift (Fagfellevurdert)

PURPOSE: The purpose of the study is to investigate disability and quality of life in individuals with the characteristic symptoms of postpolio syndrome. METHOD: Disability is assessed by means of the self-report activities of daily living instrument, and quality of life by means of Kaasa's questionnaire and the quality of life profile. RESULTS: The 39 subjects have on average lived with polio sequelae for 52 years. Their main difficulties are with moving, lifting and carrying. This means restricted mobility, sedentary activities and a need to prioritize. Half of them feel that polio has lessened their possibilities in life, and a quarter have still not accepted the limitations polio has involved. Nevertheless the majority report a high level of psychosocial well-being, and almost a quarter say that living with polio has meant personal development and strength. We found a significant correlation between on the one hand disability with regard to ambulation, arm strength and finger strength on the self-report ADL, and on the other hand the number of negative problems on the quality of life profile (0.33-0.45). CONCLUSION: The latter instrument needs further testing before its validity can be determined with certainty.

• 6.
Institute of Neuroscience and Physiology, Section of Clinical Neuroscience and Rehabilitation Medicine, University of Gothenburg, Sweden.
Institute of Neuroscience and Physiology, Section of Clinical Neuroscience and Rehabilitation Medicine, University of Gothenburg, Sweden. Institute of Neuroscience and Physiology, Section of Clinical Neuroscience and Rehabilitation Medicine, University of Gothenburg, Sweden.
Facilitators and barriers of stroke survivors in the earlypost-stroke phase.2009Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, nr 19, s. 1584-1591Artikkel i tidsskrift (Fagfellevurdert)

Purpose. To identify facilitators and barriers among persons with first-ever stroke discharged to the home in the first 3 months post-stroke by means of ICF categories.

Method. Stroke survivors were interviewed using semi-structured questions based on the ICF categories of Environmental factors of the Comprehensive ICF Core Set for Stroke (extended version) at 6 weeks and at 3 months post-stroke.

Results. The study sample exists of 67 stroke survivors with an average age of 71 years (51% women). Eleven environmental factors from the ICF chapters ‘support and relationship’, ‘products and technology’ and ‘services, systems and policies’ were experienced to be facilitators and only ‘physical geography’ was experienced as a barrier by 50% or more of the participants in the study.

Conclusions. It was possible to document facilitators and barriers among stroke survivors in a structured way using ICF categories. The high number of experienced facilitators gives an idea of how well stroke care functions in Sweden. There is a great need for further studies examining environmental factors in the post-stroke phase.

• 7.
Högskolan i Jönköping, Hälsohögskolan.
Institute of Neuroscience and Physiology, University of Gothenburg, Sweden. Institute of Neuroscience and Physiology, University of Gothenburg, Sweden.
Functioning of stroke survivors - a validation of the ICF core set for stroke in Sweden.2010Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, nr 7, s. 551-559Artikkel i tidsskrift (Fagfellevurdert)

Purpose. To validate the body functions and activities and participation part of the extended International Classification ofFunctioning, Disability, and Health (ICF) core set for stroke with a Swedish population in the first 3 months post-stroke.

Method. At 6 weeks and at 3 months post-stroke, stroke survivors were evaluated by 59 ICF categories of body functions, 59 categories of activities and participation from the stroke ICF core set (extended version).

Results. The study sample included 99 stroke survivors (54% women) with an average age of 72 years. Statistical significantproblems were identified in 28 ICF categories of body functions and in 41 ICF categories of activities and participation atboth time points, at 6 weeks and at 3 months. About 17 ICF categories were reported as problems in independent (i.e. modified Rankin Scale (mRS)$\leq$2) and about 34 categories in dependent (i.e. mRS42) stroke survivors.

Conclusions. The results suggest a possible reduction of the stroke ICF core set from 59 to 28 categories of body functionsand from 59 to 41 categories of activities and participation. Hence, feasibility of the core set for multiprofessional assessment increases and the core set might find more integration in clinical practice. The number of problems in mobility and self-care mainly distinguished between independent and dependent stroke survivors.

• 8.
Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Natl Board Hlth & Welf, Nord Ctr Classificat Hlth, S-16030 Stockholm, Sweden.
ARC, Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
Use of the International Classification of Functioning, Disability and Health (ICF) in social services for elderly in Sweden2012Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, nr 11, s. 959-964Artikkel i tidsskrift (Fagfellevurdert)

Purpose: To examine the content of health information in acts of social services of elderly people in relation to the International Classification of Functioning, Disability and Health (ICF) and to describe the health information in the different parts of the acts according to the ICF. Method: Health information of 25 acts from four municipalities was analysed and the concepts were linked to ICF codes, using the established coding rules. Results: The health information consisted of 372 concepts, which were linked to 122 specific ICF codes. The concepts in the acts were mostly linked to the ICF component Activities and Participation, except for the current functioning concepts where the ICF component Body functions was the most frequent. The 3rd level was most frequent in Activities and Participation and in Environmental factors, and the 2nd level was most frequent in Body functions. Conclusions: The ICF covers the concepts and terms contained in the acts to a large extent. Furthermore, the results show that the ICF codes differ in the different parts of the acts. The ICF provides a coherent and structured documentation, which contributes to a legally secure assessment of assistance. The selection of ICF codes can be used in development of "code sets" for social services for elderly.

• 9.
School of Exercise and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia.
Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia. School of Exercise and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia; School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia.
Community participation interventions for children and adolescents with neurodevelopmental intellectual disability: A systematic review2015Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, nr 10, s. 825-833Artikkel i tidsskrift (Fagfellevurdert)
• 10.
Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Department of Clinical and Experimental Medicine, Faculty of Rheumatology, Linköping University, Linköping , Sweden. Swedish Institute for Disability Research, Örebro University, Örebro , Sweden.
Important aspects of participation and participation restrictions in people with a mild intellectual disability2014Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, nr 15, s. 1264-1272Artikkel i tidsskrift (Fagfellevurdert)

Purpose: This study explored a possibility to assess the concepts of participation and participation restrictions in the International Classification of Functioning, Disability and Health (ICF) by combining self-ratings of the perceived importance with the actual performance of different everyday activities in people with a mild intellectual disability.

Method: Structured interviews regarding 68 items from the ICF activity/participation domain were conducted (n  = 69). The items were ranked by perceived importance, performance and by combined measures. Furthermore, the measures were related to a single question about subjective general well-being.

