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  • 51.
    Abelsson, Anna
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Department of Health Sciences, Karlstad University, Karlstad, Sweden.
    Rystedt, Ingrid
    Department of Health Sciences, Karlstad University, Karlstad, Sweden.
    Suserud, Björn-Ove
    Faculty of Caring Science, Work Life and Social Welfare, PreHospen - Centre for prehospital Research, University of Borås, Borås, Sweden.
    Lindwall, Lillemor
    Department of Health Sciences, Karlstad University, Karlstad, Sweden.
    Learning high-energy trauma care through simulation2018Ingår i: Clinical Simulation in Nursing, ISSN 1876-1399, E-ISSN 1876-1402, Vol. 17, s. 1-6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Simulation provides the opportunity to learn how to care for patients in complex situations, such as when patients are exposed to high-energy trauma such as motor vehicle accidents. The aim of the study was to describe nurses' perceptions of high-energy trauma care through simulation in prehospital emergency care. The study had a qualitative design. Interviews were conducted with 20 nurses after performing a simulated training series. Data were analyzed using a phenomenographic method. The result indicates that simulation establishes, corrects, and confirms knowledge and skills related to trauma care in prehosp ital emergency settings. Trauma knowledge is readily available in memory and can be quickly retrieved in a future trauma situation. 

  • 52.
    Abelsson, Anna
    et al.
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Rystedt, Ingrid
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Suserud, Björn-Ove
    Högskolan i Borås.
    Lindwall, Lillemor
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Simulation of high-energy trauma makes knowledge readily available from memoryManuskript (preprint) (Övrigt vetenskapligt)
  • 53.
    Abelsson, Anna
    et al.
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Rystedt, Ingrid
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Suserud, Björ-Ove
    Lindwall, Lillemor
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Mapping the use of simulation in prehospital care: a literature review.2014Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 22, nr 22, s. 12-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    High energy trauma is rare and, as a result, training of prehospital care providers often takes place during the real situation, with the patient as the object for the learning process. Such training could instead be carried out in the context of simulation, out of danger for both patients and personnel. The aim of this study was to provide an overview of the development and foci of research on simulation in prehospital care practice.

    Methods:

    An integrative literature review were used. Articles based on quantitative as well as qualitative research methods were included, resulting in a comprehensive overview of existing published research. For published articles to be included in the review, the focus of the article had to be prehospital care providers, in prehospital settings. Furthermore, included articles must target interventions that were carried out in a simulation context.

    Results:

    The volume of published research is distributed between 1984-2012 and across the regions North America, Europe, Oceania, Asia and Middle East. The simulation methods used were manikins, films, images or paper, live actors, animals and virtual reality. The staff categories focused upon were paramedics, emergency medical technicians (EMTs), medical doctors (MDs), nurse and fire fighters. The main topics of published research on simulation with prehospital care providers included: Intubation, Trauma care, Cardiac Pulmonary Resuscitation (CPR), Ventilation and Triage.

    Conclusion:

    Simulation were described as a positive training and education method for prehospital medical staff. It provides opportunities to train assessment, treatment and implementation of procedures and devices under realistic conditions. It is crucial that the staff are familiar with and trained on the identified topics, i.e., intubation, trauma care, CPR, ventilation and triage, which all, to a very large degree, constitute prehospital care. Simulation plays an integral role in this. The current state of prehospital care, which this review reveals, includes inadequate skills of prehospital staff regarding ventilation and CPR, on both children and adults, the lack of skills in paediatric resuscitation and the lack of knowledge in assessing and managing burns victims. These circumstances suggest critical areas for further training and research, at both local and global levels.

  • 54.
    Abelsson, Anna
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Lundberg, Lars
    Swedish Armed Forces Centre for Defence Medicine, Göteborg, Sweden.
    Trauma simulation in prehospital emergency care2018Ingår i: Journal of Trauma Nursing, ISSN 1078-7496, Vol. 25, nr 3, s. 201-204Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Well-educated ambulance staff is a prerequisite for high-quality prehospital trauma care. The aim of this study was to examine how nurses in the ambulance service experienced participation in trauma simulation. Sixty-one nurses, working in an emergency ambulance service, performed simulated trauma care on four different occasions and afterward rated three statements on a 5-point Likert scale. A descriptive and inferential analysis was conducted. There are statistically significant increases between the pre- and posttests regarding all three statements: I think simulation of severe trauma with manikins is realistic (0.23 or 6% increase), Simulation is a suitable method for learning severe trauma care (1.3 or 38% increase), and I am comfortable in the situation learning severe trauma care through simulation (0.74 or 19% increase). With the experience of realism in simulation, participants become more motivated to learn and prepare for future events. If the participants instead feel uncomfortable during simulation training, they focus on their own feelings instead of learning. In a realistic simulated environment, participants are prepared to understand and manage the emergency care situation in clinical work. Participants learn during simulation when they are outside their comfort zone but without being uncomfortable or experiencing anxiety.

  • 55.
    Abiib, Mulki
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin.
    Cvetkovic, Anna
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin.
    Utvärdering av instrumentet UF-5000 för automatiserad urinpartikelanalys i en metodjämförelse med manuell mikroskopering av urinsediment2018Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Inledning: Mikroskopisk analys av urinsediment anses i dagsläget vara gold standard inom urinsedimentdiagnostik, trots att metoden ofta är otillräckligt standardiserad. En rad automatiserade instrument, såsom UF-5000, finns idag tillgängliga och kompenserar för problematiken med den gamla metoden. Analys av urinsediment är avgörande vid flertal njursjukdomar, där bland annat erytrocyter, leukocyter, epitelceller, cylindrar och kristaller är av stort diagnostiskt värde. Syfte: Syftet var att utvärdera det automatiserade urinpartikelinstrumentet UF-5000 samt att jämföra metoden med manuell ljusmikroskopering av urinsediment. Metod: Vid metodjämförelse analyserades 69 prover med instrumentet UF-5000 samt i mikroskop. Data bearbetades med Passing Bablok-regression, Bland-Altman differensanalys samt Spearmans rangkorrelationkoefficient. Resultat: Statistisk signifikant skillnad förekom vid metodjämförelsen. Utvärderingen av instrumentet visade hög mätnoggrannhet med undantag för variationskoefficienten vid låg leukocytkoncentration samt avvikelser för instrumentets linjäritet. Diskussion: Då ljusmikroskopering av urinsediment är en otillräckligt standardiserad metod kunde statistiskt signifikanta skillnader ses, vilket kan bero på den bristande referensmetoden. Fortsatta studier där automatiserad metod jämförs med en mer standardiserad manuell mikroskopi är av stor vikt. Även reducering av cut-off för diverse parametrar kan vara aktuellt. Instrumentutvärdering visade en generell mätnoggrannhet med enstaka undantag vilket kan bero på felhantering vid analys. För vidare analys av linjäritet skulle ett ytterligare instrument som komplement kunna användas.

  • 56.
    Aboutouk, Rana
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Forsberg, Fredrik
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Erfarenheter av egenvård hos personer med diabetes typ 22017Självständigt arbete på grundnivå (kandidatexamen), 180 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Sammanfattning

    Bakgrund: Antalet personer med diabetes Mellitus typ 2 växer snabbt i världen. Egenvård krävs för att bromsa progressionen av DMT2 och förhindra eller fördröja komplikationer. Många personer med DMT2 sköter emellertid inte sin egenvård enligt rekommendationer.

    Syftet: Att beskriva erfarenheter av egenvård hos personer med DMT2.

    Metod: Med hjälp av Fribergs femstegsmodell gjordes en litteraturöversikt av elva kvalitativa studier om erfarenheter av egenvård hos personer med DMT2.

    Resultat: Att integrera egenvården i vardagen är en utmaning. Familjen och vårdpersonalen har en nyckelroll och kan utgöra såväl ett hinder som ett stöd för egenvården. Andra personer med diabetes upplevs som ett entydigt positivt stöd. Att acceptera sjukdomen är en förutsättning för att kunna bedriva egenvården. Brist på förståelse och okunskap kring DMT2 utgör ett hinder mot egenvård. Personliga mål och feedback är avgörande för motivationen.

    Slutsatser: Socialt stöd, acceptans av sjukdomen, positiv feedback och individualiserad information upplevs underlätta egenvård.

