BACKGROUND: Dance classes for people with Parkinson's Disease (PD) are offered worldwide; however, further studies are needed to explore patients' experiences of how dance affects well-being.

PURPOSE: To explore how Dance for Parkinson (Dance for PD) is experienced, and how it contributes to the well-being and health of participants in Sweden.

METHODS: This qualitative study collected data from four focus groups. Participants were asked how dance classes impacted their well-being, and their ability to perform activities of daily life. The focus groups were recorded and transcribed. Data were analysed using content analysis, meaning units were coded, and codes were coalesced into categories from which themes were abstracted.

RESULTS: Dance for PD provided a multifaceted experience related to social relationships, aesthetic context, feelings of wellbeing and the physical experience of dancing. The main theme contained four sub-themes: Connectedness, Pleasure and glamour, Well-being in mind and body and Customized movements.

CONCLUSION: The present study highlights that health and well-being are improved by Dance for PD. It is an enjoyable activity that meets the specific needs of persons living with the consequences of PD and should therefore be promoted by occupational therapists.

Tokyo is the most aged mega-city in the world, yet it has been subjected to few micro-scale evaluations of walkability in its super-aged neighborhoods. Systematic walking audits were conducted in two aging cities within western aspect of Tokyo to assess street-level walkability from older-adult housing to local destinations. A multi-method approach included administration of the Microscale Analysis of Pedestrian Streetscapes (MAPS-mini) tool augmented with GIS analyses and photography across 10 super-aged neighborhoods (40 walking routes and 102 street segments) in the cities of Musashino and Mitaka. Musashino city had measurably better conditions for walking than the adjacent municipality of Mitaka with evidence of significant intra- and inter-city environmental variations. Prevailing barriers across both cities included poor access to parks and public transit, limited seating and shelter, inconsistent pedestrian infrastructure, narrow roadways, and few traffic calming measures. Signs of neighborhood disorder were conspicuously absent suggesting that sociocultural influences may enhance walkability in the context of sparse infrastructural support. These findings have implications for age-friendly remediation of pedestrian conditions in aging mega cities.

Background: Sexual health is an important issue in daily life, but little is known about occupational therapy (OT) students’ views on these matters.

Aim: To explore occupational therapy students’ views on addressing sexual health in their future professional role.

Material and methods: A descriptive qualitative study involving 37 OT students in 5 focus groups was performed and analyzed using content analysis.

Results: Three categories: ‘Sexual health is part of occupational therapy and but not of the OT educational program’; ‘Need for knowledge to identify and intervene related to sexual health problems’; and finally, ‘Communication about sexual health—unknown, untried, but necessary’, formed the theme, ‘Willing to try, wanting to know more, and recognizing not only the difficulties and challenges but also the importance of sexual health in OT practice’.

Conclusions: OT-students consider sexual health as part of OT-practice, but experience lack of knowledge of sexual health related to disease/disability, cultural diversity, and age and sexual orientation. Educational programs need to cover these matters, including how to address sexual health in OT-practice, to enhance OT’s future competence related to promotion of sexual health for clients.

Significance: Knowledge on students’ views are vital to guide education on this important, rather neglected, area. 

Radiation Therapy (RT) is a common treatment after breast cancer surgery. The high-tech environment and unfamiliar nature of RT can affect the patient’s experience of the treatment. Misconceptions or a lack of knowledge about RT processes can increase levels of anxiety and enhance feelings of being unprepared at the beginning of treatment. Moreover, the waiting time can be long and experienced as meaningless or even life threatening. For successful radiotherapy, the person often needs to be immobilized. A calm, well informed patient might enhance quality of treatment, both from patient and provider perspective. Waiting times can become meaningful instead of meaningless if used wisely for information and preparation for patients and loved ones.

Background: When and how people were able to engage in everyday occupations changed suddenly with the coronavirus pandemic. Defined as a risk group due to their age, people 70 years and older in Sweden experienced confinement, as did older adults globally.

Aim: To explore how doing, being, becoming, and belonging as dimensions of occupation were manifested in the lives of Swedish people 70 years or older, 100 days into the coronavirus pandemic.

Method: Data were elicited through semi-structured interviews with 17 participants (11 women, 6 six men, mean age 76 years), living in ordinary housing in Sweden. Interviews were conducted in June 2020 as part of a larger longitudinal research project. A directed content analysis approach was used to analyse the data based on the occupational dimensions of doing, being, becoming, and belonging.

Results: After 100 days of confinement, daily occupations had been changed, and habits and routines disrupted. However, the need to engage in occupations was strong. Participants expressed how they adapted their occupations to the restrictions, but also how their doing affected their well-being, further development, and opportunities for social interactions.

Conclusion: The participants, who were older people without any specific diagnosis, reflected upon their daily occupations during an unrehearsed natural experiment when, more than anything else, the social environmental circumstances changed. The analysis elucidates how doing, being, becoming, and belonging is embedded in people?s lives. The study can serve as a foundation to further research on understanding people?s individual needs as occupational beings.