Results: Rankings of performance highlighted about the same items as “important participation”, while rankings of low performance addressed quite different items compared with “important participation restriction”. Significant correlations were found between subjective general well-being and high performance (r = 0.56), high performance/high importance (important participation) (r = 0.56), low performance (r = –0.56) and low performance/high importance (important participation restriction; r = –0.55).

Conclusions: The results support the clinical relevance of the ICF and the studied selection of 68 items. Although performance only may sometimes be a relevant aspect, knowledge about the relationship between the perceived importance and the actual performance is essential for clinical interventions and for research aiming to understand specific needs regarding participation.

• 11.
Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Kristianstad University, Sweden.
Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för socialt arbete. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Hälsohögskolan, HHJ. SALVE (Socialt arbete, Livssammanhang, Välfärd). Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
Linking youths’ mental, psychosocial, and emotional functioning to ICF-CY: Lessons learned2018Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, nr 19, s. 2293-2299Artikkel i tidsskrift (Fagfellevurdert)

Purpose: Linking ready-made questionnaires to codes within the International Classification of Functioning, Disability and Health, Children and Youth Version with the intention of using the information statistically for studying mental health problems can pose several challenges. Many of the constructs measured are latent, and therefore, difficult to describe in single codes. The aim of this study was to describe and discuss challenges encountered in this coding process.

Materials and methods: A questionnaire from a Swedish research programme was linked to the International Classification of Functioning, Disability and Health, Children and Youth Version and the agreement was assessed.

Results: Including the original aim of the questionnaire into the coding process was found to be very important for managing the coding of the latent constructs of the items. Items from the International Classification of Functioning, Disability and Health, Children and Youth Version chapters with narrow definitions for example mental functions, were more easily translated to meaningful concepts to code, while broadly defined chapters, such as interactions and relationships, were more difficult.

Conclusion: This study stresses the importance of a clear, predefined coding scheme as well as the importance of not relying too heavily on common linking rules, especially in cases when it is not possible to use multiple codes for a single item.

• Implications for rehabilitation
• The International Classification of Functioning, Disability and Health, Children and Youth Version, is a useful tool for merging assessment data from several sources when documenting adolescents’ mental functioning in different life domains.

• Measures of mental health are often based on latent constructs, often revealed in the description of the rationale/aim of a measure. The latent construct should be the primary focus in linking information.

• By mapping latent constructs to the International Classification of Functioning, Disability and Health, Children and Youth Version, users of the classification can capture a broad range of areas relevant to everyday functioning in adolescents with mental health problems.

• The subjective experience of participation, i.e., the level of subjective involvement, is not possible to code into the International Classification of Functioning, Disability and Health, Children and Youth Version. However, when linking mental health constructs to the International Classification of Functioning, Disability and Health, Children and Youth Version codes, the two dimensions of participation (the being there, and the level of involvement) need to be separated in the linking process. This can be performed by assigning codes focusing on being there as separate from items focusing on the subjective experience of involvement while being there.

• 12.
Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
Australian Catholic University, Melbourne. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
Strategies that facilitate participation in family activities of children and adolescents with profound intellectual and multiple disabilities: parents’ and personal assistants’ experiences2014Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, nr 25, s. 2169-2177Artikkel i tidsskrift (Fagfellevurdert)

Purpose: Participation throughout one's life plays a significant role for development and emotional well-being. For this reason, there is a need to identify ways to facilitate participation in family activities for children and adolescents with profound intellectual and multiple disabilities (PIMD).

Methods: The study design was qualitative and explorative, based on semi structured interviews with 11 parents and 9 personal assistants of children with PIMD.

Results: The interviews revealed participation-facilitating strategies relating to the children's/adolescent's proximal environment, such as "Availability and acceptability of the activity", "Good knowledge about the child" and a "A positive attitude of people close to the child", as well as strategies related to the children/adolescents themselves: "Sense of belonging", "Possible for the child/adolescent to understand", "Opportunities to influence" and "Feeling of being needed".

Conclusions: Children and adolescents with PIMD are dependent on support obtained through their environment. The identified strategies, individually adapted through awareness and knowledge by the parents and the personal assistants, provide important evidence to assist our understanding in gaining understanding about how to improve participation in family activities of children and adolescents with PIMD.

Implications for Rehabilitation Participation-facilitating strategies related to the child/adolescent and his or her proximal environments are identified to improve participation in children and adolescents with profound intellectual and multiple disabilities (PIMD). Examples of strategies for the child's/adolescents' proximal environment include "good knowledge about the child/adolescent", and, for the child/adolescent, include creating "sense of belonging" and "opportunities to influence". Identifying and making these strategies explicit may assist in enhancing the participation of children and adolescents with PIMD in family activities. People in the child's/adolescent's proximal environment need to set the scene for participation.

• 13.
School of Health and Welfare, Halmstad University, Sweden.
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Högskolan i Jönköping, Hälsohögskolan, HHJ. SALVE (Socialt arbete, Livssammanhang, Välfärd). Department of Research and Development, Region Halland, Halmstad, Sweden.
Documentation of everyday life and health care following gastrostomy tube placement in children: a content analysis of medical records2019Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, s. 1-11Artikkel i tidsskrift (Fagfellevurdert)

BACKGROUND: Everyday routines play a vital role in child functioning and development. This study explored health professionals' documentation of everyday life and health care during the first year following gastrostomy tube placement in children and the content of intervention goals.

METHODS: The medical records of 39 children (median age 38 months, min-max: 15-192) in one region of Sweden were analysed. A content analysis approach was used with an inductive qualitative analysis supplemented by a deductive, quantitative analysis of documented intervention goals following the ICF-CY.

RESULTS: One overall theme, "Seeking a balance", captured the view of life with a gastrostomy and the health care provided. Two categories, "Striving for physical health" and "Depicting everyday life" with seven sub-categories, captured the key aspects of the documentation. Twenty-one children (54%) had intervention goals related to the gastrostomy, and these goals primarily focused on the ICF-CY component "Body functions".

CONCLUSIONS: To some extent the medical records reflected different dimensions of everyday life, but the intervention goals clearly focused on bodily aspects. Understanding how health care for children using a gastrostomy is documented and planned by applying an ecocultural framework adds a valuable perspective and can contribute to family-centred interventions for children using a gastrostomy. Implications for Rehabilitation There is a need for increased awareness in healthcare professionals for a more consistent and holistic healthcare approach in the management of children with gastrostomy tube feeding. This study suggests that an expanded focus on children's participation in everyday mealtimes and in the healthcare follow-up of gastrostomy tube feeding is important in enhancing the intervention outcome. Multidisciplinary teams with a shared bio-psycho-social understanding of health would contribute to a situation in which the everyday lives of households adapt to living with gastrostomy. Routine care for children with gastrostomy should follow a checklist combining crucial physiological aspects of gastrostomy tube feeding with seemingly mundane family functions in order to achieve a successful gastrostomy tube feeding intervention.