  • 57.
    Abrahamsson, Agneta
    et al.
    Högskolan i Jönköping, Hälsohögskolan. University College of Kristianstad,Kristianstad.
    Lindmark, Ulrika
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin.
    Gerdner, Arne
    Högskolan i Jönköping, Hälsohögskolan, HHJ. SALVE (Socialt arbete, Livssammanhang, Välfärd). Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Sense of coherence of reindeer herders and other Samis in comparison to other Swedish citizens2013Ingår i: International Journal of Circumpolar Health, ISSN 2242-3982, E-ISSN 2242-3982, Vol. 72, s. -20633Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Samis are indigenous people in north Europe. In the territory called Sa´pmi (Lapland), reindeer herding is the traditional base for the Sami economy. The relation between living conditions and positive health of the Swedish Samis has been sparsely studied. As health is closely linked to sense of coherence (SOC), an understanding of the background factors to SOC may contribute knowledge that might be useful in promoting living conditions and health.

    Methods. The study examines relations between the level of SOC and background factors from surveys in a Sami population (n=613) in comparison to a non-Sami population (n=525) in Sweden, and in comparison between 2 subsamples of Samis, that is, herders and non-herders.

    Results. There are more similarities than differences between the Sami and non-Sami populations. However, dividing the Sami population, reindeer herders had significantly lower SOC, and in specific the subcomponent manageability, that is, less ability to use available resources to meet different demands in life, compared to non-herders.

    Conclusions. In addition to age and health, predictors of SOC are related to the life form of reindeer husbandry and the belonging to the herding community

  • 58.
    Abrahamsson, Sara
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Palmberg, Hampus
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Children with Intellectual Disabilities and Their Perceived Participation in Everyday Life Activities: A descriptive study conducted in Addis Abeba, Ethiopia2016Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Barn med intellektuella funktionsnedsättningar som lever i utvecklingsländer är sårbara för delaktighetsinskränkningar. Få studier har gjorts som rör deras perspektiv. Syfte: Att beskriva hur barn i ett låginkomstland mellan 13-17 år med en intellektuell funktionsnedsättning upplever sin delaktighet i dagliga aktiviteter. Metod: Kandidatuppsatsen genomfördes som en deskriptiv studie med en kvantitativ ansats. Deltagare samlades in genom ett icke-slumpmässigt-, målinriktat konsekutivt urval. Data samlades in med “Picture my Participation”, ett instrument designat som en strukturerad intervju med kvantitativa frågor. Data analyserades i IBM SPSS Statistics 21. Tabeller samt diagram gjordes i Microsoft Excel 2013. Resultat: Aktiviteten som barnen deltog mest frekvent i var “Daily routines at home for personal care (dressing, choosing clothing, hair care, brushing teeth)”. Aktiviteten som flest barn prioriterade som viktigast, och var mest involverade i var “Organised leisure activities”. “Services and policies” och “Social environment” var faktorer som sågs som “Facilitators” till delaktighet, medan “Family attitudes” sågs som en “Barrier” till delaktighet. Slutsats: Barnen upplevde en hög delaktighet i de prioriterade aktiviteterna och upplevde få barriärer i relation till delaktighet.

  • 59.
    Abuaita, Areej
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin.
    El Saleh, Asmaa
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin.
    Utvärdering av analysmetod för bestämning av anti-FXa aktivitet i plasma hos patienter behandlade med apixaban eller LMH2019Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Apixaban och lågmolekylärt heparin (LMH) är antikoagulantia som förhindrar blodproppsbildning genom att hämma faktor Xa. Allt mer patienter använder apixaban och LMH, vilket gör att laboratoriemedicin på länssjukhuset Ryhov är i behov av att utvärdera analysmetoder för apixaban och LMH för att kunna implementera analyserna i klinisk rutin. Syftet med studien var att utvärdera analysmetoden för bestämning av anti-FXa aktivitet i plasma hos patienter behandlade med apixaban eller LMH med hjälp av kromogen substratmetod. Metodutvärderingen bestod av fyra steg: repeterbarhet, mellanliggande precision, överensstämmelse med validerad metod och analys av normalpopulation. Utvärderingen genomfördes med hjälp av Sysmex CS-2100 där det analyserades 20 respektive 40 patientprover för apixaban och LMH samt 10 normalprover. Aktivitet av faktor Xa bestämdes kvantitativt med användning av ljusabsorption vid 405 nm. Repeterbarhet och mellanliggande precision visade låg CV. Patientprover visade överensstämmande resultat med referensvärden från andra laboratorium där r2 för apixaban och LMH var 0,95. Avvikande resultat kan bero på mätfel eller förväxling mellan prover. Analys av normalpopulation visade att värden låg under det lägsta tillförlitliga värdet. Utvärdering av analysmetoden apixaban och LMH på Ryhovs laboratorium visade goda resultat vilket bekräftar att analysmetoden kan användas i klinisk rutin.

  • 60.
    Abyan, Luul
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Gustavsson, Ellinor
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Unga vuxnas upplevelser av att leva med diabetes typ-12016Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Sammanfattning

    Bakgrund: Diabetes typ-1 är en autoimmun sjukdom och en av de vanligaste kroniska sjukdomarna i Sverige. Diabetes typ-1 kan utvecklas i alla åldrar men bryter vanligen ut under barn- och ungdomsåren. Att leva med sjukdomen innebär även att individen ansvarar för sin egenvård.

    Syftet: Syftet med studien var att beskriva unga vuxnas upplevelser av att leva med diabetes typ-1 utifrån Orem’s egenvårdsteori.

    Metod: Denna studie är en kvalitativ studie med en deduktiv ansats. Studien är baserad på tre bloggar. I denna studie användes Orem’s egenvårdsteori.

    Resultat: Gemenskapen med familj och andra diabetiker upplevs vara ett stort stöd och kan fungera som en hjälp i egenvården. Egenvården kan vara svår att lyckas med och ibland upplevs planering och struktur vara förgäves. Det upplevs som viktigt att inte låta sjukdomen begränsa det sociala livet. Det finns en stor okunskap i samhället om diabetes typ-1 vilket leder till otrygghet och brist på förtroende. Individerna med diabetes typ-1 upplever ensamhet trots en omgivning av stöttande personer.

    Slutsats: En förståelse för upplevelsen av att leva med diabetes typ-1 är viktig för sjuksköterskan. Förståelsen kan minska konflikter mellan sjuksköterskan och patienten samt förbättra förutsättningarna för en god egenvård.

  • 61.
    Acheampong, Faustina
    et al.
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik.
    Vimarlund, Vivian
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik. Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Centre for Information Technology and Information Systems (CenITIS). Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Innovating healthcare through remote monitoring: Effects and business model2017Ingår i: Health Care Delivery and Clinical Science: Concepts, Methodologies, Tools, and Applications, IGI Global, 2017, s. 247-268Kapitel i bok, del av antologi (Övrigt vetenskapligt)
    Abstract [en]

    Information technology has been suggested to improve patient health outcomes and reduce healthcare cost. This study explored the business model and effects of collaborative innovation between caregivers and patients on healthcare delivery through remote patient monitoring by interviewing caregivers and surveying atrial fibrillation patients. Findings indicate that remote monitoring enhanced early detection of potential risks and quality of clinical decision-making with patients feeling more empowered and involved in their own care. The remote monitoring system which consisted of a home-based ECG and a web-based service and was offered free to patients, brought together caregivers, patients, service provider and the government as actors. The introduction of remote monitoring increased the workload of caregivers and facilitation of timely diagnostics and decision-making were not realized. IT is an enabler of innovation in healthcare, but it must be integrated into work processes with a viable business model to realize potential benefits and sustain it. 

  • 62.
    Adair, Brooke
    et al.
    School of Allied Health, Australian Catholic University, Fitzroy, Vic., Australia.
    Ullenhag, Anna
    Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
    Keen, Deb
    Autism Centre of Excellence, Griffith University, Mt Gravatt, Qld, Australia.
    Granlund, Mats
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för beteendevetenskap och socialt arbete. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Imms, Christine
    School of Allied Health, Australian Catholic University, Fitzroy, Vic., Australia.
    The effect of interventions aimed at improving participation outcomes for children with disabilities: a systematic review2015Ingår i: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 57, nr 12, s. 1093-1104Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Aim

    Enhancement of participation has been described as the ultimate outcome for health and educational interventions. The goal of this systematic review was to identify and critically appraise studies that aimed to improve the participation outcomes of children with disabilities.

    Method

    Nine databases that index literature from the fields of health, psychology, and education were searched to retrieve information on research conducted with children with disabilities aged between 5 years and 18 years. Articles were included if the author(s) reported that participation was an intended outcome of the intervention. The articles included were limited to those reporting high-level primary research, as defined by Australia's National Health and Medical Research Council evidence hierarchy guidelines. No restrictions were placed on the type of intervention being investigated.