Background: Public transport is low cost, allows for independence, and facilitates engagement and participation for non-drivers. However, the viewpoints of individuals with cognitive disabilities are rarely considered. In Australia, the prevalence of Autism Spectrum Disorders (ASD) is approximately 1% and increasing. Many individuals with ASD do not possess a driver's licence, indicating that access to public transport is crucial for their independence. However, at present, there is no research on the opinions of adults with ASD on public transport. Aim: To identify the viewpoints of adults with ASD regarding the barriers and facilitators of public transport usage and their transportation preferences, and to contrast these against the viewpoints of neurotypical adults. Methods: Q. method was used to identify the viewpoints of both participant groups on public transport. Participants consisted of 55 adults with a diagnosis of ASD and a contrast group of 57 neurotypical adults. Both groups completed a Q sort task which took place in either Perth or Melbourne, Australia. Results: The most prominent viewpoint indicated that both groups preferred to use public transport over driving and believed that it supported their independence. This viewpoint also indicated that both groups preferred to use electronic ticketing when using public transport. Interestingly, the second most prominent viewpoint indicated that both groups preferred to drive themselves by private car rather than use public transport. Discussion: It appears that the viewpoints of adults with and without ASD regarding public transportation were largely similar. However, questions arose about whether the preference for public transport in the ASD group may be more a result of difficulties obtaining a driving licence than a deliberate choice. The only barrier specified by adults with ASD related to crowding on public transport. Safety and convenience in relation to location and timing of services were barriers reported by neurotypical adults.

The overall aim of the present thesis was to explore and characterise occupational participation and community mobility from an occupational perspective of health and well-being, and to elucidate potential barriers and facilitators for occupational participation and community mobility in older men and women.

In Study I, questionnaires were sent to a sample of older citizens (75+) in three Swedish mid-sized municipalities. This survey focused on actual and preferred travel opportunities and was returned by 957 persons (response rate 46%). Although older people appreciated the existing travel opportunities, there was evidence of restricted community mobility for some sub-groups of older people, due to various perceived barriers. More efforts must be put into accessibility improvements including usability from the perspective of older people.

In Study II nine focus group interviews with a total of 42 participants (20 men) were conducted, focusing on older peoples’ motives for, and experiences of, community mobility and occupational participation outside the home. The main category “Continuing mobility and occupational participation outside the home in old age is an act of negotiation” summarised the findings. This main category was abstracted from the generic categories “Occupational means and goals”, “Occupational and mobility adaptation” and “Occupational barriers and facilitators”, and their subcategories. Community mobility was identified as an important occupation that in itself also facilitated occupational participation outside the home. Individual community mobility seemed to be influenced by, for example, age and gender, as well as habits acquired over time. Furthermore, community mobility was negatively affected not only by physical barriers, but also by social and attitudinal barriers in the public environment.

Study III identified and described older people’s viewpoints on community mobility and occupational participation in older age through a Q-methodology study conducted with 36 participants, including men and women, both drivers and non-drivers. Three viewpoints were found and assigned content-descriptive denominations; viz.: “Prefer being mobile by car”, “Prefer being mobile by public transport” and “Prefer flexible mobility”. Unfortunately, the existing demand-responsive Special Transportation Systems was not considered an attractive enough alternative by any of the participants. Thus, intermediate community mobility options are needed for those who no longer can drive or use public transport. In

Study IV factors associated with community mobility, and decreased community mobility over time, for older men and women were described. Data were based on the Gender study “Aging in men and women: a longitudinal study of gender differences in health behaviour and health among elderly” and collected through surveys in 1994 and 2007. The base-line sample consisted of 605 twin-pairs, i.e., 1,210 individuals, aged 69-88, and the follow-up of 357 individuals (165 men and 192 women), aged 83-97. This surveycovered health and health-related issues including community mobility and occupational participation. Continuing community mobility was cross-sectionally (at follow-up) and prospectively (from baseline to follow-up) associated with better self-reported subjective health rather than self-reported health conditions for both men and women. For men, community mobility was also cross-sectionally associated with few or non-existant depressive symptoms, while reduced community mobility was prospectively associated with higher age for women. Consequently, interventions aiming to enable community mobility must move beyond interventions directed towards health conditions and instead target subjective health and well-being.

Background: Evidence-based practice (EBP) is a process through which research is applied in daily clinical practice. Occupational therapists (OTs) and physiotherapists (PTs) are expected to work in line with EBP in order to optimise health care resources. This expectation is too seldom fulfilled. Consequently, research findings may not be implemented in clinical practice in a timely manner, or at all. To remedy this situation, additional knowledge is needed regarding what factors influence the process of EBP among practitioners. The purpose of the present study was to identify factors that influence the use of EBP and the experienced effects of the use of EBP among PTs and OTs in their clinical work.

Method: This was a qualitative interview study that consisted of six group interviews involving either OTs or PTs employed by the Jönköping County Council in the South of Sweden. Resulting data were analysed using content analysis.

