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  • 701.
    Ståhl, Ylva
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Documentation in Child and School Health services: Mapping health information from a biopsychosocial perspective using the ICF-CY2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to analyze whether the documentation in the Child Health Services (CHS) and School Health Services (SHS) reflects a holistic view on health as represented by a bio-psychosocial perspective.

    The method used based on four studies, all with a descriptive design. Analyzed documents contained lists of health terms recommended to be included in the health record (HR) (I), requested information in health questionnaires (II) and the content of free text notes in health records (HRs) (III). A deductive approach was used on an item-by-item basis (I, II), and for the free text notes in HRs a qualitative content analysis with an inductive approach was chosen (III). Nurses’ and physicians’ views on documentation and electronic HR were analyzed with the help of a quantitative questionnaire design (IV).

    Results showed that information on developed lists of health terms recommended to be included in an electronic version of the HR (I) could be linked to codes in the ICF-CY. The linked health terms were mainly focused on the body, i.e. a biological perspective on health. Several health terms linked to two or more codes, which indicate a need for more clarity in content descriptions. In the locally produced health questionnaires (Study II), for all age groups, a majority of the linked health items counted only once, and involved a psychosocial perspective on health. These health items were related to communication, psychosomatic symptoms and taking care of one’s health (II). The results in the free text notes in HRs (III) mainly focused on a psychosocial perspective on health and were represented across all age groups, but were unevenly distributed. There was new health information in the free text notes which had not been covered in the standardized  part  of  the  HRs. The respective staffs acknowledged that more health information than was documented in the HR was transferred between the CHS and SHS (IV). This information concerned foremost family function. The CHS and SHS had positive opinions regarding the possibilities of an electronic version of the HR.

    Conclusions: The predominant medical content of lists of health terms was supplemented with health information related to psychosocial health in health questionnaires and in the free text notes in the HR. However, the focus was on the child as a person rather than a child within a family and preschool/school environment, and was strongly related to age groups. More information on children’s health than was recorded was transferred between and within the services. The utility of the ICF-CY as a tool has been confirmed, and indicates challenges to develop a common language to document more on psychosocial health.

  • 702.
    Ståhl, Ylva
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Almborg, Ann-Helene
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Contents of Swedish school health questionnaires2011In: British Journal of School Nursing, ISSN 1752-2803, Vol. 6, no 2, p. 82-88Article in journal (Refereed)
    Abstract [en]

    Aim: This study aims to analyse and link the content of the health information requested in questionnaires used locally in Swedish child and school health services. Background: In industrialized countries, children's health needs are changing from physical to psychosocial needs and the questionnaires used for health screening and guiding health promotion must therefore adapt to these changes. Methods: Questionnaires were analysed, together with health items linked to the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). The inter-rater agreement for linking was 80%. Standard age groups were used to improve the comparability across different questionnaires. Results: The information requested for the youngest children focused on communication and acquiring language. For the children aged 6 years and above, health questionnaires related to mental functions, the school situation, psychosomatic symptoms and issues associated with taking care of one's health. Conclusions: The information relating to health in questionnaires revealed that interest focused on health items strongly related to the different age groups and to psychosocial health. The focus was the child as a person rather than the child within a family and school environment.

  • 703.
    Ståhl, Ylva
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Andersson-Gäre, Boel
    Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Mapping of children's health and development data on population level using the classification system ICF-CY2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, p. 51-57Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to investigate if essential health and development data of all children in Sweden in the Child Health Service (CHS) and School Health Service (SHS) can be linked to the classification system International Classification of Functioning, Disability and Health - Children and Youth (ICF-CY). Method: Lists of essential health terms, compiled by professionals from CHS and SHS, expected to be used in the national standardised records form the basis for the analysis in this study. The essential health terms have been linked to the codes of ICF-CY by using linking rules and a verification procedure. RESULTS: After exclusion of terms not directly describing children's health, a majority of the health terms could be linked into the ICF-CY with a high proportion of terms in body functions and a lower proportion in activity/participation and environment respectively. Some health terms had broad description and were linked to several ICF-CY codes. The precision of the health terms was at a medium level of detail. CONCLUSION: ICF-CY can be useful as a tool for documenting child health. It provides not only a code useful for statistical purposes but also a language useful for the CHS and SHS in their work on individual as well as population levels. It was noted that the health terms used by services mainly focused on health related to body function. This indicates that more focus is needed on health data related to child's functioning in everyday life situations.