    Results

    Seven randomized controlled or pseudo-randomized studies were included. Only three of these studies identified participation as a primary outcome. Both individualized and group-based approaches to enhancing participation outcomes appeared to be effective. Studies of interventions with a primary focus on body function or activity level outcomes did not demonstrate an effect on participation outcomes.

    Intepretation

    Few intervention studies have focused on participation as a primary outcome measure. Approaches using individually tailored education and mentoring programmes were found to enhance participation outcomes, while exercise programmes, where participation was a secondary outcome, generally demonstrated little effect.

  • 63.
    Adair, Brooke
    et al.
    Centre for Disability and Development Research, Australian Catholic University, Fitzroy, Vic., Australia.
    Ullenhag, Anna
    Physiotherapy Department, Mälardalens University, Västerås, Sweden.
    Rosenbaum, Peter
    McMaster University, Hamilton, ON, Canada.
    Granlund, Mats
    Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ. Biomedicinsk plattform.
    Keen, Deb
    Autism Centre of Excellence, Griffith University, Mt Gravatt, Qld, Australia.
    Imms, Christine
    Centre for Disability and Development Research, Australian Catholic University, Fitzroy, Vic., Australia.
    Measures used to quantify participation in childhood disability and their alignment with the family of participation-related constructs: a systematic review2018Ingår i: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 60, nr 11, s. 1101-1116Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM:

    We aimed to identify measures used to assess the participation of disabled children and to map the measures' content to the family of participation-related constructs (fPRC) to inform future research and practice.

    METHOD:

    Six databases were searched to identify measures used to assess participation in health, psychology, and education research. Included studies involved children aged 0 to 18 years with a permanent impairment or developmental disability and reported use of a quantitative measure of participation. A second search sought relevant literature about each identified measure (including published manuals) to allow a comprehensive understanding of the measure. Measurement constructs of frequently reported measures were then mapped to the fPRC.

    RESULTS:

    From an initial yield of 32 767 articles, 578 reported one or more of 118 participation measures. Of these, 51 measures were reported in more than one article (our criterion) and were therefore eligible for mapping to the fPRC. Twenty-one measures quantified aspects of participation attendance, 10 quantified aspects of involvement as discrete scales, and four quantified attendance and involvement in a manner that could not be separated.

    INTERPRETATION:

    Improved understanding of participation and its related constructs is developing rapidly; thoughtful selection of measures in research is critical to further our knowledge base.

    WHAT THIS PAPER ADDS:

    The fPRC can support our rapidly evolving and expanding understanding of participation. Instruments selected to measure participation do not always align with emerging concepts. Matching research aims to a chosen measure's content will improve understanding of participation. Opportunities exist to develop validated participation measures, especially self-reported measures of involvement.

  • 64.
    Adams, Mary
    et al.
    King’s College London, UK.
    Maben, Jill
    King’s College London, UK.
    Robert, Glenn
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). King’s College London, UK.
    ‘It’s sometimes hard to tell what patients are playing at’: How healthcare professionals make sense of why patients and families complain about care2018Ingår i: Health, ISSN 1363-4593, E-ISSN 1461-7196, Vol. 22, nr 6, s. 603-623Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This article draws from sociological and socio-legal studies of dispute between patients and doctors to examine how healthcare professionals made sense of patients’ complaints about healthcare. We analyse 41 discursive interviews with professional healthcare staff working in eight different English National Health Service settings to explore how they made sense of events of complaint and of patients’ (including families’) motives for complaining. We find that for our interviewees, events of patients’ complaining about care were perceived as a breach in fundamental relationships involving patients’ trust or patients’ recognition of their work efforts. We find that interviewees rationalised patients’ motives for complaining in ways that marginalised the content of their concerns. Complaints were most often discussed as coming from patients who were inexpert, distressed or advantage-seeking; accordingly, care professionals hearing their concerns about care positioned themselves as informed decision-makers, empathic listeners or service gate-keepers. We find differences in our interviewees’ rationalisation of patients’ complaining about care to be related to local service contingences rather than to fixed professional differences. We note that it was rare for interviewees to describe complaints raised by patients as grounds for improving the quality of care. Our findings indicate that recent health policy directives promoting a view of complaints as learning opportunities from critical patient/consumers must account for sociological factors that inform both how the agency of patients is envisaged and how professionalism exercised contemporary healthcare work.

  • 65.
    Adamsson, Mathias
    et al.
    Högskolan i Jönköping, Tekniska Högskolan, JTH, Byggnadsteknik och belysningsvetenskap.
    Laike, Thorbjörn
    Lund University, Sweden.
    Morita, Takeshi
    Fukuoka Women's University, Fukuoka, Japan.
    Seasonal variation in bright daylight exposure, mood and behavior among a group of office workers in Sweden2018Ingår i: Journal of Circadian Rhythms, ISSN 1740-3391, E-ISSN 1740-3391, Vol. 16, artikel-id 2Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of the study was to investigate seasonal variation in mood and behavior among a group of office workers in Sweden (56°N). Thirty subjects participated in this longitudinal study. The subjects kept a weekly log that included questionnaires for ratings of psychological wellbeing and daily sleep-activity diaries where they also noted time spent outdoors. The lighting conditions in the offices were subjectively evaluated during one day, five times over the year. There was a seasonal variation in positive affect and in sleep-activity behavior. Across the year, there was a large variation in the total time spent outdoors in daylight. The subjects reported seasonal variation concerning the pleasantness, variation and strength of the light in the offices and regarding the visibility in the rooms. Finally, the subjects spent most of their time indoors, relying on artificial lighting, which demonstrates the importance of the lighting quality in indoor environments. 

  • 66.
    Adanko, Carina
    et al.
    Högskolan i Jönköping, Tekniska Högskolan, JTH. Forskningsområde Bebyggd miljö.
    Küller, Marianne
    Lunds universitet, LTH, Inst arkitektur och byggd miljö, Miljöpsykologi.
    LED-belysning och brukaren2014Rapport (Övrigt vetenskapligt)
    Abstract [sv]

    Ljusforskning är om något diversifierad och omfattar teorier och metoder från skilda discipliner som teknik, medicin och samhällsvetenskap. Det finns också en förväntan att erhållna forskningsresultat skall kunna appliceras direkt i verkliga miljöer. I och med introduktionen av LED har många tidigare studier som behandlat glödlampor, lysrör och andra ljuskällor inaktualiserats. Ny kunskap - och ny forskning - krävs.

    En inventering av aktuell humanrelaterad LED-forskning genomfördes under 2013. Med utgångspunkt i detta material har föreliggande forskningsöversikt sammanställts. Totalt omfattar denna drygt 400 artiklar, som redovisas under följande rubriker: Den biologiska klockan; Flimmer och dimring av LED; Energibesparing: dagsljus och ljusstyrning; Färgåtergivning; Bländning och slutligen; Upplevda ljuskvaliteter.

    Såväl bakomliggande teoretiska resonemang som det aktuella kunskapsläget redovisas i de olika avsnitten. Efter varje avsnitt ges också referenser till relevanta forskningspublikationer. Samtliga publikationer har försetts med två eller flera svenska nyckelord, som anger publikationens innehåll. Publikationerna har sedan delars in i kategorier enligt avsnitten ovan. Efter varje avsnitt redovisas de publikationer på vilka texten baserar sig, med nyckelord. I ett slutavsnitt redovisas samtliga LED-publikationer i alfabetisk ordning efter författare och med nyckelord.

  • 67.
    Adolfsson, Margareta
    Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
    Att utvärdera en behandling2011Ingår i: Handbok i att använda ICF och ICF-CY / [ed] Mia Pless & Mats Granlund, Lund: Studentlitteratur , 2011, s. 157-161Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 68.
    Adolfsson, Margareta
    Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
    ICF-CY in habilitation services for children2017Ingår i: An emerging approach for education and care: Implementing a worldwide classification of functioning and disability / [ed] S. Castro & O. Palikara, London: Routledge, 2017, s. 187-203Kapitel i bok, del av antologi (Refereegranskat)
    Abstract [en]

    Habilitation services is the name for interdisciplinary health care organisations in Sweden serving children and young people aged 0 to17 years with a wide range of disabilities categorised as mobility, behavioural, intellectual and multiple disabilities, their families and other networks. The construct of habilitation is used in childhood since it focuses on acquiring skills, whereas rehabilitation focuses on regaining lost skills. Despite this difference, the objective of services is consistent and the WHO definition of rehabilitation can apply to both: “A process aimed at enabling people with disabilities to reach and maintain their optimal physical, sensory, intellectual, psychological and social functional levels. Rehabilitation provides disabled people with the tools they need to attain independence and self-determination” (WHO, 2016). Habilitation teams include social, psychological, pedagogical and medical competencies with a marked preponderance of the latter (Figure 12.1).