Results: The analysis resulted in the following categories: “definition of evidence and EBP”, “sources of evidence”, “barriers to acquiring evidence and to using evidence in clinical work”, “factors that facilitate the acquisition of evidence and the use of evidence in clinical work”, and “personal experiences of using EBP”. Basing clinical practice on scientific evidence evoked positive experiences, although an ambivalent view towards acting on clinical experience was evident. Participants reported that time for and increased knowledge about searching for, evaluating, and implementing EBP were needed.

Conclusion: Because OTs are more oriented towards professional theories and models, and PTs are more focused on randomised controlled trials of interventions, different strategies appear to be needed to increase EBP in these two professions. Management support was considered vital to the implementation of EBP. However, the personal obligation to work in line with EBP must also be emphasised; the participants apparently underestimate its importance.

Facilitated by mobility, occupational participaton is vital in old age. However, the relative importance of other influencing factors remains unclear. The present study describes older people's motives for, and experiences of, mobility and occuoational participation outside the home. Nine focus group interviews were conducted and analyzed using content analysis. Occupational participation and mobility was individually experienced even if some subjective perspectives were common. Continuing mobility and occupational participation outside the home in old age is an act of negotiation, encompassing occupational means and goals, occupational and mobility adaptation, and occupational barrieres and facilitators.

BACKGROUND: In the beginning of the COVID-19 pandemic, Swedish authorities enforced specific recommendations on social distancing for adults 70 years and older (70+). Day-to-day life changed for 15% of the Swedish population. The aim of the study was to explore how adults 70+ experienced and managed changes in everyday life due to the COVID-19 pandemic and how those changes affected wellbeing at the beginning of the virus outbreak.

METHODS: Eleven women and six men, (mean age 76 years), living in ordinary housing, participated in remote semi-structured interviews in April 2020. The interviews were analysed with qualitative content analysis.

FINDINGS: The theme Suddenly at risk - '…but it could have been worse' included four categories My world closed down; Negotiations, adaptations and prioritizations to manage staying at home; Barriers and facilitators to sustain occupational participation; and Considerations of my own and other's health and wellbeing emerged from the data analysis.

CONCLUSION: Everyday life changes had implications for health and well-being. The participants questioned previous conceptions of meaning in relation to habitual activities, likely leading to consistent occupational changes. However, these long-term effects remain to be explored, and considered to enable older adult's health during the pandemic and beyond.

Community mobility, defined as "moving [ones] self in the community and using public or private transportation", has a unique ability to promote older peoples' wellbeing by enabling independence and access to activity arenas for interaction with others. Early predictors of decreased community mobility among older men and women are useful in developing health promoting strategies. However, long-term prediction is rare, especially when it comes to including both public and private transportation. In the present study factors associated with community mobility and decreased community mobility over time among older men and women were identified. Gender-balanced data from a project entitled "Aging in men and women: a longitudinal study of gender differences in health behavior and health among elderly" (GENDER) based on pairs of unlike-sex twins were utilized. In total, 119 men and 147 women responded to a questionnaire in 1994 and 2007. Respondents were between 82 and 96 years old at follow-up. After 13 years, 40% of men and 43% of women had decreased community mobility, but 47 % of men and 45 % of women still experienced some independent community mobility. Cross-sectional independent community mobility among men was associated with higher ratings of subjective health, reporting no depression and more involvement in sport activities. Among women, cross-sectional independent community mobility was associated with better subjective health and doing more instrumental activities of daily living outside the home. Lower subjective health predicted decreased community mobility for both men and women, whereas self-reported health conditions did not. Consequently, general policies and individual interventions aiming to improve community mobility should consider older persons' subjective health.

Community mobility, defined as "moving [ones] self in the community and using public or private transportation", has a unique ability to promote older peoples' wellbeing by enabling independence and access to activity arenas for interaction with others. Early predictors of decreased community mobility among older men and women are useful in developing health promoting strategies. However, long-term prediction is rare, especially when it comes to including both public and private transportation. The present study describes factors associated with community mobility and decreased community mobility over time among older men and women. In total, 119 men and 147 women responded to a questionnaire in 1994 and 2007. Respondents were between 82 and 96 years old at follow-up. After 13 years, 40% of men and 43% of women had decreased community mobility, but 47% of men and 45% of women still experienced some independent community mobility. Cross-sectional independent community mobility among men was associated with higher ratings of subjective health, reporting no depression and more involvement in sport activities. Among women, cross-sectional independent community mobility was associated with better subjective health and doing more instrumental activities of daily living outside the home. Lower subjective health predicted decreased community mobility for both men and women, whereas self-reported health conditions did not. Consequently, general policies and individual interventions aiming to improve community mobility should consider older persons' subjective health.

Objective: The Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs-OT) are used internationally to measure the outcomes of occupational therapy services across diagnoses, ages, and health care settings. This study reports on the inter-rater and test-retest reliability of the Self-care and Transfer scales as well as the intra-rater reliability of all scales of the Swedish (AusTOMs-OT-S) translation.