• 14.
Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
The international classification of functioning, disability and health and the version for children and youth as a tool in child habilitation/early childhood intervention: feasibility and usefulness as a common language and frame of reference for practice2010Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, nr S1, s. 125-138Artikkel i tidsskrift (Fagfellevurdert)

Early childhood intervention and habilitation services for children with disabilities operate on an interdisciplinary basis. It requires a common language between professionals, and a shared framework for intervention goals and intervention implementation. The International Classification of Functioning, Disability and Health (ICF) and the version for children and youth (ICF-CY) may serve as this common framework and language. This overview of studies implemented by our research group is based on three research questions: Do the ICF-CY conceptual model have a valid content and is it logically coherent when investigated empirically? Is the ICF-CY classification useful for documenting child characteristics in services? What difficulties and benefits are related to using ICF-CY model as a basis for intervention when it is implemented in services? A series of studies, undertaken by the CHILD researchers are analysed. The analysis is based on data sets from published studies or master theses. Results and conclusion show that the ICF-CY has a useful content and is logically coherent on model level. Professionals find it useful for documenting children's body functions and activities. Guidelines for separating activity and participation are needed. ICF-CY is a complex classification, implementing it in services is a long-term project.

• 15.
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
Multivariate relationships between pain intensity and other aspects health in rheumatoid arthritis: Cross sectional and five year longitudinal analyses (the Swedish TIRA project).2008Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 30, nr 19, s. 1429-1438Artikkel i tidsskrift (Fagfellevurdert)
• 16. Boström, Katrin
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
Living with a chronic deteriorating disease: the trajectory with muscular dystrophy over ten years.2004Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 26, nr 23, s. 1388-1398Artikkel i tidsskrift (Fagfellevurdert)

PURPOSE: The aim of the study was to elucidate experiences of living with muscular dystrophy in terms of consequences for activity over 10 years. METHODS: The study population was identified in a prevalence study in a county of Sweden. Forty-six persons of this cohort with MD were interviewed. A qualitative research approach was chosen. The World Health Organization's International Classification of Functioning, Disability and Health (ICF) was used for categorization. RESULTS: Nearly all the subjects experienced a deterioration of physical capacity. Most obvious were the restrictions on mobility and increased fatigue and feebleness. The persons described psychosocial consequences of the muscular dystrophy as well as stigma when the disability had become more obvious. In spite of reported distress several persons experienced better psychological adaptation over time. The image of the future was often dark but several focus on today and avoid thoughts about the future. ICF showed some limitation with regard to temporal aspects, emotions and the subjective perspective. CONCLUSIONS: The knowledge of the trajectory with MD is important in order to offer the best possible treatment and support. Repeated assessment by ICF can serve as a valuable source of such knowledge, and a development of the classification would increase its usefulness in future analysis of functioning and disability.

• 17.
School of Occupational Therapy and Social Work, Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, Western Australia , Australia.
School of Occupational Therapy and Social Work, Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, Western Australia , Australia. Karolinska Institutet, Sweden. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Curtin University, Australia, Linköping University, Sweden.
Investigating the driving performance of drivers with and without autism spectrum disorders under complex driving conditions2019Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, nr 1, s. 1-8Artikkel i tidsskrift (Fagfellevurdert)

Purpose: The aim of this study was to investigate the driving performance of drivers with autism spectrum disorders under complex driving conditions.

Method: Seventeen drivers with autism spectrum disorders and 18 typically developed drivers participated in a driving simulator trial. Prior to the assessment, participants completed the Driving Behaviour Questionnaire and measurements of cognitive and visual-motor ability. The driving simulation involved driving in an urban area with dense traffic and unpredictable events.

Results: In comparison with the typically developed group, drivers with autism spectrum disorders reported significantly more lapses in driving, committed more mistakes on the driving simulator, and were slower to react in challenging situations, such as driving through intersections with abrupt changes in traffic lights. However, they were also less likely to tailgate other vehicles, as measured by time-to-collision between vehicles, on the driving simulator.

Conclusions: The performances of licensed drivers with autism spectrum disorders appeared to be safer in respect to car-following distance but were poorer in their response to challenging traffic situations. Driver education for individuals with autism spectrum disorders should focus on quick identification of hazards, prompt execution of responses, and effective allocation of attention to reduce lapses in driving.

• 18.
Göteborg University.
University, Göteborg. University of Linköping. Göteborg University.
A cost-effectiveness analysis of a health education programme for elderly persons with age-related macular degeneration: A longitudinal study2005Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 27, nr 20, s. 1203-1212Artikkel i tidsskrift (Fagfellevurdert)

Purpose: To analyse the cost-effectiveness of the activity-based Health Education Programme ’Discovering New Ways’ versus a standard Individual Programme. Method: Two-hundred and twenty-nine persons were randomized to either the Health Education Programme or an Individual Programme. The present study is based on 131 persons who participated in the 28-month follow-up. Costs for the low vision clinic were documented prospectively along with external costs. A cost-effectiveness analysis was done using cases with an improved level of perceived security in daily activities as the effectiveness measure. Results: The Health Education Programme led to significantly more cases with an improved level of perceived security (45 vs. 10%, CI 95%: 21-49, p value < 0.001) and the total social cost per treatment was lower (28 004 vs. 36 341 SEK). Taken separately the low vision clinic costs were slightly higher due to a higher prescription of assistive devices, but external costs were lower for the Health Education Programme compared to the Individual Programme, though neither of these differences was statistically significant. Conclusion: The results suggest that replacing the standard Individual Programme with the Health Education Programme ’Discovering New Ways’ is cost-effective as more persons experience increased security to a lesser total cost.

• 19.
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för beteendevetenskap och socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
Studying interaction between children who do not use symbols in interaction and their parents within the family system: methodological challenges2006Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 28, nr 3, s. 175-182Artikkel i tidsskrift (Fagfellevurdert)
• 20.
Tel Aviv University, Tel Aviv, Israel.
Use of virtual reality in rehabilitation of movement in children with hemiplegia - A multiple case study evaluation2012Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, nr 7, s. 593-604Artikkel i tidsskrift (Fagfellevurdert)

Purpose:

To evaluate the feasibility and therapeutic effect of engaging children of differing neuromotor and cognitive ability in a virtual reality (VR) tabletop workspace designed to improve upper-limb function.