  • 69.
    Adolfsson, Margareta
    Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
    The development of social strengths in children with cerebral palsy2014Ingår i: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749Artikel i tidskrift (Övrigt vetenskapligt)
  • 70.
    Adolfsson, Margareta
    et al.
    Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
    Johnson, Ensa
    Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa.
    Nilsson, Stefan
    Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. University of Gothenburg, Sweden.
    Pain management for children with cerebral palsy in school settings in two cultures: Action and reaction approaches2018Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, nr 18, s. 2152-2162Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 71.
    Adolfsson, P.
    et al.
    Department of Public Health and Caring Sciences, Disability and Habilitation, Uppsala University, Uppsala, Sweden.
    Lindstedt, H.
    Department of Public Health and Caring Sciences, Disability and Habilitation, Uppsala University, Uppsala, Sweden.
    Pettersson, I.
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Hermansson, L. N.
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Janeslätt, G.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Department of Public Health and Caring Sciences, Disability and Habilitation, Uppsala University, Uppsala, Sweden.
    Perception of the influence of environmental factors in the use of electronic planning devices in adults with cognitive disabilities2016Ingår i: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 11, nr 6, s. 493-500Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Adults with cognitive disabilities often have difficulties in dealing with the complexity of everyday life. With cognitive assistive technology (e.g. electronic planning devices [EPDs] and individual support), they can bring order to their often chaotic life. Assumptions are that environmental factors influence with non-use of EPDs.

    Objective: To explore how adults with cognitive disabilities perceive the influence of environmental factors in the use of EPDs.

    Methods: A reference group with experience of use of EPDs assisted the researchers. Twelve adults with cognitive disabilities and experience of using EPDs participated. An interview guide was implemented covering environmental factors according to the International Classification of Functioning, Disability and Health. Qualitative content analysis was applied in the analyses.

    Results: Five categories and two themes emerged, which were integrated into a model of facilitating factors influencing the use of EPDs. Measures to prevent or eliminate negative influences of the device use are important to be taken.

    Conclusions: Professionals need more knowledge about EPDs, while users need individual adaption of the EPDs. EPDs need to be user-friendly, manageable and work in any seasons.

    Implications for Rehabilitation: The users should have access to specially trained prescribers. There is a need for development of user-friendly and manageable products to function in any climate. Knowledge is lacking on how to implement the users in all stages of the prescribing process. Prescribers should increase knowledge in the use of EPDs to influence the attitudes of the social environment.

  • 72.
    Adolfsson, Vendela
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Karlsson, Evelina
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Effekten av ToeOFF på infallsvinkeln mellan kroppsmasscentrum och belastningscentrum hos patienter med droppfot2016Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 73.
    Agahi, Neda
    et al.
    Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden.
    Kelfve, Susanne
    Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden; Department of Sociology, Stockholm University, Stockholm, Sweden.
    Lennartsson, Carin
    Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden.
    Kåreholt, Ingemar
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden.
    Alcohol consumption in very old age and its association with survival: a matter of health and physical function2016Ingår i: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 159, s. 240-245Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Alcohol consumption in very old age is increasing; yet, little is known about the personal and health-related characteristics associated with different levels of alcohol consumption and the association between alcohol consumption and survival among the oldest old.

    Methods

    Nationally representative data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD, ages 76-101; n = 863) collected in 2010/2011 were used. Mortality was analyzed until 2014. Alcohol consumption was measured with questions about frequency and amount. Drinks per month were calculated and categorized as abstainer, light-to-moderate drinker (0.5–30 drinks/month) and heavy drinker (>30 drinks/month). Multinomial logistic regressions and Laplace regressions were performed.

    Results

    Compared to light-to-moderate drinkers, abstainers had lower levels of education and more functional health problems, while heavy drinkers were more often men, had higher levels of education, and no serious health or functional problems. In models adjusted only for age and sex, abstainers died earlier than drinkers. Among light-to-moderate drinkers, each additional drink/month was associated with longer survival, while among heavy drinkers, each additional drink/month was associated with shorter survival. However, after adjusting for personal and health-related factors, estimates were lower and no longer statistically significant.

    Conclusions

    The association between alcohol consumption and survival in very old age seems to have an inverse J-shape; abstention and heavy use is associated with shorter survival compared to light-to-moderate drinking. To a large extent, differences in survival are due to differences in baseline health and physical function.

    Graphical abstract

  • 74.
    Agahi, Neda
    et al.
    Karolinska Institutet.
    Lennartsson, Carin
    Karolinska Institutet.
    Kåreholt, Ingemar
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa. Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Karolinska Institutet.
    Shaw, Benjamin A.
    School of Public Health, University at Albany, Rensselaer, NY, USA.
    Trajectories of social activities from middle age to old age and late-life disability: a 36-year follow-up2013Ingår i: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 42, nr 6, s. 790-793Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: to examine the association between 34-year trajectories of social activity, from middle age to old age and late-life disability.

    METHODS: data from the Swedish Level of Living Survey (LNU) and the Swedish Panel Study of the Oldest Old (SWEOLD) were used. LNU data from 1968, 1981, 1991 and 2000 were merged with SWEOLD data from 1992, 2002 and 2004 to create a longitudinal data set with five observation periods. Trajectories of social activities covered 1968-2002, and late-life disability was measured in 2004. The sample consisted of 729 individuals aged 33-61 at baseline (1968), who participated in at least four observation periods and who were free from mobility limitations at baseline. Four trajectories of social activity were identified and used as predictors of late-life disability.

    RESULTS: reporting low/medium levels of social activity from mid-life to old age was the most common trajectory group. Persons reporting continuously low/medium or decreasing levels of social activity had higher odds ratios for late-life disability (OR = 2.33 and OR = 2.15, respectively) compared with those having continuously high levels of activity, even when adjusting for age, sex and mobility limitations, and excluding persons with baseline mobility limitations.

    CONCLUSIONS: results suggest that the disability risk associated with social activities is related to recent levels of activity, but also that risk may accumulate over time, as indicated by the higher disability risk associated with the continuously low/medium level social activity trajectory.

  • 75. Agahi, Neda
    et al.
    Shaw, Ben
    Kåreholt, Ingemar
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Lennartsson, Carin
    Trajectories of social activities and mobility problems from middle to old age2012Ingår i: The 21st Nordic Congress of Gerontology, Dilemmas in Ageing Societies, Abstracts and Program, Copenhagen, Denmark, June 10th - 13th, 2012, 2012, s. 207-Konferensbidrag (Refereegranskat)
    Abstract [en]

    Objectives: To investigate how trajectories of social activities, suchas spending time with family and friends, observed during a34-year period (from middle age to old age) were associated withtrajectories of mobility problems during the same time periodamong men and women.Methods: Nationally representative data from the Swedish Levelof Living Survey (LNU) and the Swedish Panel Study of the OldestOld (SWEOLD) were used. LNU data from 1968, 1981, 1991 and2000 were merged with SWEOLD data from 1992 and 2002 tocreate a longitudinal dataset with four observation periodscovering the period 1968-2002. The sample consisted of thoseaged 40-60 years at baseline who survived through the period,and participated in at least three observation periods (n=698).Trajectories of social activity were identified through clusteranalysis, and then used as predictors of mobility trajectories inmultilevel regression models.Results: Most people had a socially active life as they moved frommiddle age into old age. Five trajectories of social activity wereidentified: continuously very active, continuously active,increasing social activity, decreasing social activity, and continuouslyinactive. Upholding a very active social life was morecommon among women than men.Mobility problems increased significantly over time for bothwomen and men. Among men, decreasing activity levels overtime were associated with a faster increase in mobility problems.Among women, those who were continuously inactive or whodecreased their activity levels had higher levels of mobilityproblems, but the increase in mobility problems with age wassimilar across trajectories of social activity.Conclusions: Most men and women had high levels of socialactivity in midlife, and continued their high activity levels into latelife. Decreasing social activity was related to worse mobility inboth men and women. The nature and direction of theseassociations need to be explored further.