  • 704.
    Ståhl, Ylva
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Andersson-Gäre, Boel
    Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Views on health information and perceptions of standardized electronic records among staff in Child and School Health Services2011In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 19, no 2, p. 201-208Article in journal (Refereed)
    Abstract [en]

    AIM: To investigate how nurses and physicians in the Child and School Health Services view the documentation and transfer of health information. Another aim concerns their perceptions of a nationally standardized electronic health record.

    BACKGROUND: Problems of mental health among children and adolescents currently pose one of the greatest challenges facing all European countries. The continuity of health work demands that all health information follow the child's development, disregarding the organizational arrangement.

    METHODS: The study was descriptive and comprised 484 questionnaires to nurses and physicians in the Child and School Health Services in Sweden.

    RESULTS: More information about children's health was transferred than documented in the health record when children started school. This additional health information concerned psychosocial health and foremost family function. There was a consensus concerning the usefulness of a nationally standardized electronic health record, although there were group differences between nurses and physicians.

    CONCLUSIONS: All information about children's health is not documented although the professional's positive perceptions to electronic health records may provide a basis to improve documentation.

    IMPLICATIONS FOR NURSING MANAGEMENT: The results indicate challenges to develop a common language to document psychosocial issues necessary for providing a holistic view of children's health.

  • 705.
    Ståhl, Ylva
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Simeonsson, Rune
    University of North Carolina at Chapel Hill, NC, USA.
    Andersson-Gäre, Boel
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Psychosocial health information in free text notes of Swedish children's health records2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 3, p. 616-623Article in journal (Refereed)
    Abstract [en]

    Background: High-quality documentation of children’s health is an important priority in health care given trends of declining mental health and reduced well-being in children. There is a lack of information concerning psychosocial health in the standardized part of the national health record in the Child Health Service and the School Health Service in Sweden. Further, little is known if the free text notes in the health record, besides information on physical health, also include information on children’s psychosocial health. The aim of this study was to describe what is recorded concerning children’s health and development in free text notes.

    Methods: The study was based on a retrospective analysis of text using an inductive approach for qualitative analyses of content.

    Results: The analysis of the free text notes in the health records yielded seven categories: development, family, health problems, living habits, medical issues, preschool/school and leisure, and well-being. The categories mainly covered psychosocial aspects of health and were not only about health and development problems of the child but also what was covered during the visits. The information was unevenly distributed across the ages. A stronger focus on the youngest age groups within a family and preschool setting is needed. There was novel information in the free text notes such as pain, general health, emotions, mother’s mental health and leisure activities, which was not covered in the standardized part of the health records.

    Conclusion: The free text notes mainly reflected a psychosocial perspective on health. The findings of this study suggest that requesting more information on children’s psychosocial health in the standardized part of the health records could contribute to more comprehensive and informative health records in the Child health Service and the School Health Service in Sweden.

  • 706. Sun, Q.
    et al.
    Xia, J.
    Foster, J.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD. School of Occupational Therapy and Social Work, Curtin University, Australia.
    Lee, H.
    Pursuing Precise Vehicle Movement Trajectory in Urban Residential Area Using Multi-GNSS RTK Tracking2017In: Transportation Research Procedia, Elsevier, 2017, Vol. 25, p. 2361-2376Conference paper (Refereed)
    Abstract [en]

    Close-to-reality vehicle movement trajectory data can be useful in many transport and geography studies when precise vehicle localization or timing is required in the application. Vehicle kinematic tracking by GPS (Global Positioning System) varies in the data accuracy depending on some factors such as the receiver capability, satellites availability. Nevertheless, advanced positioning techniques offer possibilities to enhance the tracking data quality. In this paper, the high performance of multi-GNSS (multiple Global Navigation Satellite Systems) with Real-time Kinematic (RTK) solution was investigated aiming to pursue precise vehicle movement trajectory in an urban residential area of Australia. We systematically compared vehicle kinematic recordings between different positioning solutions by multi-GNSS and GPS-only approaches. Different elevation cut-off angles ranging from 5 - 35° were applied to simulate satellites' availability in different sky view conditions. The results showed that the multi-GNSS approach outperformed conventional GPS positioning in availability and positioning accuracy, and RTK solution at 10Hz generated ideal vehicle movement trajectory suitable for driving behaviours studies.