Methods: Fifteen occupational therapists rated 11 case study clients on two occasions, separated by two weeks. Test-retest reliability and inter-rater reliability were calculated for the Self-care scale and Transfer scales. Moreover, intra-rater reliability was calculated for each of the 15 therapists across all 12 scales.

Results: The inter-rater reliability intraclass correlation coefficients (ICCs) were all found to be high to very high, ranging from ICC 0.762 to 0.904; the intra-rater reliability coefficients were also very good with 11 of the 15 therapists achieving ICCs of 0.745 or over, and finally the test-retest ICCs were also found to be high, ranging from 0.705 to 0.920.

Conclusions: Although further research is required to confirm reliability, preliminary reliability of the AusTOMs-OT Swedish translation has been demonstrated and therapists can have confidence when using the scales.

Registered Nurses (RNs) are in the immediate position to provide End-of-life (EOL) care and counselling for patients and families in various settings. However, EOL-care often creates feelings of uncertainty and inadequacy linked to inexperience, lack of education, and attitude. To identify and describe factors associated with RNs' attitudes towards EOL-care, and to identify whether and how these attitudes differ from undergraduate nursing students' (UNSs) attitudes, a descriptive and comparative, quantitative study was performed. The FATCOD-instrument, focusing on attitude towards EOL-care, was used and the results analysed with descriptive and nonparametric statistics. In total, 287 RNs in 14 different specialist programmes, and 124 UNSs participated. A statistically significant difference (p = 0.032) was found in attitude towards EOL-care based on clinical experience. RNs in “Acute Care” and “Paediatric & Psychiatry Care” specialist programmes had a less positive attitude towards EOL-care (compared to RNs in other specialist programmes), while RNs attending the Palliative Care programme had the most positive attitudes. RNs and UNSs' scores differed statistically significantly in 17 out of 30 FATCOD variables. Finally, the results imply that there is a need for greater emphasis on further continuing education within EOL care for RNs working in all types of clinical specialities to encourage RNs talking about death and to enhance attitudes towards EOL care.

Bakgrund: Förmågan och möjligheter att förflytta (mobilitet) begränsas ofta i senare delen av livet, med negativa konsekvenser fördelaktighet i dagliga och sociala aktiviteter. Såväl i praktisk verksamhet som för forskning behövs instrument som kanbedöma mobilitet. The Life Space Assessment (LSA), utvecklat i USA, är bedömer en individs mobilitet genom attfokusera på förmågan att ta sig till olika “life-spaces”, från rummet där personen sover till platser bortom hemorten undersenaste månaden. LSA beaktar dessutom hur ofta detta sker, och om det sker med hjälpmedel eller hjälp av annanperson.

Syfte: Syftet var att undersöka samtidig validitet och testa reliabilitet av LSAs svenska version.

Metod: LSA översattes till svenska och inkluderades tillsammans med andra hälsorelaterade mått i en populationsbaserad studiemed slumpmässigt utvalda personer mellan 75 och 90 år (medelålder 81 år) i enskilt boende. LSA summerades till fyrapoängsummor, dvs total, oberoende, assisterad och maximal life-space poäng. 298 individer ingick i reliabilitetstudienoch besvarade LSA vid två tillfällen med 14 dagars mellanrum. 312 individer ingick i validitetsstudien där LSA jämfördesmed andra mobilitetsrelaterade mått.

Resultat/preliminärt resultat: Det fanns inga signifikanta skillnader mellan skattningarna över tid för LSA fyra poängsummor. Medelvärdet för total life-space poäng var t ex 65 (22) och 65 (23) (max 120). Korrelationsvärden (ICC) mellan 0.84-0.94 visar på god till utmärktreliabilitet för total, oberoende och assisterad LSA. Vad gäller validitet påvisas signifikanta (p<0.01) och måttligt till godakorrelationer (0.50- 0.75) mellan LSAs fyra poängsummor och förmåga till förflyttning (överflyttning, balans, uppresningoch gångförmåga), transport (vardagliga resor och nöjesresor), och aktivitet i samhället (inköp och fritid)

Slutsats: Den svenska versionen av LSA har god validitet samt god till utmärkt reliabilitet och kan med förtroende användas för attbedöma mobilitet hos äldre i enskilt boende.

BACKGROUND: The Life-Space Assessment (LSA), developed in the USA, is an instrument focusing on mobility with respect to reaching different areas defined as life-spaces, extending from the room where the person sleeps to mobility outside one's hometown. A newly translated Swedish version of the LSA (LSA-S) has been tested for test-retest reliability, but the validity remains to be tested. The purpose of the present study was to examine the concurrent validity of the LSA-S, by comparing and correlating the LSA scores to other measures of mobility.

METHOD: The LSA was included in a population-based study of health, functioning and mobility among older persons in Sweden, and the present analysis comprised 312 community-dwelling participants. To test the concurrent validity, the LSA scores were compared to a number of other mobility-related variables, including the Short Physical Performance Battery (SPPB) as well as "stair climbing", "transfers", "transportation", "food shopping", "travel for pleasure" and "community activities". The LSA total mean scores for different levels of the other mobility-related variables, and measures of correlation were calculated.

