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  • 1.
    Boman, I.-L.
    et al.
    Division of Occupational Therapy, Karolinska Institutet, Stockholm, Huddinge, Sweden.
    Rosenberg, Lena
    Division of Occupational Therapy, Karolinska Institutet, Stockholm, Huddinge, Sweden.
    Lundberg, S.
    Royal Institute of Technology, School of Technology and Health, Handen, Sweden.
    Nygård, L.
    Division of Occupational Therapy, Karolinska Institutet, Stockholm, Huddinge, Sweden.
    First steps in designing a videophone for people with dementia: identification of users' potentials and the requirements of communication technology.2012In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 7, no 5, p. 356-63Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To identify, based on the literature, people with dementia's potentials to manage an easy-to-use videophone, and to develop a videophone requirement specification for people with dementia.

    METHOD: The study is based on the Inclusive Design method, utilising the first two of four phases. Content analyses of literature reviews were used to identify users' potentials for managing a videophone and to gather recommendations regarding communication technology design for the target group. Existing videophones in Sweden were examined regarding potential fit to users with dementia.

    FINDINGS: This led to detailed identification of cognitive, physical and psychosocial challenges that people with dementia will probably have when using an ordinary telephone or videophone. A requirement specification for videophone design to fit users with dementia was formulated, with the seven principles of Universal Design as a framework.

    CONCLUSIONS: The requirement specification presented here is aimed at designing a videophone but might also facilitate design of other products for people with dementia, particularly in the field of communication technology. Based on this, further work will focus on developing a design concept and a prototype to be empirically tested by people with dementia and their significant others, i.e. the final two design process phases.

  • 2.
    Boman, Inga-Lill
    et al.
    Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden; Department of Rehabilitation Medicine, Danderyds Hospital, Stockholm, Sweden.
    Nygård, Louise
    Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Rosenberg, Lena
    Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Users' and professionals' contributions in the process of designing an easy-to-use videophone for people with dementia2014In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 9, no 2, p. 164-172Article in journal (Refereed)
    Abstract [en]

    Purpose: To develop a design concept for an easy-to-use videophone for people with dementia and to evaluate the design and need of such a product.

    Method: In this project, we have used an inclusive design approach that includes the target users in the design process. In an earlier study, the need of a videophone was examined and a requirement specification was developed. In this study, a preliminary design concept was developed. Five focus groups of people with dementia, significant others and occupational therapists working with people with dementia were formed to capture their experiences, expectations and thoughts concerning the videophone and the design concept. Data were analysed using a grounded theory approach.

    Findings: The participants pointed out that the design of the videophone should be flexible in order to meet the needs of people with dementia, be easy-to-use and not look like assistive technology. In order to facilitate learning, the videophone should be introduced in an early stage of the disease.

    Conclusions: A videophone has potentials to enable videophone calls without assistance, add quality in communication and provide possibilities for monitoring. Further work will focus on developing a prototype to be empirically tested by people with dementia and significant others.

    Implications for Rehabilitation

    • An easy-to-use videophone was viewed as an important device that could support people with dementia in making videophone calls without assistance. It was also viewed as a product that significant others could use for monitoring the person with dementia, for example to judge the well-being of the person. But monitoring should be used with caution and not without the consent of the person with dementia.
    • It was viewed as important that the videophone be introduced in an early stage of the disease in order to facilitate learning, so that the person can get used to the new way of making telephone calls and incorporate the new habit in his/her routines.
    • In order to motivate people with dementia to start using a videophone, it was recommended that the videophone should be introduced as a product which is a pleasure to use, and not as a compensation for impairment or to solve a problem.
  • 3.
    Borell, Lena
    et al.
    Department Neurotec, Division of Occupational Therapy, Huddinge, Sweden.
    Asaba, Eric
    Department Neurotec, Division of Occupational Therapy, Huddinge, Sweden.
    Rosenberg, Lena
    Department Neurotec, Division of Occupational Therapy, Huddinge, Sweden.
    Schult, Marie-Louise
    Department Neurotec, Division of Occupational Therapy, Huddinge, Sweden.
    Townsend, Elisabeth
    School of Occupational Therapy, Dalhousie University, Halifax, NS, Canada.
    Exploring experiences of "participation" among individuals living with chronic pain2006In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 13, no 2, p. 76-85Article in journal (Refereed)
    Abstract [en]

    The aim of this paper is to advance our understanding of participation and its relation to occupation, by analysing the daily occupational experiences of six men and women living with chronic pain. Open-ended interviews are used in conjunction with a constant comparative method of analysis. The findings are thematically presented as: "taking initiative and making choices", doing something physical", "doing something social", and "doing something for others". Furthermore, a short vignette is presented in which the authors attempt to juxtapose theoretical constructs with individual experiences in order to illustrate another level of contextual richness of the data. Methodological implications are discussed in relation to the findings, analytic presentation, and previous research.

  • 4.
    Cleeve, Helena
    et al.
    NVS, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Borell, Lena
    NVS, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Rosenberg, Lena
    NVS, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Drawing in-situ: Matters of care and representation in daily life with dementia2023In: Qualitative Research, ISSN 1468-7941, E-ISSN 1741-3109, Vol. 23, no 3, p. 782-808Article in journal (Refereed)
    Abstract [en]

    This article brings methodological insight into in-situ drawings as representations of daily life with dementia. As part of ethnographic fieldwork in dementia care units in a nursing home, drawings were made on site by a researcher. We suggest that the ambiguity of in-situ drawings, and the ensuing possibilities to disambiguate them, is valuable. Inspired by Asdal and Moser’s (2012) concept of “contexting,” we experimented with arranging the drawings with fieldnotes, discussing them with staff members, as well as with configuring multiple drawings and fieldnotes in sequences. This led to reflexive engagements with the drawings, creating space for discussing concerns in research practices and care practices. Switching between different forms of contexting produced tensions, revealing that what was cared for through the practices of researchers, staff members, and residents, diverged. In this way, we argue that contexting in-situ drawings may intervene in ways of knowing, caring for, and living with dementia.

  • 5.
    Cleeve, Helena
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Borell, Lena
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Rosenberg, Lena
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    (In)visible materialities in the context of dementia care2020In: Sociology of Health and Illness, ISSN 0141-9889, E-ISSN 1467-9566, Vol. 42, no 1, p. 126-142Article in journal (Refereed)
    Abstract [en]

    Seemingly mundane materialities are intertwined with important, but often neglected, care interactions. It has been argued that if healthcare professionals paid more attention to the roles materialities can have, everyday routines could become important occasions for care. In response to such proposals, we argue that it is relevant to examine how materialities are currently understood. In this article, we explore materialities as part of work in a dementia unit. Using abstracted illustrations of everyday materialities to elicit reflections, we conducted 11 individual interviews with certified nursing assistants. Through phenomenographic analysis we explain our findings as three different categories conceptualising understandings of materialities as: ‘tools for care’, ‘a set of principles for care’ and ‘caring relationships’. Our analysis indicates that understanding materialities as instruments was reinforced and made visible through the healthcare organisation while understanding materialities as part of specific relationships with residents appeared informal and less visible. How materialities were understood seemed to have several implications for residents. While care practices could benefit from nursing assistants’ abilities to alternate between ways of understanding materialitites, such competence seemed dependent on how professional care was organised, structured and materialised.

  • 6. De Vriendt, P.
    et al.
    Gorus, E.
    Mets, T.
    Petrovic, M.
    Nygard, L.
    Kottorp, A.
    Rosenberg, Lena
    Division Of Occupational Therapy, Department Of Neurobiology, Care Science And Society, Karolinska Insitutet, Huddinge, Sweden.
    Malinowsky, C.
    Öhman, A.
    Josephsson, S.
    Graff, M.
    Vernooij-Dassen, M.
    Olde-Rikkert, M.
    Mild cognitive impairment and early stage dementia: Assessment and treatment of everyday functioning2012In: European Geriatric Medicine, ISSN 1878-7649, E-ISSN 1878-7657, Vol. 3, no Suppl. 1, p. S12-S13Article in journal (Refereed)
  • 7.
    Du Toit, Sanetta
    et al.
    University of Sydney.
    Rosenberg, Lena
    Karolinska Institutet, Stockholm, Sweden.
    Mondaca, Margarita
    Karolinska Institutet, Stockholm, Sweden.
    Lovarini, Meryl
    University of Sydney.
    Unpacking the concept of person-centred care within OT in dementia care2018Conference paper (Refereed)
    Abstract [en]

    Person-centred care (PCC), especially for frail and vulnerable elders with advanced dementia, remains in many ways an elusive concept. There appears to be a persistent strain between the medical and social models of care in institutionalised environments that strives to provide the last homely comforts to the people living there. A scoping review was conducted to determine how PCC is reflected by occupational therapy (OT) practice.