  • 707.
    Sun, Qian C.
    et al.
    Geospatial Science, School of Science, RMIT University, Melbourne, VIC, Australia.
    Xia, Jianhong C.
    School of Earth and Planetary Sciences, Curtin University, Perth, Australia.
    Foster, Jonathan
    School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD. School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Lee, Hoe
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    A psycho-Geoinformatics approach for investigating older adults’ driving behaviours and underlying cognitive mechanisms2018In: European Transport Research Review, ISSN 1867-0717, E-ISSN 1866-8887, Vol. 10, no 2, article id 36Article in journal (Refereed)
    Abstract [en]

    Introduction: Safe driving constantly challenges the driver’s ability to respond to the dynamic traffic scene under space and time constraints. It is of particular importance for older drivers to perform sufficient visual and motor actions with effective coordination due to the fact of age-related cognitive decline. However, few studies have been able to integrate drivers’ visual-motor behaviours with environmental information in a spatial-temporal context and link to the cognitive conditions of individual drivers. Little is known about the mechanisms that underpin the deterioration in visual-motor coordination of older drivers.

    Development: Based on a review of driving-related cognitive decline in older adults and the context of driver-vehicle-environment interactions, this paper established a conceptual framework to identify the parameters of driver’s visual and motor behaviour, and reveal the cognitive process from visual search to vehicle control in driving. The framework led to a psycho-geoinformatics approach to measure older drivers’ driving behaviours and investigate the underlying cognitive mechanisms. The proposed data collection protocol and the analysis and assessments depicted the psycho-geoinformatics approach on obtaining quantified variables and the key means of analysis, as well as outcome measures.

    Conclusions: Recordings of the driver and their interactions with the vehicle and environment at a detailed scale give a closer assessment of the driver’s behaviours. Using geoinformatics tools in driving behaviours assessment opens a new era of research with many possible analytical options, which do not have to rely on human observations. Instead, it receives clear indicators of the individual drivers’ interactions with the vehicle and the traffic environment. This approach should make it possible to identify lower-performing older drivers and problematic visual and motor behaviours, and the cognitive predictors of risky driving behaviours. A better targeted regulation and tailored intervention programs for older can be developed by further research. 

  • 708.
    Sun, Qian C.
    et al.
    School of Global, Urban and Social Studies, RMIT University, Australia.
    Xia, Jianhong C.
    Department of Spatial Sciences, Curtin University, Australia.
    Foster, Jonathan
    School of Psychology and Speech Pathology, Curtin University, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. School of Occupational Therapy and Social Work, Curtin University, Australia.
    Lee, Hoe
    School of Occupational Therapy and Social Work, Curtin University, Australia.
    Driving manoeuvre during lane maintenance in older adults: Associations with neuropsychological scores2018In: Transportation Research Part F: Traffic Psychology and Behaviour, ISSN 1369-8478, E-ISSN 1873-5517, Vol. 53, p. 117-129Article in journal (Refereed)
    Abstract [en]

    Older drivers experience difficulties in lane maintenance under challenging driving sections due to age-related cognitive declines, yet there is little comprehensive evidence on associations between cognitive functions and the lane maintenance in this population. In this study, fifty older drivers completed an on-road driving assessment and a battery of standard neuropsychological tests. Mean Lane Position (MLP), Standard Deviation of Lane Position (SDLP) and manoeuvre time calculated from precise vehicle movement trajectories were used as the lane maintenance parameters. The GNSS tracking vehicle movement presents comprehensive and reliable vehicle position data, which is more sensitive for detecting subtle variations of lane maintenance in older drivers. Statistical analysis results show that lower visual attention (selective and divided attention) was associated with higher MLP and SDLP; MLP was also correlated to spatial abilities, executive function, and motor speed; manoeuvre time was negatively correlated with drivers’ risk-taking personality (all p <.01). Selective attention was found to be the best predictor of MLP in lane maintenance. A combined eight variables from three neuropsychological tests, UFOV 2 and 3, BD and BJLO, D-KEFS TMT 1, 2, 3, and 4, correctly classified 80.4% of participants with good versus low-performing lane maintenance. 