RESULTS: Higher LSA total mean scores were observed with higher levels of all the other mobility related variables. Most of the correlations between the LSA and the other mobility variables were large (r = 0.5-1.0) and significant at the 0.01 level. The LSA total score, as well as independent life-space and assistive life-space correlated with transportation (0.63, 0.66, 0.64) and food shopping (0.55, 0.58, 0.55). Assistive life-space also correlated with SPPB (0.47). With respect to maximal life-space, the correlations with the mobility-related variables were generally lower (below 0.5), probably since this aspect of life-space mobility is highly influenced by social support and is not so dependent on the individual's own physical function.

CONCLUSION: LSA was shown to be a valid measure of mobility when using the LSA total, independent LS or assistive LSA.

Background

Life-space mobility is defined as the ability to access different areas extending from the room where the person sleeps to places outside one’s hometown. Life-space mobility is vital to support performance of daily life activities and autonomous participation in social life. However, there is a dearth of research that investigates a wider range of physical functions and functioning in relation to life-space mobility rather than just single aspects. Thus, the purpose of the present study was to identify and describe several measures of physical functioning associated with life-space mobility among older men and women.

Methods

Data used in this study was derived from the OCTO 2 study, a population-based study of health, functioning and mobility among older persons (n = 312) in Sweden. Associations between Life-Space Assessment (LSA) total score and age, sex, Short Physical Performance Battery (SPPB), dizziness, lung function i.e. Peak Expiratory Flow (PEF), grip strength, self-rated vision and hearing were analysed through bivariate and multivariate regression models.

Results

The bivariate models showed that life-space mobility was significantly associated with sex, but also age, SPPB, PEF and grip strength in the total group as well as among men and women. In addition, hearing was significantly associated with life-space mobility among women. Those factors that were statistically significant in the bivariate models were further analysed in multivariable models for the total group, and for men and women separately. In these models, sex, grip strength and SPPB remained significantly associated with life-space mobility in the total group, as well as SPPB among both men and women.

Conclusion

Sex, physical function in terms of physical performance measured by SPPB (balance, gait speed and chair stand), and grip strength are associated with life-space mobility. Consequently, these factors need to be considered in assessments and interventions aiming to maintain mobility in old age.

Background: Demographic changes combined with costly technological progress put a financial strain on the healthcare sector in the industrialized world. Hence, there is a constant need to develop new cost-effective treatment procedures in order to optimize the use of available resources. As a response, the concept of a Mobile Geriatric Team (MGT) has emerged not only nationally but also internationally during the last decade; however, scientific evaluation of this initiative has been very scarce. Thus, the objective of this study was to perform a mixed methods analysis, including a prospective, controlled and randomized quantitative evaluation, in combination with an interview-based qualitative assessment, to measure the effectiveness and user satisfaction of MGT.

Materials and methods: Community-dwelling, frail elderly people were randomized to an intervention group (n=31, mean age 84) and a control group (n=31, mean age 86). A two-year retrospective quantitative data collection and a prospective one-year follow-up on healthcare utilization were combined with qualitative interviews. Non-parametric statistics and difference-in-difference (DiD) analyses were applied to the quantitative data. Qualitative data were analyzed using content analysis.

Results: No significant group differences in healthcare utilization were found before inclusion. Post intervention, primary care contact (including MGTs) increased for the MGT group. Inpatient care decreased dramatically for both groups. Hence, the increase in primary care contact for MGT patients was not accompanied by a reduction in inpatient care compared to the control group. Utilization of non-primary care was lower (p< 0.01) post-intervention in both groups.

Conclusion: There appears to be a “natural” variation in healthcare needs over time among frail elderly people. Hence, it is vital to perform open, controlled clinical studies in tandem with the implementation of new caregiving strategies. The MGT initiative was clearly appreciated but did not fully achieve the desired reduction in healthcare utilization in this study.

Trial registration: Retrospectively registered 09/10/2018, ClinicalTrials.gov ID NCT03662945.