    The scoping review methodology followed guidelines by Arksey and O’Malley (2005). Eligibility criteria include peer-reviewed studies published between 1995 and 2015 focusing on OT within aged residential care with people who have moderate to severe cognitive impairment associated with dementia. Studies retrieved from the searches were first independently screened for relevance and then assessed for inclusion. Relevant data were extracted and summarised using a critical interpretive synthesis developed for this study.

    Key characteristics of each study will be presented to demonstrate how the advancement of PCC is supported or inhibited.

    PCC that is reflective of occupational engagement and supports natural scenarios of everyday life is paramount when providing services in someone’s last home. The diverse nature and holistic approach of OT; a history evident of pressure to conform to the medical model; and expanding into new areas of practice delivery continue to impact the day-to-day business of OT. In our efforts to contribute as professionals within institutional dementia care settings for older persons, we need to consider how we can better support and expand our services to reflect the essence of PCC.

  • 8.
    Gaber, Sophie N.
    et al.
    Faculty of Brain Sciences, Division of Psychiatry, University College London, London, UK; Department of Health Care Sciences, Marie Cederschiöld University College, Stockholm, Sweden; Department of Women's and Children's Health, Healthcare Sciences and e-Health, Uppsala University, Uppsala, Sweden.
    Guerrero, Manuel
    Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden; Department of Bioethics and Medical Humanities, Faculty of Medicine, University of Chile, Santiago, Chile.
    Rosenberg, Lena
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Characteristics and consequences of participatory research approaches in long-term care facilities for older adults: a meta-ethnography of qualitative studies2023In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 402, no Suppl. 1, p. S43-S43Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Participatory research approaches can potentially empower older adults and improve their quality of life and care. These include research designs, methods, and conceptual frameworks in collaboration with people directly involved and invested in the research and research outcomes. However, participatory research approaches have rarely been explored in long-term care facilities for older adults, such as nursing homes or residential care facilities. We aimed to provide increased understanding and recommendations about how participatory research approaches can be conceptualised and used in long-term care facilities for older adults.

    METHODS: Inspired by Noblit and Hare (1988) and the seven phases of the eMERGe guidelines (2019), we performed a meta-ethnography (synthesis of qualitative research). We searched MEDLINE, CINAHL, ERIC, Sociological Abstracts, and Web of science in July 2021 and June 2022 for studies published between Jan 1, 2001, and June 27, 2022 (see appendix for search terms). We included peer-reviewed qualitative publications on participatory research approaches with older adults or staff in long-term care facilities, written in English. To promote rigour, a protocol was used with two authors independently screening the articles, reaching consensus through critical discussions with a third author, and using the Critical Appraisal Skills Programme (CASP) checklist. We extracted data regarding types of participatory research approaches and themes. This study is registered with PROSPERO, CRD42021275187.

    FINDINGS: Ten of 1445 articles screened were included in the analysis. Using seven types of participatory research approaches, the included studies investigated experiences of approximately 153 residents and 99 staff from seven countries (Australia, Belgium, England, Guyana, Ireland, Sweden, and the Netherlands). We identified five themes, expressed as a conceptual model with recommendations: (1) participatory backdrop; (2) collaborative places; (3) seeking common ground and solidarity; (4) temporal considerations; and (5) empowerment, growth, and cultural change. We recommend researchers allow flexible time for the slow-paced progression and potentially unintended consequences of this emergent approach.

    INTERPRETATION: This meta-ethnography provides an international and systematic synthesis of a diverse group of small-scale qualitative studies, which are, however, limited by insufficient reporting of participants' age, gender, or ethnicity. FUNDING: The Strategic Research Area in Health Care Science (SFO-V) at Karolinska Institutet and the Swedish Research Council for Health, Working Life and Welfare (FORTE).

  • 9.
    Hwang, Amy S.
    et al.
    Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada; Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
    Rosenberg, Lena
    Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Kontos, Pia
    Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
    Cameron, Jill I.
    Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada; Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada; Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.
    Mihailidis, Alex
    Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada; Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada; Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.
    Nygård, Louise
    Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Sustaining care for a parent with dementia: an indefinite and intertwined process2017In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, no 1, article id 1389578Article in journal (Refereed)
    Abstract [en]

    This study aimed to understand how adult children sustain caring for persons with dementia (PwDs) within their family and formal care contexts in Canada. Half-day focus groups were conducted with adult daughters and adult sons in Toronto, Canada. Using constructivist grounded theory, we examined both substantive concepts and group dynamics. Sustaining care was interpreted as an indefinite process with three intertwined themes: reproducing care demands and dependency, enacting and affirming values, and “flying blind” in how and how long to sustain caring (i.e., responding to immediate needs with limited foresight). Family values and relationships, mistrust toward the institutional and home care systems, and obscured care foresight influenced care decisions and challenged participants in balancing their parents’ needs with their own. Positive and negative aspects of care were found to influence one another. The implications of these findings for research and policy are discussed.

  • 10.
    Johansson, Karin
    et al.
    Department of NVS, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Borell, Lena
    Department of NVS, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Rosenberg, Lena
    Department of NVS, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Qualities of the environment that support a sense of home and belonging in nursing homes for older people2022In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 42, no 1, p. 157-178Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to contribute with knowledge about how a sense of home and belonging is enacted and can be supported in everyday life, with a particular focus on the relationships that connect everyday life and the environment in nursing home contexts. The concepts 'a sense of home' and 'belonging' were chosen with the ambition to grasp values grounded in experiences and everyday practices, with an openness for various aspects that can support an enjoyable life and comfort for nursing home residents. The study focused on communal areas, e.g. dining room, kitchen, corridors and gardens, that serve as arenas where nursing home residents' everyday lives expand beyond the private room. Ethnographic methods were applied to identify and explore situations where a sense of home and belonging were enacted in nursing homes that had been acknowledged as good examples of nursing home environments. Through the analytic process, four qualities were identified: (a) a cornerstone for stability and everydayness, (b) the beating heart, (c) spatial dynamics, and (d) magnetic places. Following from the chosen methodology, the findings provide a situated understanding of how communal areas in nursing homes can invite a sense of home and belonging for the residents.

  • 11.
    Kottorp, A.
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden; Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, United States.
    Johansson, K.
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Aase, Per
    Per Aase Ltd, Stockholm, Sweden.
    Rosenberg, Lena
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Housing for ageing LGBTQ people in Sweden: a descriptive study of needs, preferences, and concerns2016In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 23, no 5, p. 337-346Article in journal (Refereed)
    Abstract [en]

    Abstract: Background/aim: With an increasing number of ageing people who identify themselves as lesbian, gay, bisexual, transgender, or queer (LGBTQ), there is a risk that traditional housing for older people fails to meet the needs of these people. The aim of this study was to describe LGBTQ people’s needs, preferences, and concerns according to ageing and housing.

    Materials and methods: Based on a survey (n =487), and six focus-group discussions (n =30), with LGBTQ persons, quantitative and qualitative approaches were used to analyse the findings.

    Results: When comparing the ranking of preferences (in terms of activity options, environmental features, and staff competence) in a senior housing setting between the LGBTQ people (n =200) and heterosexual matched controls (n =198), only minor differences were detected. The findings from the focus groups included: (1) a dilemma between segregation and openness, (2) the importance of safety associated with ageing together with persons with similar experiences, and (3) networks of persons at different ages connected through close friendship supported participation in activities in LGBTQ-profiled senior housing.

    Conclusion and significance: The findings provide knowledge to improve awareness of sexual orientation when it comes to needs and preferences in relation to ageing and housing in a Swedish context.