  • 76.
    Agid, Nyroz
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin.
    Sjöqvist, Evelina
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin.
    Prevalence of hookworm infection evaluated with Willis flotation and Formal Ethyl Acetate concentration: A field study in Da Nang, Vietnam2016Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Hookworm infection can cause nausea, stomach pain and anemia, with the most harmful effect being found among women of reproductive age and children. The infection rates is high in poor parts of the world with a high number of infected in Asia. The infection is many times neglected since it rarely causes mortality, however the morbidity can be destructive. In Vietnam the prevalence of hookworm is largely unknown, but there is believed to be a 29-80 % infection rate in the country. Through a field study in Da Nang, Vietnam, the prevalence of hookworm was identified using two methods, Willis flotation and formal ethyl acetate concentration. Any correlation between hookworm infection and individuals’ gender, age and geographic area was evaluated. A total of 101 consecutive selected samples from hospitals and communities in rural and urban parts of the city were obtained from both gender ranging between 1-72 years in age. No quantitative differences were found between the two methods nor any correlation between genders (p-value 0,143). The overall prevalence was 16,8%. The rural part of the city showed a higher infection rate in contrast to the urban districts (p-value 0,001). Individuals in the age group 25-48 showed a higher infection rate in contrast to the other age groups (p-value 0,035). 

  • 77.
    Agren, Susanna
    et al.
    Department of Medical and Health Sciences, Linköping University, 581 83 Linköping, Sweden and Department of Cardiothoracic Surgery, Linköping University, Linköping, Sweden.
    Ivarsson, Bodil
    Department of Cardiothoracic Surgery, Clinical Sciences, Lund University, 221 85 Lund, Sweden and Department of Cardiothoracic Surgery/THAI, Sk˚ane University Hospital and Medical Services, 221 85 Lund, Sweden.
    Rönning, Helén
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    The Unsteady Mainstay of the Family: Now Adult Children's Retrospective View on Social Support in Relation to Their Parent's Heart Transplantation.2014Ingår i: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The needs for support among children with a seriously ill parent, who is waiting for heart transplantation, are unknown today. The aim was to describe now adult children's experiences of social support in relation to a parent's heart transplant during childhood. Nine females and four males were interviewed. The median age for the children was 18 at the transplantation and their parents had been ill before for 18 months (median) and on waiting list for 161 days (mean). Three categories emerged: health care professionals' approaches, family and friends' approaches, and society approaches. Our results show that there was lack of support for children of heart transplantation patients. Support in the shape of information was in most cases provided by the sick or healthy parent. It is of great clinical importance to develop psychosocial support programs for children with a seriously ill parent waiting for heart transplantation (before, during, and after surgery).

  • 78.
    Ahacic, Kozma
    et al.
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Kennison, Robert F.
    Department of Psychology, California State University, Los Angeles, California.
    Kåreholt, Ingemar
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Alcohol abstinence, non-hazardous use and hazardous use a decade after alcohol-related hospitalization: registry data linked to population-based representative postal surveys2014Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, nr 874, s. 1-13Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Although there is evident association between alcohol-related hospitalization and alcohol use, the relationship has not been well examined. This study analyzed the extent of alcohol abstinence, non-hazardous use and hazardous use among people who had experienced alcohol-related hospitalization during the preceding decade.

    METHOD:

    Registry data concerning alcohol-related hospitalizations between 1996 and 2007 were linked to two representative surveys, in 2006 and 2007, of residents of Stockholm County. Relevant contrasts were modeled, using logistic regression, in the pooled sample (n = 54 955). Ages were 23-84 years at follow-up.

    RESULTS:

    Among persons previously hospitalized (n = 576), half reported non-hazardous use. Non-hazardous use was less prevalent than in the general population--and the extent of non-hazardous use did not change over time following hospitalization. There were no significant age differences, but non-hazardous use was less frequent among people with repeated episodes of care. One in six was abstinent. Abstinence was more common among the old, while hazardous use (exceeding 14 drinks per week for men, and 9 drinks per week for women) decreased with age. Abstinence also increased over time; among persons hospitalized ten years ago, the abstinence rate was twice that of the general population. Associations with hazardous use over time were less conclusive. Hazardous use among those previously hospitalized decreased over time in one sample but not in the other. After pooling the data, there were indications of a decrease over time following hospitalization, but more prevalent hazardous use than in the general population.

    CONCLUSIONS:

    Following alcohol-related hospitalization, abstinence increased, and there was no evidence of regression towards the mean, i.e., towards non-hazardous use. Abstinence was also more widespread among previously hospitalized persons of older ages. With advancing age, changing hazardous alcohol habits among previously hospitalized appears to yield a trend towards promotion of abstinence.

  • 79. Ahacic, Kozma
    et al.
    Kennison, Robert F.
    Kåreholt, Ingemar
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Changes in sobriety in the Swedish population over three decades: age, period or cohort effects?2012Ingår i: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 107, nr 4, s. 748-755Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: This study aimed to examine age, cohort and period trends in alcohol abstinence.

    Design: Two surveys, the Level of Living Survey collected in 1968, 1974, 1981, 1990 and 2000, and the Swedish Panel Study of the Oldest Old (SWEOLD) collected in 1992 and 2002, were studied with graphical depictions of cross-sectional and longitudinal data presented over time and over age. Cross-sectional 10-year age group differences, time-lag differences between waves and within-cohort differences between waves for 10-year birth cohorts were examined. Logistic regression models were applied to confirm the observed patterns.

    Setting: The samples were representative of the Swedish population.

    Participants: Participants ranged in age from 18 to 75 (n = 5000 per wave), and 77+ at later waves (n = 500).

    Measurements: Alcohol abstinence was determined by asking 'Do you ever drink wine, beer, or spirits?', where a 'no' response indicated abstinence.

    Findings: Decreases in abstinence rates were observed from 1968 to 2000/02. While cross-sectional analysis indicated increased abstinence with advancing age, the longitudinal analysis suggested otherwise. Inspection of cohort differences revealed little change within cohorts and large differences between cohorts; abstinence rates declined in later-born cohorts up to the 1940s birth cohorts; stability was observed in cohorts born since the 1940s. Logistic regression models indicated that neither age nor period were significant (P > 0.05) predictors of abstinence when cohort (P < 0.001) was included.

    Conclusion: Decreasing proportions of total alcohol abstainers in Sweden from 1968 to 2000 appear to be attributable primarily to decreases in successive cohorts rather than drinkers becoming abstainers.

  • 80.
    Ahacic, Kozma
    et al.
    Karolinska Institutet.
    Kåreholt, Ingemar
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa. Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Helgason, Asgeir R
    Karolinska Institutet.
    Allebeck, Peter
    Karolinska Institutet.
    Non-response bias and hazardous alcohol use in relation to previous alcohol-related hospitalization: comparing survey responses with population data2013Ingår i: Substance Abuse Treatment, Prevention, and Policy, ISSN 1747-597X, E-ISSN 1747-597X, Vol. 8, nr 10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: This study examines whether alcohol-related hospitalization predicts survey non-response, and evaluates whether this missing data result in biased estimates of the prevalence of hazardous alcohol use and abstinence.

    Methods: Registry data on alcohol-related hospitalizations during the preceding ten years were linked to two representative surveys. Population data corresponding to the surveys were derived from the Stockholm County registry. The alcohol-related hospitalization rates for survey responders were compared with the population data, and corresponding rates for non-responders were based on the differences between the two estimates. The proportions with hazardous alcohol use and abstinence were calculated separately for previously hospitalized and non-hospitalized responders, and non-responders were assumed to be similar to responders in this respect.

    Results: Persons with previous alcohol-related admissions were more likely currently to abstain from alcohol (RR=1.58, p<.001) or to have hazardous alcohol use (RR=2.06, p<.001). Alternatively, they were more than twice as likely to have become non-responders. Adjusting for this skewed non-response, i.e., the underrepresentation of hazardous users and abstainers among the hospitalized, made little difference to the estimated rates of hazardous use and abstinence in total. During the ten-year period 1.7% of the population were hospitalized.

    Conclusions: Few people receive alcohol-related hospital care and it remains unclear whether this group’s underrepresentation in surveys is generalizable to other groups, such as hazardous users. While people with severe alcohol problems – i.e. a history of alcohol-related hospitalizations – are less likely to respond to population surveys, this particular bias is not likely to alter prevalence estimates of hazardous use.

  • 81. Ahacic, Kozma
    et al.
    Trygged, Sven
    Kåreholt, Ingemar
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Income and education as predictors of stroke mortality after the survival of a first stroke2012Ingår i: Stroke Research and Treatment, ISSN 2090-8105, E-ISSN 2042-0056Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: It is well known that socioeconomic indicators, such as income and education, predict both stroke incidence and stroke mortality. This means that persons in lower socioeconomic positions are less likely to survive their stroke, and there will be a selective survival in the group discharged from hospital after their first stroke.