Bakgrund:Mobila geriatriska team (MGT), bestående av läkare och sjuksköterska, har visat sig vara en framgångsrik resurs förmultisjuka äldre med upprepade inläggningar, mycket läkemedel och nedsatt ADL-förmåga. På Höglandet i Jönköpingslän arbetar sedan hösten 2013 ett MGT, som utöver läkare och sjuksköterska också erbjuder insatser från sjukgymnastoch arbetsterapeut under 15 veckor eller längre. MGT inkluderar ett geriatriskt arbetssätt som beaktar helalivssituationen, genom att lindra symtom och behandla sjukdomar, motverka funktionsnedsättningar och främjadelaktighet i aktivitet, för att göra det dagliga livet så bra och tryggt som möjligt för patienten och dennes närstående.Syfte:Projektets syfte är att utvärdera effekter och upplevd nytta av MGT.Metod:Hittills har 18 patienter i åldrarna mellan 65 och 84 fått insatser av teamet och data för utvärdering samlas kontinuerligt.Telefonintervjuer genomförs efter utskrivning med patient och/eller närstående kring upplevd nytta ochförbättringsmöjligheter. En enkät till berörd personal utanför MGT avser att belysa MGT ur ett deras perspektiv. Skattningmed Katz och COPM genomförd före MGT och direkt efter avslutad MGT, utgör ytterligare data, liksom demografiskauppgifter och måluppfyllelse. Uppgifter om besök till sjukvård och inläggning året före anslutning till MGT, under MGT-perioden samt tre respektive sex månader efter MGT registreras.Resultat/preliminärt resultat:Preliminära resultat visar på nöjdhet med MGT från patient/närstående, men också personal. ADL-förmåga påverkasinte. Däremot har 19 av 25 rehabiliteringsmål utvärderats som uppfyllda. Gruppen hade året innan anslutning till MGT 71inläggningar/akutbesök och under 6 månaders MGT-anslutning är motsvarande siffra 24. Om denna förändring kvarståröver tid har ännu inte analyserats, men kommer att kunna presenteras vid Arbetsterapiforum tillsammans med data sombeskrivits under metod.Slutsats:MGT förväntas bidra till att främja målgruppens hälsa, trygghet, aktivitetsnivå och motverka återinläggningar

Rationale for seminar and how it relates to the conference theme:

New and good technological solutions are needed to enable older persons to age in place, i.e., to remain living in their own housing, with safety and security as long as possible (Swedish Institute of Assistive Technology, 2011). Importantly, ageing in place is the general policy in Sweden these days (National Board of Health and Welfare, 2011) and the municipalities are responsible for supporting older persons in their own housing. On the other hand a great deal of support to older persons is informal and provided by family caregivers, i.e., partners or relatives providing basic care (Johansson, Long & Parker, 2012). Moreover, technologies supporting ageing in place are likely to influence health in a positive way from both the older persons’ and their family caregiver’s perspective.

“Landräddningen” provides a GPS-based extended safety and support system (ESS) available through a mobile phone application or a special unit that the user wears around the wrist. Both these (app and special unit) works outside the home, while the traditional PERS (personal emergency response system) provided by the municipalities works merely inside the users’ home. Importantly, it is a vital, societal goal that everyone, regardless of age, functional ability and circumstance in life feel secure also when participating in activities outside the home and being mobile in the community. Consequently, “Landräddningen” is an innovative, technological solution that supports ageing in place, by also filling a gap in social services. The user of “Landräddningen” could let family caregivers follow their position when they feel unsafe. It is also possible to establish a safe perimeter (geo fencing) for people with impaired orientation or memory. “Landräddningen” also provide a monitoring station that in case of an unplanned incident could search for available, listed volunteers that could support users on spot or in case of emergency alert ambulance or police. Given the GPS function and net of volunteers “Landräddningen” has a geographical and sectorial cross border functionality.

The long term goal of “Landräddningen” is that nobody shall disappear, and that all of us shall have a good chance to receive quick support. In previous research including persons with dementia (pwd) using the same ESS that “Landräddningen” builds one, carers noted that pwd were more independent when engaged in activities dependent on community mobility. Staff considered that nearly half of pwd could remain living at home due to the ESS, compared with a third amongst carers.

Objectives/Outcomes:

The session will introduce and describe the services provided by “Landräddningen”. It will also give insight to previous research on the ESS used by “Landräddningen” focusing on users and care givers. Finally, current research on “Landräddningen” including preliminary results will be presented both from users’, care givers, ethical and organizational perspectives. The intent is also to give insight about the effects and benefits of a service like “Landräddningen”, but also challenges when introducing and implementing a service with cross border functionality and how these challenges could be successfully handled.

Outline plan for the session plus timings (not included in word count):

1. Brief introduction to “Landräddningen”
2. Previous research on “Landräddningen”
3. Current research on “Landräddningen”
4. Implications for service like “Landräddningen” including experiences from introducing and implementing and how implementation challenges could be successfully handled.

List of key references/resources (not included in word count):

Johansson, L., Long, H. & Parker M.G. (2012) Informal caregiving for Elders in Sweden: An Analysis of Current Policy Developments Journal of Aging and Social Policy 23, 335-353.

Magnusson, L., Samdman, L., Rosén, K.G., & Hanson, E. (2014) Extended saftey and support systems for people with dementia living at home Jounral of Assistive Technologies (; 188-206

National Board of Health and Welfare. (2011). Bostad i särskilt boende är den enskildes hem [Living in Nursing homes are the Individual’s home]. Stockholm: National Board of Health and Welfare.