  • 12.
    Kottorp, Anders
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago, United States.
    Nygård, Louise
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Hedman, Annicka
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Öhman, Annika
    Division of Health, Activity and Care and National Institute for the Study of Ageing and Later Life (NISAL), Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.
    Malinowsky, Camilla
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Rosenberg, Lena
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Lindqvist, Eva
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Ryd, Charlotta
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Access to and use of everyday technology among older people: An occupational justice issue – but for whom?2016In: Journal of Occupational Science, ISSN 1442-7591, E-ISSN 2158-1576, Vol. 23, no 3, p. 382-388Article in journal (Refereed)
    Abstract [en]

    Research into older people's use of remote controls, mobile phones, digital home appliances, and computerized communication systems reveals that many have difficulty accessing and using these everyday technologies. By using occupational justice theory as a lens onto this technological development, we argue in this commentary that critical analysis of the findings from an occupational perspective reveals systematic injustices that disadvantage certain sectors of the older population. In particular we propose that, contrary to what might be expected, diagnosis or disability is not the sole marker for a vulnerable population at high risk of occupational injustices. Rather, the empirical findings support that other aspects (e.g., economic, educational) may also be influencing both everyday technology access and use among the older population. In light of these concerns, we argue that (a) occupation-centred outcome measures are needed to target everyday technology populations at risk of occupational injustices, and (b) future studies evaluating the access and use of everyday technology among older people must also monitor and target socio-demographic diversities.

  • 13.
    Malinowsky, Camilla
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Kottorp, Anders
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden; Department of Occupational Therapy, Zurich University of Applied Sciences, Winterthur, Switzerland; Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, United States.
    Patomella, Ann-Helen
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden; Faculty of Health Science, School of Occupational Therapy, University of Sydney, Sydney, NSW, Australia.
    Rosenberg, Lena
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Nygård, Louise
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Changes in the technological landscape over time: Relevance and difficulty levels of everyday technologies as perceived by older adults with and without cognitive impairment2015In: Technology and Disability, ISSN 1055-4181, E-ISSN 1878-643X, Vol. 27, no 3, p. 91-101Article in journal (Refereed)
    Abstract [en]

    Everyday technology, ET (e.g. computers, TV's and vending machines) perceived as relevant and used in everyday activities change continuously. Not being able to keep up with these changes may hinder participation in activities.

    OBJECTIVE: To investigate stability and change in perceived relevance of ET, and in levels of perceived ET difficulty across two different occasions in time and between two similar samples of older adults with and without cognitive impairment.

    METHODS: Data of perceived relevance and difficulty in ET use in the samples (n = 157/118), collected with the Everyday Technology Use Questionnaire (ETUQ) was investigated.

    RESULTS: Thirty-three (70%) of the ETs in the ETUQ significantly increased in relevance, while the perceived levels of difficulty were statistically similar in 40/47 ETs (85%) across the two time occasions.

    CONCLUSIONS: The perceived relevance of ET among older adults with and without cognitive impairment was indicated to increase over time, but the levels of perceived levels of difficulty of ETs did not change as much. This knowledge could be used to support and facilitate ET use in the aging population, and in general to influence society's view of older people as active users of ET in activities at home and in public spaces.

  • 14.
    Malinowsky, Camilla
    et al.
    Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Kottorp, Anders
    Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, United States.
    Wallin, Anders
    Institute of Neuroscience and Physiology, Department of Neuropsychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Nordlund, Arto
    Institute of Neuroscience and Physiology, Department of Neuropsychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Björklund, Eva
    Institute of Neuroscience and Physiology, Department of Neuropsychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Melin, Ilse
    Institute of Neuroscience and Physiology, Department of Neuropsychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Pernevik, Anette
    Institute of Neuroscience and Physiology, Department of Neuropsychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Rosenberg, Lena
    Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Nygård, Louise
    Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Differences in the use of everyday technology among persons with MCI, SCI and older adults without known cognitive impairment2017In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 29, no 7, p. 1193-1200Article in journal (Refereed)
    Abstract [en]

    Background: To use valid subjective reports sensible to cognitive decline is vital to identify very early signs of dementia development. Use of everyday technology (ET) has been shown to be sensitive to differentiate adults with mild cognitive impairment (MCI) from controls, but the group with subjective cognitive impairment (SCI) has not yet been examined. This study aims to investigate and compare self-perceived ability in ET use and number of ETs reported as actually used in a sample of older adults with SCI, MCI, and older adults with no known cognitive impairment, i.e. controls.

    Methods: Older adults with MCI (n = 29), SCI ( n = 26), and controls (n = 30) were interviewed with the short version of the Everyday Technology Use Questionnaire (S-ETUQ) to capture self-perceived ability in ET use and number of ETs used. To generate individual measures of ability to use ET, Rasch analysis was used. The measures were then compared group-wise using ANCOVA. The numbers of ETs used were compared group-wise with ANOVA.

    Results: Controls versus SCI and MCI differed significantly regarding ETs reported as used, but not SCI versus MCI. Similarly, in ability to use ET, controls versus SCI and MCI differed significantly but not SCI versus MCI.

    Conclusions: The significantly lower numbers of ETs reported as actually used and the lower ability in SCI and MCI groups compared to controls suggest that ET use is affected already in very minor cognitive decline. This indicates that self-reported ET use based on the S-ETUQ is sensitive to detect changes already in SCI.

  • 15.
    Malinowsky, Camilla
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    Nygård, Louise
    Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    Tanemura, Rumi
    Graduate School of Health Sciences, Kobe University, Kobe, Japan.
    Nagao, Toru
    Graduate School of Health Sciences, Kobe University, Kobe, Japan.
    Noda, Kazue
    Graduate School of Health Sciences, Kobe University, Kobe, Japan.
    Nakata, Osamu
    Graduate School of Health Sciences, Kobe University, Kobe, Japan.
    Sagara, Jiro
    Department of Product Design, Kobe Design University, Kobe, Japan.
    Rosenberg, Lena
    Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    Asaba, Eric
    Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Stockholms Sjukhem Foundation, Unit for Research, Education, and Development, Stockholm, Sweden; Department of Product Design, Kobe Design University, Kobe, Japan.
    Kottorp, Anders
    Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, United States.
    Everyday technology use among older adults in Sweden and Japan: A comparative study2018In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 25, no 6, p. 446-456Article in journal (Refereed)
    Abstract [en]

    Background: As context may impact everyday technology (ET) use it is relevant to study this within different contexts.

    Aims: To examine the usefulness of the Everyday Technology Use Questionnaire (ETUQ) in different contexts by investigating and comparing (1) the level of challenge of ETs in the ETUQ and (2) the relevance of and perceived ability to use ET in samples of Swedish and Japanese older adults.

    Materials and methods: The Swedish and the Japanese samples (n = 86/86) were interviewed using the ETUQ about relevance of and perceived ability to use ET. Data were analyzed using Rasch analysis, chi square and a general linear model. Moreover, Differential Item Functioning (DIF) was investigated.

    Results: The hierarchy of ETs’ level of challenge was generally stable in the two contexts. On group-level, the relevance was somewhat higher and the perceived ability to use ET significantly higher in the Swedish sample than in the Japanese.

    Conclusions and significance: The similarities and differences between the technological landscapes of Sweden and Japan could be detected by ETUQ, demonstrating its usefulness in both countries. The potential causes to the differences in relevance of and perceived ability to use ET between older adults in Sweden and Japan need further exploration.

  • 16.
    Malinowsky, Camilla
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden.
    Rosenberg, Lena
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden.
    Nygård, Louise
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden.
    An approach to facilitate healthcare professionals' readiness to support technology use in everyday life for persons with dementia2014In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, no 3, p. 199-209Article in journal (Refereed)
    Abstract [en]

    Everyday technologies (ETs) like microwave ovens and automatic telephone services as well as assistive technologies (ATs) are often used in the performance of everyday activities. As a consequence, the ability to manage technology is important. This pilot study aimed to clarify the applicability of a model for knowledge translation to support healthcare professionals, to support technology use among older adults with dementia and their significant others. An additional aim was to explore the process of translating the model into practice. The applicability of the model (comprising a one-day course, including introduction and provision of tools, followed by interviews during and after a period of practice) was clarified for 11 healthcare professionals using a constant comparative approach. The content of the model gave the participants an eye-opening experience of technology use among persons with dementia. They also described how they had incorporated the model as a new way of thinking which supported and inspired new investigations and collaborations with colleagues and significant others. This study provided an applicable model of how research knowledge about technology use can be translated into clinical practice and be used by healthcare professionals to support the use of technology for persons with dementia.