    Question: Does socioeconomic position continue to predict mortality, stroke specific, or from other causes, among patients surviving their first stroke in spite of this selective survival?

    Methods: All persons in Sweden aged 40–59 years who were discharged after a first hospitalization for stroke in 1996–2000 were included (n = 10,487), then followed up until the end of the fourth calendar year after discharge. Data were analysed with Cox regressions controlling for age, sex, and stroke type.

    Results: Persons with high socioeconomic position, measured by education and income, have lower mortality than those of low position. Education was not significant when adjusted for income, however. The risk of dying was similar for stroke-specific mortality and all-cause mortality, for those with cerebral infarction as well as for all patients.

    Conclusions: Socioeconomic position predicted stroke-specific mortality also in the selective group of persons who survived their first stroke.

  • 82.
    Ahl, Gullan
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Språkets betydelse för kvalitetssäkring i vård och rehabiliteringsinsatser: en validitetsstudie av terminologin i ADL-verktyget Rainbow2017Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Titel: Språkets betydelse för kvalitetssäkring i vård och rehabiliteringsinsatser

    en validitetsstudie av terminologin i ADL-verktyget Rainbow

    Sammanfattning

    INLEDNING Vårdplaneringar kräver ett entydigt och nyanserat språk för att identifiera patienternas förmåga och insatsbehov gällande aktiviteter i det dagliga livet (ADL). Studiens utgångspunkt är KASAM, människans behov av sammanhang, begriplighet, hanterbarhet och meningsfullhet i sitt dagliga liv. SYFTE Att belysa och validera ADL-terminologin inom sjukvård och rehabilitering. METOD Uppsatsen är en kvalitativ och kvantitativ studie med en deduktiv ansats. ADL-verktyget Rainbow användes som mall. Materialet har insamlats genom enkäter och fokusgruppsintervjuer. Biståndshandläggare och arbetsterapeuter har intervjuats. Studien beskriver även hur en grupp seniorer, utan relation till eller erfarenhet av vård eller vårdplanering, tolkade terminologin och synonymerna. Intervjuerna behandlade följande teman: ADL-terminologi, synonymer, uppfattningar samt kategorisering utifrån en hierarkisk ordning. RESULTAT Nuvarande terminologi och tillvägagångssätt kan innebära att patienterna och deras anhöriga upplever otrygghet angående teamets planerade insatser. Studiens resultat visar att sjukvårdens team och patienter kan dela och använda ett gemensamt språk. SLUTSATS Språket är nyckeln till att förstå sammanhang. KASAM som ledstjärna i språket skapar en värdegrund för vad som har överenskommits och kvalitetssäkrar patienternas vård- och rehabiliteringsinsatser.

     

    Nyckelord: ADL-terminologi, validering, team, språk, uppfattningar, deduktiv ansats.  

  • 83.
    Ahlander, Britt-Marie
    et al.
    Department of Radiology, Ryhov County Hospital, Jönköping, Sweden.
    Maret, Eva
    Department of Radiology, Ryhov County Hospital, Jönköping, Sweden.
    Brudin, Lars
    Department of Clinical Physiology, Kalmar County Hospital, Kalmar, Sweden.
    Starck, Sven-Åke
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin. Department of Oncology, Hospital Physics, Ryhov County Hospital, Jönköping, Sweden.
    Engvall, Jan
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    An echo-planar imaging sequence is superior to a steady-state free precession sequence for visual as well as quantitative assessment of cardiac magnetic resonance stress perfusion2017Ingår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 37, nr 1, s. 52-61Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: To assess myocardial perfusion, steady-state free precession cardiac magnetic resonance (SSFP, CMR) was compared with gradient-echo–echo-planar imaging (GRE-EPI) using myocardial perfusion scintigraphy (MPS) as reference.

    Methods: Cardiac magnetic resonance perfusion was recorded in 30 patients with SSFP and in another 30 patients with GRE-EPI. Timing and extent of inflow delay to the myocardium was visually assessed. Signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were calculated. Myocardial scar was visualized with a phase-sensitive inversion recovery sequence (PSIR). All scar positive segments were considered pathologic. In MPS, stress and rest images were used as in clinical reporting. The CMR contrast wash-in slope was calculated and compared with the stress score from the MPS examination. CMR scar, CMR perfusion and MPS were assessed separately by one expert for each method who was blinded to other aspects of the study.

    Results: Visual assessment of CMR had a sensitivity for the detection of an abnormal MPS at 78% (SSFP) versus 91% (GRE-EPI) and a specificity of 58% (SSFP) versus 84% (GRE-EPI). Kappa statistics for SSFP and MPS was 0·29, for GRE-EPI and MPS 0·72. The ANOVA of CMR perfusion slopes for all segments versus MPS score (four levels based on MPS) had correlation r = 0·64 (SSFP) and r = 0·96 (GRE-EPI). SNR was for normal segments 35·63 ± 11·80 (SSFP) and 17·98 ± 8·31 (GRE-EPI), while CNR was 28·79 ± 10·43 (SSFP) and 13·06 ± 7·61 (GRE-EPI).

    Conclusion: GRE-EPI displayed higher agreement with the MPS results than SSFP despite significantly lower signal intensity, SNR and CNR.

  • 84.
    Ahldén, Maria KC
    et al.
    Oslo University Hospital.
    Rönning, Helén
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Ågren, Susanna
    Department of Medicine and Health Sciences, Linköping University.
    Facing the unexpected - A content analysis of how dyads face the challenges of postoperative heart failure2014Ingår i: Clinical Nursing Studies, ISSN 2324-7940, Vol. 2, nr 2, s. 74-83Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: The aim of this study was to identify the challenges, strategies and needs of dyads who are dealing with postoperative heart failure.

    Background: An increasing number of patients with postoperative heart failure are living with their partner as primary caregiver. Heart failure is known to reduce quality of life but little is known about the strategies dyads use to cope with postoperative heart failure or what kind of support they need.

    Methods: Data were collected through semi-structured dialogue guides. Content analysis was performed to derive the main themes and categories of the data.

    Results: Three main themes were derived from the data; Everyday challenges, Strategies to deal with everyday challenges and Factors facilitating everyday life.

    Conclusions: Dyads living with postoperative heart failure find the change in everyday life challenging, but have strategies to handle the situation and know what kind of help they need. With the right help from health care, quality of life and self-care can be improved.

  • 85.
    Ahlgren, Jennie
    et al.
    Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, Ämnesforskning.
    Görman, Ulf
    Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, Ämnesforskning.
    Nordström, Karin
    Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, Ämnesforskning.
    Ethical considerations in relation to personalised nutrition: An overview of Work Package 5, with respect to ethics2015Rapport (Övrigt vetenskapligt)
    Abstract [en]

    The objectives of Food4Me work package 5 included a baseline assessment of the ethical and legal aspects of personalised nutrition at the start of the project in 2011, as well as a final assessment at the end of the project (2015), taking into account results achieved in other work packages. The initial assessment made a number of ethical issues visible, most of them relating to the consumer of personalised nutrition service. The results depicted in this publication indicate that many of the questions raised in relation to these issues remain unsolved, and in some cases they seem to be neglected in relation to the services offered by internet companies.

  • 86.
    Ahlgren Kvist, Cia
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Karlsson, Linda
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Hundens betydelse inom arbetsterapin: - Hur hundar kan främja och motivera till meningsfulla aktiviteter2016Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Syftet var att beskriva hur arbetsterapeuter arbetar i aktivitet med vård- och terapihund och upplevd nytta med detta. Metoden som valdes var en kvalitativ induktiv ansats med semistrukturerade intervjuer. Elva arbetsterapeuter rekryterades genom ett bekvämlighetsurval via grupper på Facebook. Telefonintervjuer och intervjuer via personligt möte spelades in och transkriberades för att slutligen analyseras med hjälp av en kvalitativ innehållsanalys. Resultatet mynnade ut i ett övergripande tema som var: Arbetsterapeuten och hunden som ett stöd till meningsfulla aktiviteter, vilket resulterade i tre huvudkategorier som var: nytta, aktivitet och kommunikation, samt 14 underkategorier. Slutsatsen av examensarbetet var att hunden kunde vara användbar i att motivera patienter till aktivitet samt att aktiviteter tillsammans med och för hunden kändes mer meningsfulla.