Method:

Single-subject experimental design with multiple baselines was employed. Four children with hemiplegia participated in VR-based training between nine and 19, 30-minute sessions, over three-four weeks. Outcomes were assessed from the perspective of the International Classification of Functioning, Disability and Health; considering body function, activity performance and participation. Upper-limb performance was assessed using system-measured variables (speed, trajectory and accuracy) and standardized tests. Trend analyses were employed to determine trends on system variables between baseline phase and treatment phases. Standardised measures were compared between pre- and post-training.

Results:

Two children made progress across system variables with some translation to daily activities. Performance of the other two children was more variable, however, they engaged positively with the system by the end of the treatment phase.

Conclusions:

The VR (RE-ACTION) system shows promise as an engaging rehabilitation tool to improve upper-limb function of children with hemiplegia, across ability levels. Trade-offs between kinematic variables should be considered when measuring improvements in movement skill. Larger trials are warranted to evaluate effects of augmented feedback, intensity and duration of training, and interface type to optimise the system's effectiveness.

Implications for Rehabilitation:

The RE-ACTION system shows promise as a relatively low-cost solution to support therapies for upper-limb function and activity participation for children with hemiplegia and associated conditions. The combination of goal-directed tasks, augmented feedback, and engaging exploratory environments is a potentially quite powerful rehabilitation solution for children. Increased task engagement supported positive outcomes of the International Classification of Functioning, Disability and Health - Children and Youth version, including body function and activity levels as well as enhanced participation. Larger experimental trials are required to test the capacity of the system to progress the skills of children with multiple disabilities.

• 21.
Department of Occupational Therapy, Central Queensland University, Melbourne, Australia.
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Department of Occupational Therapy, Central Queensland University, Melbourne, Australia. School of Public Health La Trobe University, Melbourne, Australia.
The experience of attempting to return to work following spinal cord injury: a systematic review of the qualitative literature.2018Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, nr 15, s. 1745-1753Artikkel i tidsskrift (Fagfellevurdert)

PURPOSE: This review sought to answer the question "What are the barriers and facilitators influencing people's experience of return to work following spinal cord injury?"

METHODS: Studies that met the selection criteria were identified, presented and critically appraised using National Institute for Health and Care Excellence guidelines. Thematic synthesis was completed with studies possessing strong methodological rigor. Synthesis and interpretation involved three stages; coding of primary data; development of descriptive themes reflective of the primary data; and establishment of analytical themes to answer the review question.

RESULTS: Data from nine papers were included in the thematic synthesis. Several descriptive themes and three analytical themes were drawn from the data to answer the research question. Analytical themes included: a matrix of personal and environmental factors exists requiring complex navigation in order to create possibilities and opportunities for postinjury employment; the process of seeking or gaining employment shares a reciprocal relationship with the temporal nature of adjustment to spinal cord injury; and there is an intrinsic need for occupational engagement through paid employment.

CONCLUSIONS: Returning to or gaining employment after spinal cord injury is a fundamentally difficult experience for people. Multiple strategies are required to support the navigation of the process. There is, however, a need in people with spinal cord injury, to be a worker, and with that comes the inherent benefits of being employed. Implications for rehabilitation Returning to work should be a significant focus of spinal cord injury rehabilitation. Employment is both possible and health promoting following spinal cord injury. Multiple strategies are required to support people to navigate the return to work process. It is important to be cognizant of the individual motivations for being a worker and the complexity of the adjustment process. Spinal cord injury centers can provide a consistent and supportive framework and culture of positivity about employment after spinal cord injury.

• 22.
Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
The School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. University of North Carolina at Chapel Hill, USA. Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan. Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
Linkage of ICF-CY codes with environmental factors in studies of developmental outcomes of infants and toddlers with or at risk for motor delays2014Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, nr 2, s. 89-104Artikkel, forskningsoversikt (Fagfellevurdert)

Purpose: Environmental variables have been explored in studies of the development of young children with motor delays. Linking environmental variables to the International Classification of Functioning, Disability and Health – Children and Youth (ICF-CY), environmental factors (EFs) categories can provide a common language for documenting their contribution to developmental outcomes. This review of studies aimed to (1) link EFs for developmental outcomes in infants with or at risk for motor delays to ICF-CY categories and (2) synthesize the influences of EFs (with ICF-CY linkage) on developmental outcomes.

Method: A systematic literature search was performed of multiple databases. After applying selection criteria, environmental variables in 28 articles were linked to ICF-CY categories and underwent qualitative synthesis.

Results: Results indicated that physical environmental variables could be linked successfully to ICF-CY EFs categories, but not social environmental variables. Multiple environmental variables were associated with motor and other developmental outcomes.

Conclusion: Difficulties in linking social factors to ICF-CY categories indicate that additional EFs codes may need to be considered in the ICF-CY revision processes. The review provides empirical data on relationships between EFs and developmental outcomes in children with or at risk for motor delay.

• 23.
Mälardalens Högskola.
Mälardalens Högskola. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för beteendevetenskap och socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
The utility of ICF for describing interaction in non-speaking children with disabilities: Caregiver ratings and perceptions2007Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 29, nr 22, s. 1689-1700Artikkel i tidsskrift (Fagfellevurdert)
• 24.
Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för beteendevetenskap och socialt arbete.
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för beteendevetenskap och socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ. SALVE (Socialt arbete, Livssammanhang, Välfärd). Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
Physiotherapists’ clinical reasoning about patients with non-specific low back pain, as described by the International Classification of Functioning, Disability and Health2011Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, nr 23-24, s. 2217-2228Artikkel i tidsskrift (Fagfellevurdert)

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.

• 25.
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd.
Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd. Högskolan i Jönköping, Hälsohögskolan, HHJ. SALVE (Socialt arbete, Livssammanhang, Välfärd). Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för socialt arbete.
Problem-solving in physiotherapy - physiotherapists' talk about encounters with patients with non-specific low back pain2013Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 35, nr 8, s. 668-677Artikkel i tidsskrift (Fagfellevurdert)

Purpose: To investigate how physiotherapists talk about the choice of intervention for patients with NSLBP, particularly how professionals manage clinical encounters that may be experienced as challenging.