  • 17.
    Malinowsky, Camillo
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    Kottorp, Anders
    Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, United States.
    Tanemura, Rumi
    Graduate School of Health Sciences, Kobe University, Kobe, Japan.
    Asaba, Eric
    Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    Nagao, Toru
    Graduate School of Health Sciences, Kobe University, Kobe, Japan.
    Noda, Kazue
    Graduate School of Health Sciences, Kobe University, Kobe, Japan.
    Sagara, Jiro
    Kobe Design University, Kobe, Japan.
    Bontje, Peter
    Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan.
    Rosenberg, Lena
    Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    Nygård, Louise
    Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    Validation of the Everyday Technology Use Questionnaire in a Japanese context2015In: Hong Kong Journal of Occupational Therapy, ISSN 1569-1861, Vol. 26, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Background/Objective

    The Everyday Technology Use Questionnaire (ETUQ), which evaluates the perceived relevance of and the perceived ability in everyday technology (ET) use, has demonstrated acceptable psychometric properties in Swedish studies of older adults. The aim of this study was to examine the reliability and validity of the ETUQ in a Japanese context in older Japanese adults.

    Methods

    A sample of older Japanese adults (n = 164) including persons with (n = 32) and without (n = 132) cognitive impairment was interviewed with the ETUQ, including original items (ETs) and added Japanese context-specific items. Data were analyzed using a Rasch measurement model.

    Results

    The analysis demonstrated acceptable functioning of the rating scale, internal scale validity, person response validity, and person-separation reliability of the Japanese ETUQ according to the Rasch model. However, evidence supporting unidimensionality in the Japanese ETUQ was not consistent in this sample. The added Japanese items did not significantly change the estimated individual person measures of perceived ability to use ET.

    Conclusion

    The Japanese ETUQ seems to be a sensitive tool to evaluate perceived ability in ET use among elderly people in Japan with and without cognitive impairment. Therefore, it could be used in research and clinical practice.

  • 18.
    Mondaca, Margarita
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Johansson, Karin
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Josephsson, Staffan
    Department of Applied Social Sciences, NTNU, Norway University of Technology and Science, Trondheim, Norway.
    Rosenberg, Lena
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    In search for the “humane”: staffs’ perspectives on everyday activities in a nursing home2020In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 24, no 4, p. 679-688Article in journal (Refereed)
    Abstract [en]

    Objectives: To better understand how a dialogue about the influence of nursing home residents on their everyday activities evolve among diverse practitioners and to identify the consequences of such an understanding in practice.

    Methods: Inspired by a collaborative approach, five workshops, one focus group and follow up interviews were conducted. The participants were 19 diverse practitioners. Analysis followed a dialogical approach.

    Findings: Tensions, opportunities and challenges were articulated and discussed during the workshops and are developed in: a) Bypassing the “humane”? The dilemma between using shields preventing engagement or acting in a clandestine manner b)“What is our stance?” Seeking common ground on which to stand regarding everyday activities and c) Recognising expertise and seeking connections.

    Discussion: For the staff, acting in a clandestine manner seems to create ways of enabling “humane” practices towards nursing home residents. The “clandestine manners” seem to be grounded in an effort on the part of the staff to make sense of the everyday activities for the nursing home residents. These “clandestine manners” could be seen as responses to institutional routines and a lack of common ground on the understanding of everyday activities in the context of nursing homes.

  • 19.
    Mondaca, Margarita
    et al.
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Occupational therapy, Huddinge, Sweden.
    Josephsson, Staffan
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Occupational therapy, Huddinge, Sweden; Norway University of Technology and Science, Department of Applied Social Sciences, NTNU, Trondheim, Norway.
    Borell, Lena
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Occupational therapy, Huddinge, Sweden.
    Katz, Arlene
    Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, Cambridge, MA, United States.
    Rosenberg, Lena
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Occupational therapy, Huddinge, Sweden.
    Altering the boundaries of everyday life in a nursing home context2019In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 26, no 6, p. 441-451Article in journal (Refereed)
    Abstract [en]

    Background: Despite global and local policy frameworks that explicitly aim to privilege participation and active engagement of older adults living in nursing homes, this group often has limited possibilities to engage in occupations and to have influence in their everyday lives. Aim: To explore how older adults’ engagement and influence in an occupation can emerge in everyday life in a nursing home setting.

    Material and methods: A participatory qualitative approach was applied. Older adults living in a nursing home participated in a Book Club that was created collaboratively between researchers, residents, and the nursing home community.

    Findings: The analysis identified qualities of altering the boundaries of everyday life and addressing the uncertain conditions for influence and engagement as processes actualized by the residents when engaging in the Book Club. Further analysis identified how these processes involved ordinariness, familiarity, fellowship, and connectedness.

    Conclusion and Significance: Engagement and influence in occupation in a nursing home is possible when enabling partnerships and resourcefulness among the residents. However, such enablement is not guaranteed and needs to be actively upheld by the nursing home community in order to build practices aligned with policy frameworks of participation.

  • 20.
    Mondaca, Margarita
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Josephsson, Staffan
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Applied Social Sciences, Norway University of Technology and Science (NTNU), Trondheim, Norway.
    Katz, Arlene
    Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States.
    Rosenberg, Lena
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Influencing everyday activities in a nursing home setting: A call for ethical and responsive engagement2018In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 25, no 2, article id e12217Article in journal (Refereed)
    Abstract [en]

    This study focuses on influence that older adults, living in nursing homes, have over everyday activities. Everyday activities are key to sustain a sense of stability, predictability, and enjoyment in the local world of people's everyday and therefore a critical dimension of the person-centeredness framework applied within gerontology. This narrative ethnographic study aimed to shed light on how influence can be situated contextually, and how it can emerge through activities as well as how it is negotiated in everyday by frail older adults living in a nursing home. Residents, staff members, and significant others from one nursing home in an urban area of Sweden participated in this study. Data were gathered through fieldwork, including participant observation and formal and informal conversations during a period of 6 months. Data were analyzed through a narrative interpretative approach. The findings are presented in narrative form as exemplars. The exemplars—Craquelures as justification, Seeking a place for other life worlds and An almost perfect trip—reveal a gap between the client-centeredness framework and lived experiences regarding older adults’ influence in everyday activities. The role of everyday activities in the context of frailty is discussed in terms of ethical and responsive engagement, and implications for health-care practices are considered.

  • 21.
    Nilsson, Ingeborg
    et al.
    Department of Community Medicine and Rehabilitation, Occupational Therapy, Umeå University, Umeå, Sweden.
    Luborsky, Mark
    Institute of Gerontology, Wayne State University, Detroit, MI, USA; Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Rosenberg, Lena
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Rehabilitation. Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Sandberg, Linda
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Boström, Anne-Marie
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden; Karolinska University Hospital, Theme Ageing, Stockholm, Sweden; Western Norway University of Applied Sciences, Campus Haugesund, Haugesund, Norway.
    Borell, Lena
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Perpetuating harms from isolation among older adults with cognitive impairment: observed discrepancies in homecare service documentation, assessment and approval practices2018In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 18, article id 800Article in journal (Refereed)
    Abstract [en]

    Background: Older persons with cognitive impairment (CI) risk social isolation. Strong evidence shows that perceived loneliness, or inadequate social networks, triggers and increases health problems. How homecare systems address social participation remains unknown; anecdotal data suggests there are significant gaps. This study's objective was to identify and describe how the assessors of homecare needs document social participation among persons with CI and how their documentation corresponds with the services actually provided to meet social needs. The research questions were: How and what kinds of social participation needs are documented on need assessment forms? What types of homecare services (with a social focus) are documented and approved? How are specified needs in social participation profiles addressed by a homecare service?

    Methods: Descriptive data from need assessment forms and their attached care plans for all applicants aged 65+ were collected during a 2 month period from a large homecare agency serving a municipality in Sweden. Persons with documented CI (n = 43) in the group were identified. Qualitative data analysis was conducted to examine the research questions.

    Results: Social participation factors were not documented consistently. The relationship between recognition of limitations to social participation and approval of service eligibility was not consistent. Social participation was designated by references to social status, sometimes by social network size, and occasionally by limitations to social participation. The range of approved homecare services (with social focus) covered services such as day care center visits or companionship. Three profiles of social participation were identified: clients with, (a) no participation limitations; (b) potential limitations; and (c) marked limitations.