  • 709.
    Sun, Qian C.
    et al.
    School of Science, RMIT University, Australia.
    Xia, Jianhong C.
    School of Earth and Planetary Sciences, Curtin University, Australia.
    Foster, Jonathan
    School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Lee, Hoe
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Unpacking older drivers’ mobility at roundabouts: Their visual-motor coordination through driver–vehicle–environment interactions2019In: International Journal of Sustainable Transportation, ISSN 1556-8318, E-ISSN 1556-8334, Vol. 13, no 9, p. 627-638Article in journal (Refereed)
    Abstract [en]

    While mobility and safety of older drivers are challenged by age-related cognitive changes, the increasingly complex road environment has placed a higher demand on their adaptability. Older drivers experience difficulties in regulating their operational level behaviors which rely on the second-to-second decision-making, e.g., using the visuospatial information to guide their steering. The roundabout maneuver is one of the critical scenarios for older drivers which requires efficient visual and motor coordination. Understanding older drivers’ visual-motor coordination at roundabouts will provide insights into the mobility and safety of older driver population, which is important yet to be explored. This paper contributes to new measurements in driving behavior through quantitative examinations on driver–vehicle–environment interactions. The drivers’ visual-motor coordination is conceptualized as a sequence of eye fixations coupling with the vehicle trajectory in a space–time path. The experimental data were from 38 older adults’ on-road driving recorded using context and location-aware enabled eye tracking and precise vehicle movement tracking. A visual-motor coordination composite indicator (VMCCI) was developed to measure the efficiency of visual-motor coordination in GIS based on the aggregate multiple parameters of visual and motor behaviors at entry, circulating and exit stage of a roundabout. The results show that the VMCCI is a sensitive indicator for identifying risky drivers, problematic road sections, problematic behaviors. Older drivers’ VMCCI was associated with the angle of deviation at roundabouts, particularly at the entry stage. Findings of this study have implications for actual roundabout designing practice, which will contribute to improve the safety of older drivers behind the wheel. 

  • 710.
    Sun, Qian C.
    et al.
    School of Science, RMIT University, Australia.
    Xia, Jianhong C.
    School of Earth and Planetary Sciences, Curtin University, Australia.
    Li, Yongfu
    Institute of Architectural Design, Shanghai University, China.
    Foster, Jonathan
    School of Psychology and Speech Pathology, Curtin University, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. School of Occupational Therapy and Social Work, Curtin University, Australia.
    Lee, Hoe
    School of Occupational Therapy and Social Work, Curtin University, Australia.
    Unpacking older drivers’ maneuver at intersections: Their visual-motor coordination and underlying neuropsychological mechanisms2018In: Transportation Research Part F: Traffic Psychology and Behaviour, ISSN 1369-8478, E-ISSN 1873-5517, Vol. 58, p. 11-18Article in journal (Refereed)
    Abstract [en]

    Background: Negotiating intersections is one of the principal concerns for older drivers as it requires precision and efficiency in visual-motor coordination (VMC). The complex intersection manoeuvre places high demands on visual perception, attention, motor control and executive functioning. Understanding the relationship between VMC and cognitive abilities in older drivers is important, but yet to be systematically explored.

    Methods: We recorded 38 older adults’ driving manoeuvre at intersections using eye tracking and advanced surveying positioning technologies. VCM performance of the participants were indexed using multiple parameters of visual and motor behaviors with a Data Envelopment Analysis (DEA) model. Participants also performed a battery of cognitive tests of visual attention, spatial abilities, visual-motor speed and executive functions.

    Results: Significant correlations were identified between VMC performance and eight cognitive measurements: UFOV 2 and 3, Block Design, Benton's JLO, D-KEFS TMT 1, 2, 3 and 4. Cognitive tests measuring selective attention, spatial ability and executive function were found to be the best predictors for VMC performance.

    Conclusions: Specific cognitive abilities in older drivers were associated with poorer VMC at intersections. VMC assessment can be used to identify risky older drivers and their problematic behaviors. In the future, tailored VMC evaluations and intervention programs may be developed to improve older drivers’ safety behind the wheel. 