Swedish Institute of Assistive Technology. (2011). Teknik för äldre [Technology for older people].   Retrieved 0830, 2013, from http://teknikforaldre.se/

Radiation Therapy (RT) is a common treatment after breast cancer surgery and a complex process using high energy X-rays to eradicate cancer cells, important in reducing the risk of local recurrence. The high-tech environment and unfamiliar nature of RT can affect the patient’s experience of the treatment. Misconceptions or lack of knowledge about RT processes can increase levels of anxiety and enhance feelings of being unprepared at the beginning of treatment. Moreover, the waiting time is often quite long. The primary aim of this study will be to evaluate whether a digital information tool with VR-technology and preparatory information can decrease distress as well as enhance the self-efficacy and health literacy of patients affected by breast cancer before, during, and after RT. A secondary aim will be to explore whether the digital information tool increase patient flow while maintaining or increasing the quality of care.

While a broad spectrum of technologies is integrated in everyday life and routines, most research on ageing, health and technology has focused on attitudes toward and adoption of digital technologies including e-health, or home based monitoring systems. The aim of this study was to explore differences and similarities in attitudes and experiences with different types of technologies and development within and between three generations. We applied a qualitative, descriptive design and recruited a purposeful sample of participants from three generations (30-39, 50-59, 70-79 year old). The 25 participants took part in 3 x 2 focus groups. Forming four categories, the findings show that technologies enable as well as complicate everyday life. Participants expressed trust as well as uncertainty about risks when using technology and stated that use of digital services is required while support is limited. They identified that technology development is inevitable but not always in the service of users. In conclusion, experiences of and attitudes towards technologies and technology development are not limited to generation; perspectives sometimes unite individuals across rather than within generations. Thus future technologies and technology development, as well as services and policies aiming to support the use of said technologies should consider individual user perspectives including needs, desires, beliefs or goals neglected in the existing technology models, and involve users beyond generations defined by chronological age. Such strategies are likely to be more successful in supporting development of technologies usable for all.

Background/Aim: Community mobility supports participation in activities. However, knowledge about issues that influence community mobility and, hence, participation in activities outside the home is limited. Since participation and community mobility are subjectively defined phenomena, further knowledge from an insider’s perspective is needed. The aim of this study was to identify and describe viewpoints on community mobility and participation in older age. Methods: A Q-methodology study was conducted with 36 male and female participants, including drivers and non-drivers. Participants sorted 45 Q-statements along a most to least continuum, indicating their current habitual situation of mobility and participation in activities outside their homes. Results: Three viewpoints were found and assigned content-describing denominations; “Prefer being mobile by car, “Prefer being mobile by public transport” and “Prefer flexible mobility”. Conclusions: All participants were satisfied with their actual participation in activities outside their homes. However, those who preferred to use public transport were less satisfied with their opportunities and possibilities to participate in activities outside their homes. The existing demand-responsive Special Transportation System was not considered to be an attractive enough alternative by any of the participants. Intermediate community mobility options are thus needed for those who can no longer drive or use public transport.

Patienter och professionella vårdaktörer är i en gemensam förändrings- och lärandeprocess, där vården parallellt med medborgarna och samhället lär sig hantera digitalisering. Under senare år, bl.a. pådrivet av covid-pandemin, har digitaliseringen och införande av nya arbetssätt gått så fort att utvärdering och forskning inte hunnit med i samma takt. Syftet med rapporten ”Hur klickar vi med vården?” är att bidra med aktuell kunskap om patienters användarmönster och erfarenheter av digitala och fysiska kontakter med primärvården. Resultaten är tänkt att användas som faktaunderlag och stöd för vårdens utvecklingsarbete.

Sveriges Kommuner och Regioner (SKR) tog hösten 2022 initiativet till forskningsprojektet ”Hur klickar vi med vården?”. Uppdraget genomfördes under 2023 av en oberoende forskargrupp på Hälsohögskolan vid Jönköping University. Resultaten är presenterade i två delstudier baserade på registerdata från primärvården och intervjuer med patienter. All registrerad data från den regionala primärvården i Region Jönköpings län och Region Sörmland under perioden januari 2020 – december 2022 har ingått i undersökningen. Data från Region Jönköpings län omfattar ca 352.000 personer vilka sammanlagt hade haft kontakt med primärvården ca 4,2 miljoner gånger, motsvarande för Region Sörmland var ca 245.000 personer som hade haft ca 3,2 miljoner kontakter. I dessa data ingår kontakter med privata helt digitala vårdgivare och för Region Jönköpings län data från 1177 Sjukvårdsrådgivning. I rapporten ingår även 35 kvalitativa intervjuer med ett nationellt urval av patienter. Resultatet av den kvalitativa studien är presenterat som sex teman som beskriver patienters erfarenheter av kontakt med vården.

INTRODUCTION: The importance of holidays, traditions, and family celebrations to human culture and occupational engagement has been neglected. The aim of this study was to explore how older adults experienced holidays and celebrations with social and physical distancing during the COVID-19 pandemic.

METHODS: A secondary analysis was made on data from the At-Risk Study. Seventeen community-living adults (11 women and 6 men) aged 71-87 years, from Sweden participated. They were interviewed remotely four times during the first year of the pandemic. Data were analysed with qualitative content analysis. No consumer/community involvement occurred.