    Conclusion: Given the known health harms from social isolation and the high risk of isolation among older persons with CI, this novel study's documentation of inadequate and inconsistent information in homecare social need assessments and services is sobering. The findings suggest a pressing need for initiatives to formulate best practices and standards to ensure alignment of care service systems to the health needs of the growing group of aging individuals with CI.

  • 22.
    Nordin, Therese
    et al.
    Department of Community Medicine and Rehabilitation, Division of Occupational Therapy, Umeå University, Umeå, Sweden.
    Rosenberg, Lena
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Nilsson, Ingeborg
    Department of Community Medicine and Rehabilitation, Division of Occupational Therapy, Umeå University, Umeå, Sweden.
    Personhood in aloneness and in affinity: satisfactory social participation among home care recipients2022In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 29, no 7, p. 563-577Article in journal (Refereed)
    Abstract [en]

    Background: Social participation can be described as engaging in activities that provide interaction with others, and support for social participation may reduce loneliness and improve health. However, there is limited knowledge about social participation in a home care context.

    Aim: To explore the perceptions and experiences of community-dwelling older adults with regard to aspects related to social participation in a home care context.

    Materials and methods: Seven home care recipients, aged 79-94 years, from two Swedish municipalities participated in semi-structured interviews. The interviews were analyzed using qualitative content analysis.

    Results: The study identified the central theme, Personhood in aloneness and in affinity, as important in accomplishing satisfactory social participation. The results incorporated cultivating personal interests and navigating occupations, as well as having one's needs seen and experiencing mutuality in social encounters.

    Conclusions: The study nuances existing knowledge about social participation among older home care recipients, and the findings strengthen the importance of framing a home care environment where recipients can cultivate personhood and be recognized as valuable individuals with relevant needs.

    Significance: This study extends current understandings of the variety and richness of the social participation and occupational engagement enjoyed by older home care recipients, to be considered in research and practice.

  • 23.
    Nygård, Louise
    et al.
    Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Kottorp, Anders
    Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Rosenberg, Lena
    Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Making use of research: Clinical views on an evaluation of everyday technology use2015In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 22, no 1, p. 24-32Article in journal (Refereed)
    Abstract [en]

    Objective: The study aim was to investigate how and when an evaluation of perceived difficulty in use of everyday technology (Everyday Technology Use Questionnaire, ETUQ) could be used in clinical occupational therapy.

    Method: Eight focus-group interviews were undertaken with a total of 42 participants (occupational therapists), and data were analysed with a constant comparative approach.

    Results: The findings are presented in four main categories, including (i) appropriate purposes and contexts for using ETUQ, (ii) standardization versus individual flexibility, (iii) approaching everyday technology use and occupation as one whole, and (iv) synthesizing and documentation.

    Conclusions: In conclusion, the participants considered ability to use technology to be an important topic for occupational therapy, particularly in investigations of clients with subtle disabilities and in connection with discharge from hospital-but not in inpatient care. They had different views on how to integrate ETUQ with evaluations of occupational performance, and new ideas on how information about clients' ability to use technology could be utilized in interventions. They held standardized evaluations in high regard, but a paradox appeared in that many of them would use ETUQ in a non-standardized way, while simultaneously asking for a standardized output to be used in clients' medical files and to guide interventions.

  • 24.
    Nygård, Louise
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Mäki Petäjä Leinonen, Anna
    University of Eastern Finland, Joensuu, Finland.
    Astell, Arlene
    Ontario Shores & Univerity of Toronto, Toronto, Canada.
    Nedlund, Ann-Charlotte
    Linköping University, Linköping, Sweden.
    Boger, Jennifer
    University of Waterloo, Waterloo, Canada.
    Heimonen, Sirkkaliisa
    The Age Institute, Helsinki, Finland.
    Rosenberg, Lena
    Karolinska Institutet, Stockholm, Sweden.
    Ylhäinen, Marjo
    University of Eastern Finland, Joensuu, Finland.
    Karjalainen, Katja
    University of Eastern Finland, Joensuu, Finland.
    Kottorp, Anders
    Malmö University, Malmö, Sweden.
    Ryd, Charlotta
    Karolinska Institutet, Stockholm, Sweden.
    Issakainen, Mervi
    University of Eastern Finland, Joensuu, Finland.
    Dementia or mild cognitive impairment: @ work in progress2018In: 28th Alzheimer Europe Conference, Making dementia a European priority, Barcelona, Spain, 29–31 October 2018: Abstract book, 2018, p. 119-119Conference paper (Refereed)
    Abstract [en]

    This multidisciplinary project (occupational therapy, psychology, elder law and labour law, social and political science, and engineering) will provide new insights into what happens when people develop mild cognitive impairment or early stage dementia while still working, how this is infuenced by legislation, and how it is experienced and potentially managed by those concerned. The empirical project will include case studies and the joint compilation of information gathered from the case studies from different countries, providing in-depth understanding of how their situation and transition process might be experienced and managed, and of the influencing conditions, particularly related to the role of technology. Technology might be a hindrance as well as an asset in different cases, that is; technology might not be the solution for all. Development and evaluation of new tools will be included in cases. Based on knowledge generated in these longitudinal case studies, we will co-create a new computer-based tool to support the person in the transition, for example by supporting communication, education, and adapted occupation. We will also investigate how laws, regulations and policies in different countries and organizations can support and/or hinder continued work and/or transition from work, how these are practiced and how they can be understood better by people with dementia/MCI and their employers. Researchers from Sweden, Finland and Canada will collaborate with people with MCI/dementia in the workplace, their families, employers and HR staf. An interdisciplinary, in-depth inquiry into cases in all countries, in combination with analyses of legal regulations and their translation into practice, will add profound new conceptual understanding to produce new guidelines, tools and technologies that enable people with MCI/dementia to take a lead role in managing and choosing their work life and that support these persons, employers, and workplaces as well as the social system.

  • 25.
    Nygård, Louise
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden.
    Nedlund, Ann-Charlotte
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden.
    Mäki Petäjä Leinonen, Anna
    Faculty of Social Sciences and Business Studies, Law School, University of Eastern Finland, Joensuu, Finland.
    Astell, Arlene
    Department of Occupational Sciences & Occupational Therapy & Department of Psychiatry, University of Toronto, Toronto, Canada.
    Boger, Jennifer
    Systems Design Engineering, University of Waterloo, Waterloo, Canada.
    Issakainen, Mervi
    Department of Social Sciences, Faculty of Social Sciences and Business Studies, Kuopio.
    Engvall, Ann-Louise
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden.
    Heuchemer, Birgit
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden.
    Rosenberg, Lena
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Rehabilitation. Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden.
    Ryd, Charlotta
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden.
    What happens when people develop dementia whilst working?: An exploratory multiple case study2023In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 18, no 1, article id 2176278Article in journal (Refereed)
    Abstract [en]

    Purpose

    This study is an in-depth exploration of the unfolding experiences of five persons who developed dementia while still in paid work/employment, and of their significant others. Namely, we explore how they experienced the actions and decisions taken with respect to work, and what the consequences meant to them.

    Methods

    A qualitative longitudinal case study design with multiple cases was used, including five participants with dementia and significant others of their choice. Interviews were undertaken longitudinally and analysed with the Formal Data-Structure Analysis approach.

    Results

    The joint analysis resulted in two intertwined themes: 1) The significance and consequences of a dementia diagnosis: a double-edged trigger, and 2) Sensemaking and agency. The prevalent images of what dementia is, who can/cannot get it and what it will bring, were revealed as the critical aspects. Having the opportunity to make sense of what has happened and participate in decision-making, contributed decisively to the participants? experiences.

    Conclusions

    Findings illustrate how a dementia diagnosis is alien in work-life, but once diagnosed, it may trigger self-fulfiling expectations based upon stereotypical understanding of dementia. A shift is needed from a deficit-focused perspective, to viewing people with dementia as citizens capable of agency.

  • 26.
    Nygård, Louise
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    Rosenberg, Lena
    Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    How attention to everyday technology could contribute to modern occupational therapy: A focus group study2016In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 79, no 8, p. 467-474Article in journal (Refereed)
    Abstract [en]

    Introduction

    Everyday technologies such as mobile phones and ticket vending machines have become increasingly indispensable, profoundly influencing daily life activities. Yet this has been given little attention in occupational therapy. The aim of this study was to explore occupational therapists' views on everyday technologies' relevance, meaning and potential applicability in practice.