Method: Discourse analysis was performed of four focus groups’ talk. Twenty-one experienced physiotherapists working in primary health care in southern Sweden participated.

Results: Four focal themes appeared: Responsibility for health and health-related problems; Normalization – what counts as a normal back pain problem in relation to living an ordinary life; Change process – how to lead one’s life; and Individualization of the intervention in relation to the individual patient but also from the physiotherapists’ point of view. The themes shape an over-arching pattern of Problem-solving – which concerned both the professional task and the back pain problem, and was related to varying case complexity. This may have implications for the intervention the individual patient will be offered and on outcome.

Conclusions: Physiotherapists’ attitudes and approaches seem to entail components of professional and personal values which may influence patients’ access to health care, with a risk for unequal assessment and intervention as a consequence. We argue that enhanced physiotherapist-patient collaboration, including patient-led problem-investigation, is a prerequisite for improved outcome in terms of patient satisfaction, and for physiotherapy development. Future investigations of patients’ roles in specific face-to-face encounters are needed.

• 26. Lenardi, Mathilde
Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
From functioning and disability measurement to policy development: The experience of the EU-MHADIE Project (Measuring Health and Disability inEurope: supporting policy development)2010Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, ISSN ISSN 0963-8288, Vol. 32, nr S1, s. 139-147Artikkel i tidsskrift (Fagfellevurdert)
• 27.
Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Neurology, Public Health and Disability Unit, Neurological Institute C. Besta IRRCS Foundation, Milan, Italy.
Department of Health Statistics and Informatics, World Health Organization, Geneva, Switzerland. Hospital Universitario de la Princesa, Universidad Autonoma de Madrid, Madrid, Spain. National Disability Authority, Dublin, Ireland. Department of Health Statistics and Informatics, World Health Organization, Geneva, Switzerland. Department of Health Statistics and Informatics, World Health Organization, Geneva, Switzerland. European Federation of Neurological Association, Brussels, Belgium. Högskolan i Jönköping, Högskolan för lärande och kommunikation. Italian WHO Collaborating Centre for the Family of International Classifications, Friuli Venezia Giulia Region, Udine, Italy. Health Services Research Unit, IMIM-Hospital del Mar, Barcelona, Spain. Regione Lombardia, Direzione Generale Famiglia e Solidarietà Sociale. National Authority for the Persons with Handicap, Bucharest, Romania. National Disability Authority, Dublin, Ireland. Institute for Health and Rehabilitation Sciences, Ludwig-Maximilians-University, Munich, Germany. Department of Rehabilitation Medicine, Charles University, Prague, Czech Republic. Department for Medical Psychology, University Clinic of Hamburg-Eppendorf , Hamburg, Germany. Institute for Rehabilitation, Republic of Slovenia, Ljubljana, Slovenia. Institute for Rehabilitation, Republic of Slovenia, Ljubljana, Slovenia. Neurology, Public Health and Disability Unit, Neurological Institute C. Besta IRRCS Foundation, Milan, Italy. Swiss Paraplegic Research (SPF), ICF Research Branch of the World Health Organization' Family of International Classifications Collaborating Center in Germany.
Integrating research into policy planning: MHADIE policy recommendations2010Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, nr S1, s. 139-147Artikkel i tidsskrift (Fagfellevurdert)

MHADIE project (Measuring Health and Disability in Europe: Supporting policy development) aimed at developing realistic, evidence-based and effective national policies for persons with disabilities. A preliminary step towards this goal was the demonstration on the feasibility of employing the ICF in clinical, educational and statistical fields, which corresponds to the recognised need to enhance the European Union's capacity of analysis of disability, as highlighted in its Disability Action Plan 2006–2007. The ultimate outcome of the project is the production of 13 policy recommendations, dealing with statistics clinical and educational areas, and four general policy recommendations focusing on: (a) the need of coordinating and integrating disability conceptualisation at all policy levels and across sectors; (b) the need of conducing longitudinal cohort studies which include children aged 0–6; (c) the need of reviewing transportation policies in light of the requirements of persons with disabilities; (d) the need of reviewing all disability policies to emphasise and support the role of the family, which is a consistent and substantial environmental facilitator in the lives of persons with disabilities.

• 28.
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
Swedish Institute for Health Sciences, Lund University, Lund, Sweden.
Experiences of providing prosthetic and orthotic services in Sierra Leone - the local staff's perspective2012Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, nr 24, s. 2111-2118Artikkel i tidsskrift (Fagfellevurdert)

In Sierra Leone, West Africa, there are many people with disabilities in need of rehabilitation services after a long civil war. Purpose: The aim of this qualitative study was to explore the experiences of prosthetic and orthotic service delivery in Sierra Leone from the local staff’s perspective. Method: Fifteen prosthetic and orthotic technicians working at all the rehabilitation centres providing prosthetic and orthotic services in Sierra Leone were interviewed. The interviews were transcribed and subjected to latent content analysis. Results: One main theme emerged: sense of inability to deliver high-quality prosthetic and orthotic services. This main theme was generated from eight sub-themes: Desire for professional development; appraisals of work satisfaction and norms; patients neglected by family; limited access to the prosthetic and orthotic services available; problems with materials and machines; low public awareness concerning disabilities; marginalisation in society and low priority on the part of government. Conclusions: The findings illustrated traditional beliefs about the causes of disability and that the public’s attitude needs to change to include and value people with disabilities. Support from international organisations was considered necessary as well as educating more prosthetic and orthotic staff to a higher level.

• 29.
Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. National Oral Disability Centre for Rare Disorders, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
Departement of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden. CHU Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för beteendevetenskap och socialt arbete.
Specialised dental care for children with complex disabilities focusing on child's functioning and need for general anaesthesia2017Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 39, nr 24, s. 2484-2491Artikkel i tidsskrift (Fagfellevurdert)

PURPOSE: To describe and analyse dental care and treatment modalities for children with complex disabilities from a biopsychosocial perspective, with special focus on dental treatment under general anaesthesia (GA) and its relationship to child's functioning.

METHOD: An ICF-CY Checklist for Oral Health was completed using structured interview, direct observations, and dental records for patients attending a specialist paediatric dentistry clinic. Descriptive and comparative data analysis was performed. Performance qualifiers from the ICF-CY component Activities and participation were used to calculate functional factors.

RESULTS: Median referral age was 1.5 years and the majority were referred by their paediatrician. Almost all visited a dental hygienist regularly. Dental treatment under GA was common and was combined in 78% of sessions with medical treatment. Children with limitations in their interpersonal interactions and relationships were most likely to have dental GA.