  • 711.
    Sun, Qian (Chayn)
    et al.
    Department of Spatial Sciences, Curtin University, Australia.
    Odolinski, Robert
    School of Surveying, University of Otago, New Zealand.
    Xia, Jianhong (Cecilia)
    Department of Spatial Sciences, Curtin University, Australia.
    Foster, Jonathan
    School of Psychology and Speech Pathology, Curtin University, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. School of Occupational Therapy and Social Work, Curtin University, Australia.
    Lee, Hoe
    School of Occupational Therapy and Social Work, Curtin University, Australia.
    Validating the efficacy of GPS tracking vehicle movement for driving behaviour assessment2017In: Travel Behaviour & Society, ISSN 2214-367X, E-ISSN 2214-3688, Vol. 6, p. 32-43Article in journal (Refereed)
    Abstract [en]

    Vehicle movement trajectory recorded by GPS maps the vehicle's lane position in time sequence, therefore theoretically can be used to assess driving behaviour. However, the data quality level which can be achieved for vehicle movement tracking by different GPS receivers and positioning techniques hasn't been fully explored and documented. This study systematically validated the efficacy of GPS recording vehicle movement using different types of receivers and positioning techniques. The receivers include both recreational and professional devices; the positioning techniques refer to Single Point Positioning (SPP), Differential GPS (DGPS) and Real-time kinematic (RTK) solutions. The field trials tested the positioning accuracy as well as the quality of trajectory tracking by comparing the recorded positions to benchmarks. The study findings indicate that vehicle movement trajectories recorded by recreational-grade GPS receivers can only match other spatial information at low resolution, which is limited to the assessment of wayfinding and navigation behaviour. In contrast, the SPP, DGPS and RTK techniques undertaken by professional receivers can raise horizontal accuracy to the metre, decimetre, and centimetre level respectively. For under open sky road driving, the RTK solution generated accurate and precise vehicle movement trajectories sufficient for extracting vehicle lane position, speed, acceleration/deceleration, so as to detect detailed driving events and quantitatively assess individual driver behaviour. This paper serves as a critical reference for other researchers on the different types of GPS receivers and solutions prior to engaging a GPS in their studies. © 2016 Hong Kong Society for Transportation Studies.

  • 712.
    Sun, Qian (Chayn)
    et al.
    Curtin University, Australia.
    Xia, Jianhong (Cecilia)
    Curtin University, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Curtin University, Australia.
    Lee, Hoe
    Curtin University, Australia.
    Investigating the spatial pattern of older drivers' eye fixation behaviour and associations with their visual capacity2016In: Journal of Eye Movement Research, E-ISSN 1995-8692, Vol. 9, no 6, p. 1-16Article in journal (Refereed)
    Abstract [en]

    Visual capacity generally declines as people age, yet its impact on the visual search patterns along sections of different road during actual driving still remains undocumented. This on-road driving study simultaneously recorded 30 older drivers' eye movement and precise vehicle movement trajectories. The vehicle positions were linked to every identified eye fixation for each individual driver, so that the locations of the driver's gaze origin in geo-spatial coordinates were obtained. Spatial distribution pattern of drivers' eye fixations were then mapped and analysed. In addition, the associations between older drivers' visual ca-pacity (processing speed, divided and selective attention) and their eye fixation patterns in various driving manoeuvres were investigated. The results indicate that driving scenarios have a significant impact on older drivers' visual patterns. Older drivers performed more frequent eye fixations at roundabouts, while they tended to fixate on certain objects for longer periods during straight road driving. The key findings show that the processing speed and divided attention of older drivers were associated with their eye fixations at complex right-turns; drivers with a lower capacity in selective attention performed less frequent eye fixations at roundabouts. This study has also demonstrated that visualisation and spatial sta-tistics are effective and intuitive approaches to eye movement analysis.

  • 713.
    Sun, Qian (Chayn)
    et al.
    Department of Spatial Sciences, Curtin University, Perth, Australia.
    Xia, Jianhong (Cecilia)
    Department of Spatial Sciences, Curtin University, Perth, Australia.
    Nadarajah, Nandakumaran
    Department of Spatial Sciences, Curtin University, Perth, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Foster, Jonathan
    School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
    Lee, Hoe
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Assessing drivers' visual-motor coordination using eye tracking, GNSS and GIS: a spatial turn in driving psychology2016In: Journal of Spatial Science, ISSN 1449-8596, Vol. 61, no 2, p. 299-316Article in journal (Refereed)
    Abstract [en]