    Method

    Focus groups were undertaken with 42 occupational therapists who had been introduced to an assessment of people's ability to use everyday technologies. Data comprised eight focus groups and were analysed with a constant comparative approach.

    Findings

    The findings show how the participants' fields of vision expanded when they discovered new ways of using information related to their clients' everyday technology use, and new roles as therapists that would help make occupational therapy 'modern', that is, more timely and up-to-date. However, this also implied a risk of receiving information that was considered potentially unethical if the detected problems could not be dealt with.

    Conclusion

    Attending to clients as everyday technology users could give occupational therapists new expert roles, and allow clients to be seen as more complete persons. However, as this opportunity also involves priority conflicts and ethical dilemmas, the issue can inspire critical discussion about client-centred occupational therapy. © The College of Occupational Therapists Ltd.

  • 27.
    Palmgren, Marianne
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Division of Information Design, School of Innovation, Design and Engineering, Mälardalen University, Eskilstuna, Sweden.
    Rosenberg, Lena
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Rehabilitation. Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Gaber, Sophie Nadia
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden.
    Johansson, Karin
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Family members' reasoning in relation to pleasant environments in nursing homes2023In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 22, no 1, p. 235-251Article in journal (Refereed)
    Abstract [en]

    The physical environment plays an important role in how everyday life is shaped and experienced for persons living in nursing homes as well as for the residents' family and friends. Still, there is a scarcity of research exploring the perspectives of family members of residents regarding everyday life in common areas in nursing homes. In this study, we chose the term, 'a pleasant place', with the ambition of remaining open to various ideas and aspects that family members perceive as relevant when reasoning about the nursing home environment. The study aimed to explore how family members of nursing home residents reason in relation to pleasant places in nursing homes. Four focus group sessions were conducted with a total of 14 family members. Data were analysed using qualitative content analysis. The analysis resulted in four themes. 'A door ajar', highlighted the importance of a nursing home environment that provides potential opportunities for pleasurable everyday moments. 'Why does it have to be so ugly?', revealed how family members perceived institutional logics as guiding the design of the nursing homes, which were misaligned with the logics of a pleasant place. 'A place to care for?', emphasised the physical environment as an integrated aspect of care, in terms of being carefully arranged and used with sensitivity. Finally, 'allegiance to the place' showed that despite the family members' recognitions of shortcomings in the nursing home physical environments, their allegiance to the place provided a sense of the nursing home as a pleasant place. The study contributes knowledge regarding the perceived value of the design of the physical environment in nursing homes, particularly in common areas, as an integral aspect of care, and moves beyond the ideas of homelike and non-institutional nursing home environments.

  • 28.
    Patomella, Ann-Helen
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden; College of Applied Health Sciences, Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, United States.
    Kottorp, Anders
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden; College of Applied Health Sciences, Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, United States.
    Ferreira, Manuela
    Occupational Therapy Department, Escola Superior de Saúde do Alcoitão (Health High School of Alcoitão), Alcabideche, Portugal.
    Rosenberg, Lena
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Uppgard, Brittmari
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Nygård, Louise
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Everyday technology use among older adults in Sweden and Portugal2018In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 25, no 6, p. 436-445Article in journal (Refereed)
    Abstract [en]

    Background: Technology use is relevant for engaging in everyday occupations and aging in place and difficulties might limit participation.

    Aim: The aim of the present study was two-fold: to investigate the internal scale validity of the Everyday Technology Use Questionnaire (ETUQ) in a matched Portuguese and a Swedish sample of older adults without known cognitive impairments and to compare everyday technology use (i.e., the relevance of Everyday Technology (ET) and perceived difficulty of using ET).

    Methods: The Rasch rating scale model was used to investigate the psychometric properties of the data from the two countries. Analyses were then used to compare the samples.

    Results: There is evidence of internal scale and person response validity in the Swedish and Portuguese ETUQ datasets. The Swedish sample demonstrated almost 25% more ETs to be relevant, as compared to the Portuguese sample (p <.05). The samples’ means of perceived difficulty in using ETs were similar.

    Conclusions: The results support that the ETUQ is a valid assessment for measuring the relevance of and perceived difficulty of ET use and is able to detect differences and similarities between older adults in these European countries in relation to ET use in the home and society.

  • 29.
    Rosenberg, Lena
    Department of Neurobiology, Care Sciences And Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Navigating through technological landscapes: Views of people with dementia or MCI and their significant others2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The general aim of this thesis was to increase knowledge about people with MCI or dementia and their significant others, particularly as users of everyday technology and assistive technology (AT). The overall aim included increasing knowledge about the interactions between people with MCI or dementia and their significant others, and technology.

    In Study I the psychometric properties of the Everyday Technology Use Questionnaire (ETUQ), when used with older adults with and without cognitive deficits, were investigated using the Rasch rating scale model. Study II compared the perceived relevance of and difficulty in using everyday technology, measured with the ETUQ, in people with mild-stage dementia, people with MCI, and older adults without known cognitive impairment, using one-way ANOVA analyses. In Study III, actions and driving forces of the agents involved in the process of introducing AT to people with dementia were explored, using a case study methodology combined with grounded theory. Study IV explored and described how significant others of people with dementia related to technology, and their readiness to use AT together with the person with dementia, using a grounded theory approach with focus groups and individual interviews.

    The findings of Study I suggested that the ETUQ demonstrates acceptable validity in terms of internal scale validity and person response validity, when used in this population. The ETUQ showed sensitivity in detecting differences between three subgroups in perceived difficulties in everyday technology use. Study II showed significant differences in perceived difficulty in everyday technology use between all three groups. Here everyday technology was perceived most difficult by people with dementia, followed by people with MCI, and older adults without known cognitive impairment. It also suggested that older adults with MCI or dementia experienced fewer technology artifacts and services as relevant to their daily lives, as compared to older adults without knowncognitive impairment. In Study III, Doing the right thing was the main driving force among actors in this AT intervention process. However, as conflicting views appeared of what the right thing to do was, findings suggest that it is important to be attentive to who has decision power, as this person is likely to influence the process profoundly. Study IV s findings showed that the significant others took a utilitarian perspective on technology, as they refused technology for technology s sake but showed an overall readiness toward using technology if they considered it to benefit them and their relatives with dementia. Technology was found to be important for keeping an active lifestyle and for creating and maintaining self-images among people with dementia and their significant others.

    The thesis contributed new knowledge about the perceived relevance of and difficulty in everyday technology use in older adults, particularly in those with MCI or dementia. Findings also indicate that the ETUQ is a tool that generates valid, sensitive measures of perceived difficulty in everyday technology use, and valuable information about its perceived relevance that may support researchers and clinicians. The thesis contributed new knowledge about the complex situation of a person with dementia and his/her significant others when AT is introduced in the home, suggesting the need of a more flexible and process-oriented procedure with ends-in-view instead of clearly set goals. Significant others of people with dementia were found to be generally ready to adopt technology, although they took a utilitarian perspective. Technology was perceived by them as important for keeping an active lifestyle and for creating and maintaining self-images, which suggests that such conceptions should be considered. Finally, the thesis contributes knowledge of design-related principles and conditions that may be decisive in transactions between people with dementia andtechnology. It is suggested that what is communicated through the interface of the technology isparticularly crucial, as this is likely to guide the person through suitable use, whereas instructions are likely to be forgotten.

  • 30.
    Rosenberg, Lena
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Johansson, Karin
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Where the transactions happen: The unit of analysis when applying a transactional perspective2013In: Transactional Perspectives on Occupation / [ed] M. P. Cutchin, & V. A. Dickie, Dordrecht: Springer, 2013, Vol. 9789400744295, p. 147-156Chapter in book (Refereed)
    Abstract [en]

    In this chapter, we discuss the methodological challenges of applying a transactional perspective in the context of occupational therapy research. We suggest how a unit of analysis that focuses on where and when the transactions happen can be conceptualized and applied. Based on clinical practice and research on interventions in the home environment for older adults with functional limitations, we conclude that a transactional perspective contributes substantially to the understanding of how such interventions are integrated into everyday life. Further, we argue that the situation is an appropriate unit of analysis to grasp where and when the transactions happen. We present examples from two different empirical studies that employed the situation as the unit of analysis to illustrate key points of the argument. We end by discussing the challenges and strengths of using a non-traditional unit of analysis.