CONCLUSION: Children without caries experience had been referred for specialist dental care at an earlier age than children with caries experience. GA was a common treatment modality and dental and medical treatments were coordinated under the same GA for a majority of children. By using the ICF-CY, it was possible to identify functional limitations characterising children with disabilities that require dental treatment under GA. Implications for Rehabilitation Early referral to a specialist in paediatric dentistry is valuable for oral disease prevention in children with disabilities. Availability of dental treatment under general anaesthesia (GA) is also important. Combining dental and medical interventions during the same GA session optimises resources both for the individual and for the health organisation. Children with limitations in interpersonal interactions and relationships are more likely to need dental treatment under GA than other children.

• 30.
Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
Mälardalens högskola. Tandvårdshögskolan, Malmö högskola. Clermont Université, Université d’Auvergne, EA3847, Centre de Recherche en Odontologie Clinique, Clermont-Ferrand, France. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
Oral health, medical diagnoses, and functioning profiles in children with disabilities receiving paediatric specialist dental care – a study using the ICF-CY2015Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, nr 16, s. 1431-1438Artikkel i tidsskrift (Fagfellevurdert)

Purpose: To describe 0–16-year-old children with disabilities receiving paediatric specialist dental care from a biopsychosocial perspective, with focus on relationship between oral health, medical diagnosis, and functioning. Method: A questionnaire with an International Classification of Functioning, Disability and Health – Children and Youth version (ICF-CY) Checklist for Oral Health was completed using structured interview, direct observation, and information from dental records. Descriptive data analysis was performed together with principle component analysis to calculate factors of functioning used in cluster analysis in order to present functioning profiles. Results: Ninety-nine children with at least one major medical diagnosis were included. Twenty had previous caries experience. Two factors of functioning were calculated, labelled “Physical ability” and “Intellectual ability, communication, and behaviour”. Based on functioning profiles three clusters were determined. There were no statistically significant differences in caries experience between medical diagnoses or clusters. Conclusion: It was possible to identify profiles of functioning in children with disabilities receiving specialist dental care. Despite complex disabilities, the children had good oral health. Neither medical diagnosis nor functioning was found to have a clear relationship with oral health. To understand the environmental context leading to high-quality oral health, further studies of dental management in relation to medical and oral diagnoses and child functioning are needed.

Implications for Rehabilitation

• Child Oral Health

• The use of ICF-CY makes it possible for paediatric dentists to assess children’s functioning, disability, and health from a biopsychosocial perspective, showing that the medical diagnosis alone is not enough to assess functions relevant for oral health in the individual.

• In order to adequately organize, plan, and improve dental care for this heterogenic group of young patients with disabilities a biopsychosocial approach is valuable, aiding a holistic perspective on oral health.

• Despite complex medical and functional disabilities that may challenge oral health and dental care, this study finds oral health to be good in a group of children with disabilities attending a specialist dental clinic.

• 31. Nätterlund, Birgitta
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
Disability, coping and quality of life in individuals with muscular dystrophy: a prospective study over five years.2000Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 22, nr 17, s. 776-785Artikkel i tidsskrift (Fagfellevurdert)

PURPOSE: The present study investigates progressive muscular dystrophy over a five year period. The purpose is twofold: to describe changes over time and to investigate relations between disability, coping and quality of life. METHOD: The study group comprised 45 adults (16 men and 29 women), with an average age of 44 years. All were assessed in 1991 and 1996, with the following instruments: the ADL staircase, the Self-report ADL, the Mental Adjustment to Cancer scale, the Sickness Impact Profile and the Psychosocial well-being questionnaire (Kaasa). RESULTS: Increasing disability was accompanied by an increase in dependence on others and a significant deterioration of health-related quality of life and with regard to 'Satisfaction'. The predominant type of coping was 'Fighting spirit', whilst 'Fatalism' showed the greatest decline over time. 'Ambulation' and the ADL staircase correlated with 'Physical index' on the SIP. Correlations between disability, coping and quality of life were moderate. The results can serve as a basis for planning and evaluation of recurring rehabilitation for persons with MD.

• 32. Nätterlund, Birgitta
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
The illness experience of adult persons with muscular dystrophy.2001Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 23, nr 17, s. 788-798Artikkel i tidsskrift (Fagfellevurdert)

PURPOSE: The purpose of the present study is to describe the illness experience of persons with muscular dystrophy, their experience of activities of daily living, and whether there are any differences in how different types of muscular dystrophy affect people's lives. METHOD: Fifty-eight subjects were interviewed on two occasions. The interviews with 15 subjects (five for each type of muscular dystrophy; proximal muscular dystrophy, myotonic muscular dystrophy, myopathia distalis tarda hereditaria) were subjected to inductive content analysis. The interviews were about experiences of the first symptoms, learning of the diagnosis, life in general from then to the present, managing daily living and thoughts about the future. RESULTS: After a deductive validation procedure the results were presented as three core narratives', one for each type of muscular dystrophy. The illness experience was mainly similar irrespective of type of muscular dystrophy. Learning of the incurable, progressive, hereditary disease was traumatic and the subjects hoped the diagnosis was wrong. They felt uncertain about the future, and were sad and worried about the consequences of a hereditary disease for their children. CONCLUSION: The results will enable rehabilitation staff to better understand the patient's need for psychosocial support.

• 33.
Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, USA .
Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, USA . Shriners Hospital for Children, Shriners Burn Hospital, Galveston, USA. School of Education & FPG Child Development Institute, University of North Carolina, Chapel Hill, USA. Shriners Hospital for Children, Shriners Burn Hospital, Galveston, USA . Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, USA.
The Burn Model Systems outcome measures: a content analysis using the International Classification of Functioning, Disability, and Health2017Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 39, nr 25, s. 2584-2593Artikkel i tidsskrift (Fagfellevurdert)

Background: The National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) Burn Injury Model Systems (BMS) is a nationwide database that uses patient-reported outcome measures to collect data. Though the outcome measures demonstrate good psychometric properties, the question remains whether or not these measures collect data that encompass the entire experience of burn patients over time.

Methods: Each meaningful concept included in the BMS assessments was linked to the International Classification of Functioning, Disability and Health (ICF) in order to classify and describe the content of each measure. The linking was completed by two experienced coders. The perspective of each assessment was also determined.

Results: The body function component was most frequently addressed overall followed by the activities and participation component. The component body structures and environmental factors are not extensively covered in the BMS assessments. ICF chapter and category distribution varied greatly between assessments. The assessments were of the health status perspective.