    Vehicle-driving in real traffic can be considered as a human-machine system involving not only the attribute of the vehicle movement but also the human visual perception, cognition and motion of the driver. The study of driving behaviours, therefore, would integrate information related to driver psychology, vehicle dynamics and road information in order to tackle research questions concerning driving safety. This paper describes a conceptual framework and an integrated GIS data model of a visual-motor coordination model (VMCM) to investigate drivers' driving behaviour via the combination of vision tracking and vehicle positioning. The eye tracker recorded eye fixations and duration on video images to exhibit the drivers' visual search pattern and the traffic scenes. Real-time kinematic (RTK) post-processing of multi-GNSS (global navigation satellite system) tracking generated the vehicle movement trajectory at centimeter-level accuracy, which encompasses precise lateral positioning and speed control parameters of driving behaviours. The eye fixation data were then geocoded and linked to the vehicle movement trajectory to represent the VMCM on the GIS platform. An implementation prototype of the framework and the VMCM for a study of older drivers is presented in this paper. The spatial-temporal visualisation and statistical analysis based on the VMCM data-set allow for a greater insight into the inherent variability of older drivers' visual search and motor behaviours. The research framework has demonstrated a discriminant and ecologically valid approach in driving behaviour assessment, which can also be used in studies for other cohort populations with modified driving scenarios or experiment designs.

  • 714.
    Sundler, Annelie J.
    et al.
    School of Life Sciences, University of Skövde, Sweden.
    Björk, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD. School of Life Sciences, University of Skövde, Sweden.
    Bisholt, Birgitta
    Department of Health Sciences, Karlstad University, Karlstad, Sweden.
    Ohlsson, Ulla
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Engström, Agneta Kullén
    School of Health, University of Borås, Borås, Sweden.
    Gustafsson, Margareta
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Student nurses' experiences of the clinical learning environment in relation to the organization of supervision: a questionnaire survey2014In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 34, no 4, p. 661-666Article in journal (Refereed)
    Abstract [en]

    Aim

    The aim was to investigate student nurses' experiences of the clinical learning environment in relation to how the supervision was organized.

    Background

    The clinical environment plays an essential part in student nurses' learning. Even though different models for supervision have been previously set forth, it has been stressed that there is a need both of further empirical studies on the role of preceptorship in undergraduate nursing education and of studies comparing different models.

    Method

    A cross-sectional study with comparative design was carried out with a mixed method approach. Data were collected from student nurses in the final term of the nursing programme at three universities in Sweden by means of a questionnaire.

    Results

    In general the students had positive experiences of the clinical learning environment with respect to pedagogical atmosphere, leadership style of the ward manager, premises of nursing, supervisory relationship, and role of the nurse preceptor and nurse teacher. However, there were significant differences in their ratings of the supervisory relationship (p < 0.001) and the pedagogical atmosphere (p 0.025) depending on how the supervision was organized. Students who had the same preceptor all the time were more satisfied with the supervisory relationship than were those who had different preceptors each day. Students' comments on the supervision confirmed the significance of the preceptor and the supervisory relationship.

    Conclusion

    The organization of the supervision was of significance with regard to the pedagogical atmosphere and the students' relation to preceptors. Students with the same preceptor throughout were more positive concerning the supervisory relationship and the pedagogical atmosphere.

  • 715.
    Sundler, Annelie Johansson
    et al.
    University of Skövde, Skövde, Sweden.
    Hallström, Inger
    Lund University, Lund, Sweden .
    Hammarlund, Kina
    University of Skövde, Skövde, Sweden.
    Björk, Maria
    Jönköping University, School of Health Science, HHJ. CHILD. Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. University of Skövde.
    Living an everyday life through a child’s cancer trajectory: Families' lived experiences 7 years after diagnosis2013In: Journal of Pediatric Oncology Nursing, ISSN 1043-4542, E-ISSN 1532-8457, Vol. 30, no 6, p. 293-300Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to illuminate the lived experiences of families where a child had survived 7 years from a diagnosis of childhood cancer. This article describes one part of an inductive and longitudinal research project that included 17 families. Four families whose child was diagnosed with cancer 7 years previously were interviewed using a hermeneutical phenomenological approach. The families lived experience was described in one essential theme, "Living an everyday life through the child's cancer trajectory," further illuminated in 3 related themes: "Leaving the disease behind yet feeling its presence," "Being the same yet always different," and "Feeling stronger yet vulnerable." The results suggest that family members feel vulnerable even if a long period of time has passed since completion of treatment. To varied degrees they still may need support. When moving forward in life, the family members are helped if they can reconcile their memories and experiences derived from the childhood cancer trajectory.