FINDINGS: Three categories on how the participants hoped for, planned, decided, adapted, avoided, and experienced holidays and celebrations with social and physical distancing included expectations and preparations in unpredictable times; the constant need for re-evaluation; and almost everything turned out differently.

CONCLUSIONS: The desire to celebrate despite pandemic restrictions shows the importance and meaning holidays hold for older adults. Celebrations can be disrupted for many reasons, not only as extreme as the ongoing pandemic. For wellbeing in later life health care, social care, and society need to understand the inherent components and acknowledge ways of supporting participation in occasional events such as holidays, traditions, and family celebrations.

Background Patients diagnosed with cancer who are due to commence radiotherapy, often, despite the provision of a considerable amount of information, report a range of unmet information needs about the treatment process. Factors such as inadequate provision of information, or the stressful situation of having to deal with information about unfamiliar things, may influence the patient’s ability to comprehend the information. There is a need to further advance the format in which such information is presented. The composition of information should be tailored according to the patient’s individual needs and style of learning. Method and findings The PD methodology is frequently used when a technology designed artefact is the desired result of the process. This research is descriptive of its kind and provides a transparent description of the co-design process used to develop an innovative digital information tool employing PD methodology where several stakeholders participated as co-designers. Involving different stakeholders in the process in line with recommended PD activities enabled us to develop a digital information tool that has the potential to be relevant and user-friendly for the ultimate consumer. Conclusions Facilitating collaboration, structured PD activities can help researchers, healthcare professionals and patients to co-design patient information that meets the end users’ needs. Furthermore, it can enhance the rigor of the process, ensure the relevance of the information, and finally have a potential to employ a positive effect on the reach of the related digital information tool.

BACKGROUND: Individuals undergoing radiation therapy for breast cancer frequently request information before, throughout and after the treatment as a means to reduce distress. Nevertheless, the provision of information to meet individuals needs from their level of health literacy is often overlooked. Thus, individuals information needs are often unmet, leading to reports of discontent. Internet and digital information technology has significantly augmented the available information and changed the way in which persons accesses and comprehends information. As health information is no longer explicitly obtained from healthcare professionals, it is essential to examine the sequences of the health information process in general, and in relation to health literacy. This paper reports on qualitative interviews, targeting women diagnosed with breast cancer who were given access to a health information technology tool, Digi-Do, before commencing radiation therapy, during, and after treatment. METHODS: A qualitative research design, inspired by the integrated health literacy model, was chosen to enable critical reflection by the participating women. Semi-structured interviews were conducted with 15 women with access to a digital information tool, named Digi-Do, in addition to receiving standard information (oral and written) before commencing radiation therapy, during, and after treatment. A deductive thematic analysis process was conducted. RESULTS: The results demonstrate how knowledge, competence, and motivation influence women's experience of the health information process. Three main themes were found: Meeting interactive and personal needs by engaging with health information; Critical recognition of sources of information; and Capability to communicate comprehended health information. The findings reflect the women's experience of the four competencies: to access, understand, appraise, and apply, essential elements of the health information process. CONCLUSIONS: We can conclude that there is a need for tailored digital information tools, such as the Digi-Do, to enable iterative access and use of reliable health information before, during and after the radiation therapy process. The Digi-Do can be seen as a valuable complement to the interpersonal communication with health care professionals, facilitating a better understanding, and enabling iterative access and use of reliable health information before, during and after the radiotherapy treatment. This enhances a sense of preparedness before treatment starts.

The discipline of Digital health is devoted to the accumulation of sociotechnical aspects which includes running digital care programs, healthcare technologies, sharing health related experiences, providing support for the people with chronic diseases and healthcare needs of the society to deliver the healthcare services in an effective manner. This is a special project which is focused on older persons’ health (range 65 to 79 years) in the home setting from the perspectives of design science, information ethics, systems thinking, information technology, and occupational science/therapy. Older people represent a particular community which is very focused on self-care to maintain and enhance health, prevent disease and cope with illness, as well as keep themselves social and participate in their community. However, generally, it is thought that the elderly community is reluctant to adopt new technologies and are seldomly included in the development of new technologies. Therefore, it is relevant to ask: How can emerging technologies support older person’s self-care and social participation? Implementation and use of technology at home is not only important for the older persons and their families, but it also impacts other stakeholders including care personnel, municipal health and social care managers as well as health sector policymakers. Overall, aim of the project is to establish the sustainable process of capturing and describing the self-care requirements and specifications for older people in Sweden and Japan through the development of a digital self-care tool together with older people. Following goals are set for this project:

• To establish close collaborations with the technology industry (e.g., medtech start-ups from Sweden and Japan).
• Applying ELSI framework.
• Seeking partners from researcher and practitioners’ community, industry, end-users.
• To explore the needs of community-dwelling older persons for self-care and participation in their communities and society.
• To explore available technologies to support older persons’ self-care and digital engagement in the communities and society.