  • 31.
    Rosenberg, Lena
    et al.
    Department NVS, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Kottorp, Anders
    Department NVS, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Johansson, Karin
    Department NVS, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    LGBQ-Specific Elderly Housing as a “Sparkling Sanctuary”: Boundary Work on LGBQ Identity and Community in Relationship to Potential LGBQ-Specific Elderly Housing in Sweden2018In: Journal of Homosexuality, ISSN 0091-8369, E-ISSN 1540-3602, Vol. 65, no 11, p. 1484-1506Article in journal (Refereed)
    Abstract [en]

    This study explored how boundaries in relationship to community and identity were created and negotiated among lesbian, gay, bisexual, and queer (LGBQ) people within the framework of picturing LGBQ-specific elderly housing as a housing alternative in older age, by applying focus group methodology. “An island as a sparkling sanctuary” was identified as a metaphor for how symbolic resources defining the LGBQ community can be manifested in LGBQ-specific qualities of elderly housing. The boundary work underlying this manifestation included elaborations on the dilemma between exclusiveness and normality. The findings illustrate further how symbolic resources and collective identities were developed through dialectic interplay between internal and external definitions. Further, the findings show how boundary work generated shared feelings of similarity and group membership. The associated symbolic and social resources not only served to deal with difficult situations but also to manifest LGBQ identity and sense of community as a “gold medal.”

  • 32.
    Rosenberg, Lena
    et al.
    Karolinska Institutet, Division of Occupational Therapy, Huddinge, Sweden.
    Kottorp, Anders
    Karolinska Institutet, Division of Occupational Therapy, Huddinge, Sweden.
    Nygård, Louise
    Karolinska Institutet, Division of Occupational Therapy, Huddinge, Sweden.
    Readiness for technology use with people with dementia: The perspectives of significant others2012In: Journal of Applied Gerontology, ISSN 0733-4648, E-ISSN 1552-4523, Vol. 31, no 4, p. 510-530Article in journal (Refereed)
    Abstract [en]

    Technology is believed to have a potential for supporting significant others of people with dementia but little is known of their experiences and views of technology. The aim of this study is to explore how significant others relate to technology and to their relatives with dementia as technology users. The focus is on both their own use of technology as significant others and the use of technology by their relatives with dementia. Individual interviews and focus group discussions were undertaken and analyzed using a grounded theory approach. The significant others showed an overall readiness toward using technology in their present roles. Technology use in daily activities was perceived to be an important means to keeping retained abilities exercised but could also be perceived as a possible threat to health if activities were oversimplified. The significant others asked for flexible technology not perceived as stigmatizing, to be integrated into existing habits.

  • 33.
    Rosenberg, Lena
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Kottorp, Anders
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Winblad, Bengt
    KI-Alzheimer Disease Research Center, Department of Neurobiology, Caring Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Nygård, Louise
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Perceived difficulty in everyday technology use among older adults with or without cognitive deficits2009In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 16, no 4, p. 216-226Article in journal (Refereed)
    Abstract [en]

    This study's purpose was comparing perceived relevance of and difficulty in use of everyday technology such as remote controls, cell phones, and microwave ovens, in older adults with/without cognitive deficits. Three groups included 157 participants; 34 had mild-stage dementia, 30 had mild cognitive impairment (MCI), and 93 lacked known cognitive impairments. Data were collected in structured interviews with the Everyday Technology Use Questionnaire (ETUQ). Analyses revealed that participants with no known cognitive deficits (Group 3) considered a higher proportion of technologies relevant to their life situation than participants with mild-stage dementia (Group 1) and those with MCI (Group 2). Furthermore, participants with no known cognitive deficits reported the lowest mean level of perceived difficulty in everyday technology use, followed by those with MCI and those with mild-stage dementia. All three groups differed significantly (p <0.01; p <0.001) in perceived difficulty using technology, indicating that measurement of perceived difficulty in everyday technology use may sensitively detect changes resulting from MCI/dementia. Findings indicate that perceived difficulty in using everyday technology increases in people with MCI and is accentuated in mild-stage dementia. This calls for increased attention to these issues when assessing functional ability in daily activities of older adults with possible MCI/dementia, and for further research. © 2009 Informa UK Ltd.

  • 34.
    Rosenberg, Lena
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Nygård, Louise
    Division of Occupational Therapy, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Learning and knowing technology as lived experience in people with Alzheimer's disease: a phenomenological study2017In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 21, no 12, p. 1272-1279Article in journal (Refereed)
    Abstract [en]

    Objectives: Most research on learning in the field of dementia has studied teaching approaches, while little is known about learning as experienced and enacted by the people with dementia. The aim was to explore the lived experience of learning and maintaining knowledge related to technology among people with mild to moderate stage dementia.

    Method: Seven persons with dementia were interviewed in-depth, and data were analyzed with a phenomenological approach.

    Results: The participants positioned themselves on a continuum from ‘Updating and expanding is not for me’ to ‘Updating and expanding is really for me’. They used different ways of learning in their everyday life - relying on one's habituated repertoire of actions, on other people or on technology itself, or belonging to a learning context.

    Conclusions: We have much to gain from better understanding of how people with dementia strive to learn and maintain their skills and knowledge related to technology. This is particularly important as they seem to use other approaches than those employed in current teaching methods. The necessity of learning stands out particularly when it comes to the interaction with the current multitude and ever-changing designs of technologies, including assistive technologies developed specifically to support people with dementia. 

  • 35.
    Rosenberg, Lena
    et al.
    Karolinska Institutet, Sweden.
    Nygård, Louise
    Karolinska Institutet, Sweden.
    Learning and using technology in intertwined processes: A study of people with mild cognitive impairment or Alzheimer's disease2014In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 13, no 5, p. 662-677Article in journal (Refereed)
    Abstract [en]

    People with mild cognitive impairment and Alzheimer's disease are likely to be challenged by the multitude of everyday technology in today's society. The aim of this study was to explore how they try to prohibit, avoid or solve problems in everyday technology use, maintain skills, and learn to use new technology. To explore how the participants applied and reasoned about using everyday technology in real-life situations interviews were conducted while the participants used their own technology in their homes. Interviews were conducted with 20 participants with mild cognitive impairment (n = 10) or Alzheimer's disease (n = 10). The analyses were inspired from grounded theory and resulted in one core category and three sub-categories that represent sub-processes in the core. The core finding presents a continuous, intertwined process of learning and using everyday technology, highlighting how the context was interwoven in the processes. The participants used a rich variety of management strategies when approaching technology, including communication with the everyday technologies on different levels. The findings underscore that it is important to support continued use of everyday technology as long as it is valued and relevant to the person with mild cognitive impairment or Alzheimer's disease. The intertwined process of learning and using everyday technology suggests how support could target different sub-processes.

  • 36.
    Rosenberg, Lena
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Nygård, Louise
    Karolinska Institutet, Stockholm, Sweden.
    P2-251: Assistive technology in the hands of people with dementia and their significant others2008In: Alzheimer's & Dementia: Journal of the Alzheimer's Association, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 4, no 4S Part 13, p. T445-T445Article in journal (Refereed)
    Abstract [en]

    Background

    This is an in-depth, qualitative study of the process that takes place when a person with mild stage dementia is to become a user of assistive technology. The aim is to explore the interaction between the person with dementia, the home context, the assistive technology and significant others.

    Methods

    Data was collected through observations and in-depth interviews on repeated occasions in the homes of persons with dementia. Informants were persons with dementia and, depending on each case, other significant persons (e.g. family, neighbours, occupational therapists, home helpers). Each person with dementia together with the significant others that were related to him/her was considered as one case. Theoretical sampling guided the data collection and the analysis followed the principles of Grounded Theory. The three included cases encompassed a total of eleven informants and eight assistive technologies.

    Results

    Preliminary results indicate that the significant others in each case perceived the assistive technology in different ways and had different views about how it should be used and for what purposes, which also led them to take different steps of action. For example, significant others tried to help the person with dementia to interact with the assistive technology in a way that interfered with the person's own strategies. Moreover, the persons with dementia used assistive technology such as electronic calendar to keep up with forthcoming events but also, even more important to them, to recall what had happened and how they had felt in certain situations. This was in contrast to the significant others who expected the assistive technology to support the prospective memory rather than the episodic memory. Furthermore, the results showed that minor adjustments could profoundly change the meaning and usability of the technology, for example, the placement of it, or combining the assistive technology with another source of information.