  • 87.
    Ahlstrand, Inger
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Pain and its relation to participation in valued activities in rheumatoid arthritis2015Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    There has been a dramatic change over the past two decades for persons with rheumatoid arthritis (RA) not only due to early diagnosis, structured treatment, and aggressive medication but also due to an increased demand of participation in work life and society. Despite these treatment changes, RA continues to impact these individuals’ participation in valued daily activities. Participation in valued daily activities provides wellbeing and the opportunity for engagement and participation. By persons with RA pain has been highlighted as one of the most restrictive symptoms. This thesis uses the International Classification of Functioning, Disability, and Health (ICF) as a conceptual framework to describe disability and how participation is related to pain.

    Aims: The overall aim of this thesis was to explore and describe the relationship between pain and participation in valued activities, in RA. Paper I compared pain and activity limitations in women and men with contemporary treated early RA with persons who were diagnosed ten years earlier. Paper II described experiences of pain and pain’s relationship with daily activities. Paper III examined difficulties performing valued life activities in relation to pain intensity. Paper IV described personal factors, including self-efficacy and pain acceptance, and studied whether personal factors are mediators of the relationbetween pain and performance of valued life activities.

    Methods: Different methodological approaches were used to provide a comprehensive understanding of pain and participation in valued activities in persons with RA. A prospective longitudinal cohort study was used to compare women and men treated with contemporary treated RA (n=276) with their counterparts ten years earlier (n=373) (Paper I). This study was followed by a focus group study where 33 persons with RA participated in seven focus groups (Paper II). Subsequently, Papers III and IV were conducted based on data from The Swedish Rheumatology Quality Registry (SRQ) and data from a postal questionnaire that gathered data on demographics, pain, personal factors, and participation in valued life activities (n=737). In addition, these studies used descriptive and analytical statistics with multiple regression and structural equation modelling (SEM).

    Results: Pain and activity limitations were still pronounced in women and men with RA despite recent treatment advances (Paper I). The relationship between participation and pain was dynamic and is related to fatigue, stress, and mood, factors that generated difficulties finding a suitable level of activity, resulting in difficulties balancing daily activities (Paper II). Both women and men reported restrictions in participation in valued life activities. Pain was identified as having an important relationship to difficulties performing valued life activities (Paper III). Personal factors were found important as mediators for pain in relation to participation (Paper IV).

    Conclusions: This thesis found a continued need for multidisciplinary interventions despite current treatments. Pain was identified as related to participation restrictions and had an important relationship to difficulties performing valued life activities. Pain and participation in valued activities needs to be comprehensively analysed and treated in the context of the person’s perspective and needs and demands of persons with RA. The subjective experience of participation, the engagement, must be highlighted. Personal factors mediated the relationship between pain and participation and this finding supports the value of self-management interventions to enable participation in valued activities

  • 88.
    Ahlstrand, Inger
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Björk, Mathilda
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Linköping university.
    Thyberg, Ingrid
    Linköping university.
    Low levels of pain impact on valued life activities in women and men with Rheumatoid Arthritis2013Konferensbidrag (Refereegranskat)
  • 89.
    Ahlstrand, Inger
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Björk, Mathilda
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Thyberg, Ingrid
    AIR/Rheumatology Unit, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University Hospital, Linköping, Sweden.
    Börsbo, Björn
    Rehabilitation Medicine, IKE, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden.
    Falkmer, Torbjörn
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. School of Occupational Therapy, La Trobe University, Melbourne, VIC, Australia.
    Pain and Daily Activities in Rheumatoid Arthritis2012Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, nr 15, s. 1245-1253Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 90.
    Ahlstrand, Inger
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Björk, Mathilda
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Thyberg, Ingrid
    Linköping University.
    Börsbo, Björn
    Linköping university.
    Falkmer, Torbjörn
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Smärta och dagliga aktiviteter vid Reumatoid artrit ur ett patientperspektiv2011Konferensbidrag (Övrigt vetenskapligt)
    Abstract [sv]

    Bakgrund: Smärta vid Reumatoid artrit (RA) ärett välkänt symtom som orsakar lidande ochaktivitetsbegränsning. Traditionellt mäts smärtainom reumatologin som smärtintensitet på enVisuell Analog Skala (VAS). Kunskapen kring hurpatienter med RA upplever smärta och dess konsekvenser är begränsad. Patientens egenbeskrivning behövs som underlag för behandlingsplanering och för att utveckla nya metoderför att beskriva problematiken.Syfte: Syftet med studien är att beskriva smärtavid RA ur ett patientperspektiv med fokus på hursmärtan påverkar dagliga aktiviteter.Metod: Patienter med diagnostiserad RA i syd-östra Sverige identifierades via Svenska Reumatologiregistret. Urvalet baserades på minst 5 årssjukdomsduration och minst 40 mm smärtintensitet på VAS vid de två senaste besöken på reumatologklinik. Sammanlagt 33 patienter, 7 män och26 kvinnor, deltog i sju fokusgrupper. Gruppernaformades utifrån kön och ålder. Intervjuguideninnehöll frågor som: Hur beskriver patienter medRA sin smärta? Vad påverkar smärtan? Vilkakonsekvenser har smärtan för aktivitetsutförande,aktivitetsbalans och undvikande av aktivitet? Enkvalitativ innehållsanalys görs.Resultat/förväntat resultat: Analyser hittills visar patienternas frustration över att inteklara det man vill eller behöver göra, beroendeav andra, minskade möjligheter till delaktigheti sociala sammanhang. Och närståendes betydelse. Analyserna visar att smärtan är relaterad till Göteborg6-8 april 201134trötthet, stress och sinnesstämning och att arbeteeller andra aktiviteter medverkar till att glömmabort smärtan och uppehålla förmåga. Analysenslutförs under hösten.Konklusion: Denna studie förväntas genererany angelägen kunskap om och förståelse försmärta.

  • 91.
    Ahlstrand, Inger
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Björk, Mathilda
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Thyberg, Ingrid
    Linköping University.
    Falkmer, Torbjörn
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Pain and difficulties performing valued life activities in women and men with rheumatoid arthritis2015Ingår i: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 34, nr 8, s. 1353-1362Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study aimed to examine the difficulties with performing valued life activities in relation to pain intensity in women and men with rheumatoid arthritis (RA). In total, 737 persons with RA (73 % women) from three rheumatology units in Sweden responded to a questionnaire measuring performance of 33 valued life activities and self-rated pain. The relationships between performance of valued life activities (VLAs) and pain (measured by visual analogue scale (VAS)) were analysed based on gender. Multiple linear regression analyses were conducted with the total VLA score as dependent variable. Women reported more pain and difficulties in performing valued life activities than men. Across genders, 85 % reported at least one valued life activity affected by RA. Significantly more women than men encountered difficulties in performing some activities such as cooking, gardening and meeting new people. Women reported higher pain intensity (35 mm) than men (31 mm). Almost all 33 difficulty ratings for valued life activities were higher among persons with high pain (>40 mm) than persons with lower pain. Difficulty ratings for valued life activities correlated positively with pain in persons with lower pain, but not among those with high pain. The results highlight the importance of addressing pain, especially among women with RA, as they reported pain to impact on their valued life activities. Interestingly, this was evident also in women with lower levels of pain.

  • 92.
    Ahlstrand, Inger
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Thyberg, Ingrid
    Linköping University.
    Falkmer, Torbjörn
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Dahlström, Ö
    Linköping University.
    Björk, Mathilda
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Pain and activity limitations in women and men with contemporary treated early RA compared to 10 years ago: the Swedish TIRA project2015Ingår i: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 44, nr 4, s. 259-264Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To study differences regarding pain and activity limitations during the 3 years following diagnosis in women and men with contemporary treated early RA compared with their counterparts who were diagnosed 10 years earlier.

    METHOD: This study was based on patients recruited to the Early Intervention in RA (TIRA) project. In the first cohort (TIRA-1) 320 patients were included in time for diagnosis during 1996-1998 and 463 patients were included in the second cohort (TIRA-2) during 2006-2009. Disease activity, pain intensity (Visual Analogue Scale, VAS), bodily pain (BP) in the 36-item Short Form Health Survey (SF-36), activity limitations (Health Assessment Questionnaire, HAQ), and medication were reported at inclusion and at follow-up after 1, 2, and 3 years.

    RESULTS: Disease activity, pain, and activity limitations were pronounced at inclusion across both genders and in both cohorts, with some improvement observed during the first year after diagnosis. Disease activity did not differ between cohorts at inclusion but was significantly lower at the follow-ups in the TIRA-2 cohort, in which the patients were prescribed traditional disease-modifying anti-rheumatic drugs (DMARDs) and biological agents more frequently. In TIRA-2, patients reported significantly lower pain and activity limitations at all follow-ups, with men reporting lower pain than women. Women reported significantly higher activity limitations at all time points in TIRA-2.