Conclusion: This study suggests a need to revisit the item composition of the BMS assessments to more evenly distribute ICF topics and subtopics that are pertinent to burn injury which will ensure a broader but more precise understanding of burn injury recovery.Implications for RehabilitationA better understanding of the data collected through the Burn Model Systems (BMS) project may contribute to improve data collection tools and ultimately lead to clinical practice innovations and improvements. Clinicians interested in using BMS data for research purposes can better understand what topics are included and excluded in the collection and what perspectives are addressed.This study highlights the need for burn clinicians around the world to lend their expertise to the WHO for the development of a much needed burn injury International Classification of Functioning, Disability and Health Core Set.

• 34.
Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
Italian National Neurological Institute ‘‘Carlo Besta’’, Milan, Italy, and the World Health Organization, Geneva, Switzerland. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Pädagogische Hochschule Zürich, Department of Research and Development, Zürich, Switzerland. Medea, Conegliano Research Centre, Conegliano, Italy.
Applying the International Classification of Functioning, Disability and Health (ICF) to measure childhood disability2003Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 25, nr 11-12, s. 602-610Artikkel i tidsskrift (Fagfellevurdert)

The International Classification of Functioning, Disability and Health-ICF addresses the broad need for a common language and classification of functioning and disability. A parallel need is appropriate measures compatible with the content of the ICF to document the nature and impact of limitations of function, activities and participation. The interaction of developmental characteristics and disability among children represent special challenges for classification as well as measurement. Demographic trends emphasize the need for universal measures that encompass the components of the ICF and can be used in surveillance, screening and evaluation. This paper identifies issues related to application of the ICF to measure disability in childhood; reviews approaches and tools to assess childhood disability and identifies priorities for the development of measures of functioning and disability in children based on the ICF. The development of measures should be framed within a framework of children's rights and application of the biopsychosocial model to document profiles of functioning and disability of children.

• 35.
Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
Public Health & Preventive Medicine, Oregon Health Sciences University, Portland, OR, USA. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Westat, Washington, DC, USA. Rehabilitation Institute, Beijing, China. Occupational Therapy & Neurology, Washington University, St. Louis, MO, USA. FPG Child Development Institute, University of North Carolina, Chapel Hill, NC, USA.
ICF and ICF-CY lessons learned: Pandora’s box of personal factors2014Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, nr 25, s. 2187-2194Artikkel i tidsskrift (Fagfellevurdert)

Methods: A critical examination of the construct of “personal factors” and description of the component was made with reference to conceptual and taxonomic criteria.

Results: The “personal factors” component in the ICF/ICF-CY is not defined, there is no taxonomy of codes, there is no explicit purpose stated for its use and no guidelines are provided for its application. In spite of these constraints, the component of “personal factors” is being applied as part of the classifications. Such uncontrolled applications constitute significant risks for the status of ICF/ICF-CY as the WHO reference classification in that: (a) the component is accepted for use by default simply by being applied; (b) component content is expanded with idiosyncratic exemplars by users; and (c) there is potential misuse of “personal factors” in documenting personal attributes, including “blaming the victim”.

Conclusion: In the absence of formal codes, any application of the component of “personal factors” lacks the legitimacy that documentation with a scientific taxonomy should provide. Given the growing use of the ICF/ICF-CY globally, a priority for the revision process should be to determine if there is in fact need for “personal” or any other factors in the ICF/ICF-CY.

• 36.
School of Health Medical and Applied Sciences, Central Queensland University, Melbourne, Australia.
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. School of Health Medical and Applied Sciences, Central Queensland University, Melbourne, Australia. School of Health Medical and Applied Sciences, Central Queensland University, Melbourne, Australia.
Occupational therapy and activity pacing with hospital-associated deconditioned older adults: a randomised controlled trial2019Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, s. 1-9Artikkel i tidsskrift (Fagfellevurdert)

PURPOSE: To examine the efficacy of an occupational therapy activity pacing intervention with deconditioned older adults in rehabilitation.

METHOD: Randomised, single-blind controlled trial of deconditioned older adults admitted for rehabilitation following treatment of an acute medical condition, allocated to intervention [n = 51, males = 14, mean age = 80(8)] or control [n = 49, males = 12, mean age = 81(7)] group. The intervention group received individual and group activity pacing education with practice and application of techniques to daily activities and the home environment, while the control group received a typical occupational therapy program, which included brief activity pacing education. Outcomes included participation in daily living skills, health status (including pain and fatigue symptoms), self-efficacy in daily activities and activity pacing techniques using the Australian Therapy Outcome Measures-Occupational Therapy (AusTOMs-OT), Short Form-36 Health Survey (SF-36), Self-Efficacy Gauge and Activity Pacing Assessment.

RESULTS: No differences in groups at admission. Comparison at discharge and three months post discharge using 2 × 2 mixed ANOVA demonstrated small differences in only one scale of the activity limitation domain of the AusTOMs-OT. No significant differences were found in other scales or domains of the AusTOMs-OT, nor secondary outcome measures.

CONCLUSION: Activity pacing in addition to typical occupational therapy during inpatient rehabilitation did not demonstrate benefits to participants in the management of their daily activities on returning home post hospitalisation. Implications for rehabilitation Activity pacing has been identified as one of the commonly used occupational therapy interventions utilised with deconditioned older adults in rehabilitation. An activity pacing intervention in conjunction with typical occupational therapy demonstrated no benefits for deconditioned older adults over typical occupational therapy which included basic education on this topic. Continuation of the activity pacing intervention into the outpatient setting may be of benefit to older adults and requires further investigation.

• 37.
Department of Women’s and Children’s Health, Karolinska Institutet, Neuropediatric Unit, Stockholm, Sweden.
Department of Women’s and Children’s Health, Karolinska Institutet, Neuropediatric Unit, Stockholm, Sweden. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. School of Sustainable Development of Society and Technology, Mälardalen University, Västerås, Sweden.
Differences in patterns of participation in leisure activities in Swedish children with and without disabilities2014Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, nr 6, s. 464-471Artikkel i tidsskrift (Fagfellevurdert)

Purpose: To compare participation in leisure activities between Swedish children with and without disabilities and to examine whether age, gender, presence of disabilities, and mother’ seducational level influence participation.