    Conclusions

    Based on these preliminary results, assistive technology should not be viewed or introduced as ready-to-use objects without adjustments to fit the user's needs and situation. The process of implementation needs time and attention, including consideration of the expectations and perceptions of the significant others of the person with dementia.

  • 37.
    Rosenberg, Lena
    et al.
    Karolinska Institutet, Sweden.
    Nygård, Louise
    Karolinska Institutet, Sweden.
    Persons with dementia become users of assistive technology: A study of the process2012In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 11, no 2, p. 135-154Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore actions and driving forces of the actors involved in the process of bringing assistive technology (AT) into the life of a person with dementia. Specific focus is placed on the unfolding transactions and what they led to, and how the AT intervention corresponded to the situation of the person with dementia. Three cases, i.e. three persons with dementia and their significant others (n=13), were followed using case methodology and grounded theory. The findings show how doing the right thing was the main driving force, although sometimes a source of conflict between actors. The actors' views differed in many aspects, influencing the choice of problem and selected AT solution as well as the role of the AT and how it was placed and adjusted. A potential risk scenario was also identified, exemplifying how profoundly the view of the one who had decision power influenced the process.

  • 38.
    Rosenberg, Lena
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Nygård, Louise
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Kottorp, Anders
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Everyday technology use questionnaire: Psychometric evaluation of a new assessment of competence in technology use2009In: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 29, no 2, p. 52-62Article in journal (Refereed)
    Abstract [en]

    People with mild cognitive impairment or dementia in a mild phase who live at home are expected to manage the everyday technology that is common in this context. However, the knowledge of how technology use may interfere with the performance of daily activities is sparse. The purpose of this study was to evaluate whether a new instrument measuring relevance and competence in everyday technology use, the Everyday Technology Use Questionnaire, could generate linear measures of competence in a valid manner when used in a population of 157 older adults with and without cognitive impairment or dementia. The results from this study indicate that the Everyday Technology Use Questionnaire demonstrates acceptable levels of scale validity and person response validity, supporting researchers and clinicians with a tool that generates a valid measure of competence in use of everyday technology for people with mild cognitive impairment or dementia in a mild phase who live at home.

  • 39.
    Sandberg, Linda
    et al.
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Borell, Lena
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Edvardsson, David
    School of Nursing and Midwifery, La Trobe University, Heidelberg, VIC, Australia; Department of Nursing, Umeå University, Umeå, Sweden.
    Rosenberg, Lena
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Boström, Anne-Marie
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden; Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Department of Nursing, Western Norway University of Applied Sciences, Haugesund, Norway.
    Job strain: a cross-sectional survey of dementia care specialists and other staff in Swedish home care services2018In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 11, p. 255-266Article in journal (Refereed)
    Abstract [en]

    Introduction: An increasing number of older persons worldwide live at home with various functional limitations such as dementia. So, home care staff meet older persons with extensive, complex needs. The staff's well-being is crucial because it can affect the quality of their work, although literature on job strain among home care staff is limited.

    Aim: To describe perceived job strain among home care staff and to examine correlations between job strain, personal factors, and organizational factors.

    Methods: The study applied a cross-sectional survey design. Participants were dementia care specialists who work in home care (n=34) and other home care staff who are not specialized in dementia care (n=35). The Strain in Dementia Care Scale (SDCS) and Creative Climate Questionnaire instruments and demographic variables were used. Descriptive and inferential statistics (including regression modeling) were applied. The regional ethical review board approved the study.

    Results: Home care staff perceived job strain - particularly because they could not provide what they perceived to be necessary care. Dementia care specialists ranked job strain higher (m=5.71) than other staff members (m=4.71; p=0.04). Job strain (for total score and for all five SDCS factors) correlated with being a dementia care specialist. Correlations also occurred between job strain for SDCS factor 2 (difficulties understanding and interpreting) and not having Swedish as first language and SDCS factor 5 (lack of recognition) and stagnated organizational climate.

    Conclusion: The study indicates that home care staff and particularly dementia care specialists perceived high job strain. Future studies are needed to confirm or reject findings from this study.

  • 40.
    Sandberg, Linda
    et al.
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Borell, Lena
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Rosenberg, Lena
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Risks as dilemmas for home care staff caring for persons with dementia2021In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 25, no 9, p. 1701-1708Article in journal (Refereed)
    Abstract [en]

    Objectives: Many persons with dementia live at home with support from home care services. Despite this, research is scarce concerning how risks in daily life among persons with dementia are perceived and handled by home care staff. This study aimed to explore how home care staff identify risks in the everyday lives of persons with dementia, and to inquire into how they reasoned about their own actions related to those risks.

    Method: A qualitative approach was applied for the study. Both individual interviews and focus groups were conducted with home care staff (n = 23). Data was analysed using a constant comparative method.

    Results: Identifying, reasoning and acting upon risks in the everyday lives of persons with dementia were related to several dilemmas for the home care staff. These dilemmas are described and elaborated on in three categories: 1) Strategies for tracking risks, 2) Dilemmas concerning where to draw the line and deciding when to act, and 3) Dilemmas when acting on risks.

    Conclusion: The study provides new knowledge about the dilemmas that staff in home care services may face and how they reason about managing risks in the homes of persons with dementia. The study shows that the staff had to weigh risk and safety against the autonomy of persons with dementia. Based on these findings, we want to highlight the importance of competence among home care staff and the organizational conditions that must exist in order to manage the challenges of risky situations.

  • 41.
    Sandberg, Linda
    et al.
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Nilsson, Ingeborg
    Department of Community Medicine and Rehabilitation, Occupational therapy, Umeå University, Vårdvetarhuset, Umeå, Sweden; Faculty of Health, Care and Nursing, Norwegian University of Science and Technology, Gjøvik, Norway.
    Rosenberg, Lena
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Borell, Lena
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Boström, Anne-Marie
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Nursing, Karolinska Institutet, Huddinge, Sweden; Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Western Norway University of Applied Sciences, Haugesund, Norway.
    Home care services for older clients with and without cognitive impairment in Sweden2019In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 27, no 1, p. 139-150Article in journal (Refereed)
    Abstract [en]

    Little is known about the types of home care services granted to older clients in Sweden. The objectives of this study were to: (a) identify and describe the range of granted home care services and service hours; (b) compare services granted for clients with and without documented cognitive impairment; and (c) examine associations between the range of granted home care services and factors related to cognitive impairment and demographical characteristics. The study design was descriptive and cross‐sectional. The data, included records of granted home care services for clients age 65+ with (n = 43) and without (n = 88) cognitive impairment documented by the local municipality assessors, collected from one agency in Sweden during a 2‐month period in 2015. Data analyses resulted in an overview of the range of home care services divided into two categories: personal care and service. In the personal care category, the median was 3 for types of services (range 0–12), and shower (n = 69; 52.7%) was the most common service. In the service category, the median was 5 for types of services (range 0–10), and cleaning the household (n = 103; 78.6%) was the most common service. The median for service hours was 27 hr per month (range 2.5–127.5). Logistic regression models revealed that cognitive impairment was associated with a higher number of services in the personal care category and a higher number of hours per month. Living alone was associated with a higher number of services in the service category. In conclusion, a wide range of home care services were provided for clients who have complex needs in daily life. Home care services were granted to clients with cognitive impairment and to a greater extent with clients who were living alone.

  • 42.
    Sandberg, Linda
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Rosenberg, Lena
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Sandman, Per-Olof
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Department of Nursing, Umeå University, Umeå, Sweden.
    Borell, Lena
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Risks in situations that are experienced as unfamiliar and confusing – the perspective of persons with dementia2017In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 16, no 4, p. 471-485Article in journal (Refereed)
    Abstract [en]

    An increasing number of people with dementia are ageing at home in Sweden and in other countries. In order to meet the safety requirements, knowledge about how persons with dementia experience risks is required. The aim of the study was to explore and better understand how persons with dementia, living at home, experience risks in their daily life and how they handle these situations. Twelve persons with dementia were interviewed using open-ended questions, and the data were analyzed using a content analysis approach. Findings showed that participants experienced situations fraught with risks in their daily life as unfamiliar and confusing. Previously familiar places became unfamiliar to them, and details did not come together. They were uncertain about what actually had happened. How the participants handled these situations in order to reduce the risks are described.

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