    CONCLUSIONS: Pain and activity limitations were still pronounced in the contemporary treated early RA cohort compared with their counterparts diagnosed 10 years earlier and both of these factors need to be addressed in clinical settings.

  • 93.
    Ahlstrand, Inger
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Thyberg, Ingrid
    Linköping University.
    Falkmer, Torbjörn
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Dahlström, Örjan
    Linköping University.
    Björk, Mathilda
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Less pain and activity limitations in today's early RA patients compared with patients diagnosed 10 years earlier (the swedish TIRA-project)2014Ingår i: EULAR 2014: Scientific Abstracts, 2014, s. 141-142Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background: Over the last decades the RA-treatment strategies have changed considerably. Routines for early RA diagnosis and instituted disease modifying anti rheumatic drugs (DMARDs) have been established. In the early 2000s biologic agents also became available for treatment purposes. Despite these altered and improved strategies RA patients continue to report pain and activity limitations; women more so than men.

    Objectives: To study differences regarding pain and activity limitations during the first three years after diagnosis of RA in today's patients compared with patients diagnosed 10 years earlier from a gender perspective.

    Methods: This study was based on patients recruited to the project “early interventions in RA” (TIRA). In the first cohort (TIRA-1) 320 patients were included during 1996-1998. In the second cohort (TIRA-2) 463 patients were included during 2006-2008. Disease activity score 28 joint count (DAS-28) and medication were registered. Pain intensity (VAS), bodily pain (BP) in Short Form36 (SF-36) and activity limitation (Health Assessment Questionnaire, HAQ) were reported at inclusion and at follow-ups after one, two and three years.

    Results: Disease activity did not differ between cohorts at inclusion, but was significant lower at the follow ups in the TIRA-2 cohort compared with the TIRA-1 cohort. Patients in TIRA2 were prescribed traditional DMARD:s and biologic agents more frequent than in TIRA-1. The TIRA-2 patients reported significantly higher pain intensity and activity limitations at inclusion but lower pain intensity and activity limitations at all follow-ups than TIRA-1 patients. There were no significant differences between cohorts regarding bodily pain at inclusion, but thereafter the TIRA-2 patients showed significant lower bodily pain than the TIRA-1 patients. Men reported lower activity limitation than women in TIRA-1; otherwise there were no gender differences in TIRA-1. In TIRA-2, there were no significant gender differences regarding pain at inclusion. However, men reported lower pain than women at all follow-ups. Women, in turn, reported significantly higher activity limitations at all time points in TIRA-2. Pain and activity limitations were significantly reduced from inclusion to the one year follow-up but remained stable thereafter.

    Conclusions: Both women and men in today's early RA patient cohort report lower pain and less activity limitations at the follow ups after diagnosis of RA compared to 10 years earlier. However, both activity limitations and bodily pain are still pronounced.

  • 94.
    Ahlstrand, Inger
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Vaz, Sharmila
    School of Occupational Therapy & Social Work, CHIRI, Curtin University, Perth, WA, Australia.
    Falkmer, Torbjörn
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Thyberg, Ingrid
    Department of Rheumatology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Björk, Mathilda
    Department of Rheumatology and Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.
    Self-efficacy and pain acceptance as mediators of the relationship between pain and performance of valued life activities in women and men with rheumatoid arthritis2017Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, nr 6, s. 824-834Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To study whether personal factors (self-efficacy and pain acceptance) mediate the relationship between pain and performance of valued life activities in persons with rheumatoid arthritis.

    METHODS: Persons with rheumatoid arthritis for at least four years (n = 737; 73% women) answered a questionnaire measuring self-efficacy, pain acceptance, performance of valued life activities, and self-rated pain. Relationships among these constructs were explored using univariate and multivariate analyses. Structural equation modelling was then used to examine the mediational role of personal factors on the relationship between pain and performance of valued life activities.

    RESULTS: A direct negative association between pain and performance of valued life activities was identified (Beta = .34, P < .001). This suggests that people with rheumatoid arthritis who had higher levels of pain has increased difficulties in performing valued life activities. Self-efficacy and activity engagement component of pain acceptance mediated the relationship between pain and performance of valued life activities, however the pain willingness component of pain acceptance did not influence participation in valued life activities.

    CONCLUSION: These findings highlight the importance of considering personal factors, such as pain acceptance and self-efficacy, in facilitating participation in valued life activities.

  • 95.
    Ahlstrand, Inger
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Vaz, Sharmila
    School of Occupational Therapy & Social Work, CHIRI, Curtin University, Perth, WA, Australia.
    Falkmer, Torbjörn
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Rehabilitation Center and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Thyberg, Ingrid
    Department of Rheumatology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Björk, Mathilda
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Self-efficacy and painacceptance in relation to pain and performance of valued life activities inwomen and men with RAArtikel i tidskrift (Övrigt vetenskapligt)
  • 96.
    Ahlstrand, Inger
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Wagman, Petra
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Hakansson, C.
    Lund Univ, Div Occupat & Environm Med, Lund, Sweden.
    Bjork, M.
    Linkoping Univ, Dept Rheumatol, Linkoping, Sweden.
    Occupational balance and its relation to performance of valued life activities in persons with rheumatoid arthritis in working age2018Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, nr Suppl. 2, s. 186-186Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Experience of balance in everyday activities where work is an essential part is important to health and well-being, as has also been observed in previous studies in people with rheumatoid arthritis (RA). The Valued life activity scale (VLA-swe) is a questionnaire in which patient’s first report if the separate activities are valued or not to perform and secondly difficulties to perform these activities. Occupational Balance Questionnaire (OBQ) focuses on satisfaction with the amount and variation of occupations.

    Objectives The objectives were to 1) describe the relationship between performance of valued activities and experienced occupational balance, and to 2) identify aspects associated with low occupational balance in persons with RA.

    Methods 368 persons (age 18–65 years, 77% women) with RA responded to a questionnaire measuring occupational balance (OBQ) and performance of valued life activities (VLA-swe). Other aspects of interest were activity limitations measured by Health Assessment Questionnaire (HAQ), pain (measured by VAS), continuous stress (stressed continuously for more than a month during the last 12 months), children at home, education, and living situation. The relation between OBQ and performance in VLA across genders and Workers/Non-workers were analysed using non-parametric correlation analyses. To identify the impact of different aspects on the likelihood that participants would report lower occupational balance, OBQ was analysed using workers/nonworkers, stress, gender, age, pain and difficulties performing valued activities as independent variables in logistic regressions models. The study was approved by the Regional Ethics Committee (Dnr2011/452–31).

    Results The OBQ was significantly related to difficulties to perform valued activities reported by VLA (r=-0.41, p<0.001). Having more difficulties performing valued activities was the strongest predictor of lower occupation balance and increased the risk of reporting lower occupation balance with nearly five times (OR=4.54, p 0.001). Continuous stress increased the risk of having lower occupation balance more than three times (OR=3.27, p<0.0001) than those who not reported being stressed. The other variables show no significant impact on the likelihood that the participants would report lower occupational balance.

    Conclusions The results showed support for the relationship between occupation balance and performance of valued life activities and highlights to identify what’s important for the individual and to assume that in the rehabilitation. The results also show the importance of ability to manage stress, in order to enable for retaining ability to work and achieve high occupational balance.

  • 97.
    Ahlström, Gerd
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Assessment of coping and quality of life in adults with neuromuscular diseases.1998Ingår i: European Congress on Evaluation of Rehabilitation in a Lifelong Course, 1998Konferensbidrag (Refereegranskat)
  • 98.
    Ahlström, Gerd
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Consequences of Muscular Dystrophy: Impairment, Disability, Coping and Quality of Life.1994Doktorsavhandling, monografi (Övrigt vetenskapligt)
  • 99.
    Ahlström, Gerd
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Coping with Long-term Neurological illness and the Implications for Nursing.2005Ingår i: Journal of neuroscience nursing, ISSN 0888-0395, Vol. 37, nr 6, s. 301-302Artikel i tidskrift (Refereegranskat)
  • 100.
    Ahlström, Gerd
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Coping with Long-term Neurological Illness and the Implications for Nursing Interventions.2005Ingår i: 9th Quadrennial World Federation of Neuroscience Nurses, 2005Konferensbidrag (Refereegranskat)
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