Method: A Swedish version of the Children’s Assessment of Participation and Enjoyment was used to study the diversity, intensity, and enjoyment of participation in leisure activities of children aged 6 to 17 years. Fifty-five of the children had disabilities and 337 of the children did not have disabilities. A multiple regression analysis was conducted to explore the impact of age, gender, mother’s level of education, and disability on the diversity, intensity, and enjoyment of leisure activities. At-test for independent samples was used to compare the diversity and intensity of participation between children withand without disabilities.

Results: The multiple regression analysis explained 4–36% of the variance of diversity, intensity, and enjoyment. Children with disabilities participated with higher diversity, but with less intensity, than children without disabilities. Younger children had higher levels of enjoyment.

Conclusions: Children with disabilities participated in several different activities, but the presence of a disability was associated with lower intensity ofparticipation. The low explanatory value of the investigated variables indicates that the combined effect of several variables needs to be taken into consideration when designing participation interventions.

• 38.
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. School of Health Medical and Applied Science, Central Queensland University, Bundaberg, Australia.
Department of Occupational Therapy, Australian Catholic University, Melbourne, Australia. College of Science Health and Engineering, La Trobe University, Bundoora, Australia. School of Health Sciences and Social Care, Brunel University London, London, UK. Sunshine Hospital, Melbourne, Australia. School of Health Medical and Applied Science, Central Queensland University, Bundaberg, Australia.
Predicting fitness-to-drive following stroke using the Occupational Therapy - Driver Off Road Assessment Battery2019Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, nr 15, s. 1797-1802Artikkel i tidsskrift (Fagfellevurdert)

INTRODUCTION: It is difficult to determine if, or when, individuals with stroke are ready to undergo on-road fitness-to-drive assessment. The Occupational Therapy - Driver Off Road Assessment Battery was developed to determine client suitability to resume driving. The predictive validity of the Battery needs to be verified for people with stroke.

AIM: Examine the predictive validity of the Occupational Therapy - Driver Off Road Assessment Battery for on-road performance among people with stroke.

METHOD: Off-road data were collected from 148 people post stroke on the Battery and the outcome of their on-road assessment was recorded as: fit-to-drive or not fit-to-drive.

RESULTS: The majority of participants (76%) were able to resume driving. A classification and regression tree (CART) analysis using four subtests (three cognitive and one physical) from the Battery demonstrated an area under the curve (AUC) of 0.8311. Using a threshold of 0.5, the model correctly predicted 98/112 fit-to-drive (87.5%) and 26/36 people not fit-to-drive (72.2%).

CONCLUSION: The three cognitive subtests from the Occupational Therapy - Driver Off Road Assessment Battery and potentially one of the physical tests have good predictive validity for client fitness-to-drive. These tests can be used to screen client suitability for proceeding to an on-road test following stroke. Implications for Rehabilitation: Following stroke, drivers should be counseled (including consideration of local legislation) concerning return to driving. The Occupational Therapy - Driver Off Road Assessment Battery can be used in the clinic to screen people for suitability to undertake on road assessment. Scores on four of the Occupational Therapy - Driver Off Road Assessment Battery subtests are predictive of resumption of driving following stroke.

• 39. Wenneberg, Stig
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
Using a novel exercise programme for patients with muscular dystrophy. Part I: a qualitative study.2004Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 26, nr 10, s. 586-594Artikkel i tidsskrift (Fagfellevurdert)

Muscular dystrophy patients have often experimented with different alternative or complementary methods since there is at present no curative medical treatment. PURPOSE: To evaluate, through qualitative analysis of interview data, the subjective experiences of twenty-eight patients with muscular dystrophy practising a complementary method, qigong. METHODS: Semi-structured qualitative interviews were performed and data were analysed by a method inspired by Grounded Theory. The material was first coded into 119 categories, thereafter condensed to 59 categories through a constant comparison analysis. In the final analysis, six broad categories were formed out of these 59 categories. RESULTS: These broad categories were: (1) experience of health care and alternative methods; (2) expectations, acceptance and compliance; (3) qigong as an adaptable form of exercise; (4) stress reduction and mental effects; (5) increased body awareness and physical effects; (6) psychosocial effects of group training. CONCLUSION: Qigong was accepted as a novel exercise regimen and there was a wide variation of experience regarding it among the participants. Depending upon factors such as expectation of benefits, time available to do qigong and perceived effects doing it, compliance varied. One major advantage of qigong is the ability to adapt the different exercises to the physical capability of the person practising qigong. There were reports of mental, physical and psychosocial effects of the qigong, which reduced the feeling of stress and improved well-being.

• 40. Wenneberg, Stig
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
Using a novel exercise programme for patients with muscular dystrophy. Part II: a quantitative study.2004Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 26, nr 10, s. 595-602Artikkel i tidsskrift (Fagfellevurdert)

PURPOSE: To quantitatively evaluate the effects of qigong in patients with muscular dystrophy. METHODS: Thirty-six patients with muscular dystrophy were assigned to either a treatment or comparison group, by means of a stratified randomization procedure. The intervention period lasted for 3 months. Balance and respiratory function were assessed by means of Berg's Balance Scale and an electronic spirometer, respectively. Health-related quality of life was tested by means of a Swedish version of the Medical Outcome Study Short Form Health Survey (SF-36), coping levels by means of a Swedish version of the Ways of Coping Questionnaire and depression levels by means of a modified version of the Montgomery åsberg Depression Rating Scale. RESULTS: Perceived general health was maintained in the treatment group whereas this was not the case in the comparison group (p=0.05). Positive reappraisal coping decreased in the treatment group but not in the comparison group (p=0.05). There was a tendency to maintain balance function during training and performance of qigong whilst there was a decline when not training. CONCLUSION: Qigong may be useful as an adjunct therapy regimen in patients with muscular dystrophy in that it can bring about a decreased rate of decline in general health. The change in coping pattern in this study needs more investigation. More research is also needed in order to more fully investigate the effects of qigong on such physical variables as balance function.

• 41. Wilder, J
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för beteendevetenskap och socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
Parent-child interaction: A comparison of parents' perceptions in three groups2004Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 26, nr 21-22, s. 1313-1322Artikkel i tidsskrift (Fagfellevurdert)
• 42. Zakirova-Engstrand, Rano
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för beteendevetenskap och socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
The International Classification of Functioning, Disability and Health: Children and youth (ICF-CY): Testing its utility in classifying information from eco-cultural family interviews with ethnically diverse families with children with disabilities in Kyrgyztan2009Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, nr 12, s. 1018-1030Artikkel i tidsskrift (Fagfellevurdert)
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