  • 716.
    Svedberg, Petra
    et al.
    School of Health and Welfare, Halmstad University, Halmstad, Sweden.
    Einberg, Eva-Lena
    Jönköping University, School of Health and Welfare, HHJ. CHILD. School of Health and Welfare, Halmstad University, Halmstad, Sweden.
    Wärnestål, Pontus
    School of Information Technology, Halmstad University, Halmstad, Sweden.
    Stigmar, Jennie
    Department of Pediatrics, Skåne University Hospital, Lund, Sweden.
    Castor, Anders
    Department of Pediatrics, Skåne University Hospital, Lund, Sweden.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Nygren, Jens M.
    School of Health and Welfare, Halmstad University, Halmstad, Sweden.
    Support from healthcare services during transition to adulthood – Experiences of young adult survivors of pediatric cancer2016In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 21, p. 105-112Article in journal (Other academic)
    Abstract [en]

    PURPOSE:

    Improved survival rates of pediatric cancer have drawn attention on how to best facilitate long-term follow up and transition from pediatric to adult care. The transition process is multifactorial and necessitates the joint involvement of the patient, the family and the healthcare providers. The purpose of this study was to explore the experiences of support from healthcare services during the transition from adolescence to adulthood described by young adult survivors of pediatric cancer.

    METHODS:

    A mixed method with a convergent parallel design was used to evaluate the experiences of receiving support from healthcare services (eg pediatric oncology and pediatric clinic) during transition from adolescence to adulthood described by young adult survivors of pediatric cancer (n = 213) in a nation wide cross-sectional survey.

    RESULTS:

    A quantitative assessment of the experienced extent and satisfaction of support from healthcare services to handle physical, mental and social changes to continue life after the disease showed that a majority of the participants had received insufficient support. The qualitative analysis indicated a need for equal roles in healthcare to promote participation, a need to manage and process consequences of the disease, and a need for continuous support.

    CONCLUSIONS:

    During transition to adulthood, there's a need for a personalized care plan that takes a holistic approach towards supporting the young cancer survivor in managing life in the best way. Identifying and handling the individual needs of pediatric cancer survivors is important for providing the resources and support required to increase the likelihood of successful transition to adulthood.

  • 717. Sörensen, Gunilla
    et al.
    Anund, Anna
    Wretling, Peter
    Törnström, EvaMarie
    Falkmer, Torbjörn
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. CHILD.
    Matstoms, Ylva
    Trafiksäkerhet vid skolskjutsning: Slutrapport2002Report (Other academic)
  • 718.
    Tammimies, Kristiina
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Li, Danyang
    Karolinska Institutet, Stockholm, Sweden.
    Rabkina, Ielyzaveta
    Karolinska Institutet, Stockholm, Sweden.
    Stamouli, Sofia
    Karolinska Institutet, Stockholm, Sweden.
    Becker, Martin
    Karolinska Institutet, Stockholm, Sweden.
    Nicolaou, Veronika
    Karolinska Institutet, Stockholm, Sweden.
    Berggren, Steve
    Karolinska Institutet, Stockholm, Sweden.
    Coco, Christina
    Karolinska Institutet, Stockholm, Sweden.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Curtin University, Australia.
    Jonsson, Ulf
    Karolinska Institutet, Stockholm, Sweden.
    Choque-Olsson, Nora
    Karolinska Institutet, Stockholm, Sweden.
    Bölte, Sven
    Karolinska Institutet, Stockholm, Sweden.
    Association between rare copy number variation and response to social skills training in autism spectrum disorder2018In: bioRxivArticle in journal (Other academic)
    Abstract [en]

    Challenges in social communication and interaction are core symptoms in autism spectrum disorder (ASD) for which social skills group training (SSGT) is a commonly used intervention. SSGT has shown modest but heterogeneous effects in clinical trials, and therefore identification of effect moderators could enable more precise intervention decisions. One of the major genetic risk factors in ASD are rare copy number variation (CNV). However, limited information exists whether rare CNVs profiles can be used to aid in intervention decisions. Therefore, we conducted the first study to date analyzing rare CNVs as genetic moderators in the outcome of SSGT in ASD. For this, we analyzed rare genic CNV carrier status of 207 children of which 105 received SSGT and 102 standard care as part of a recent randomized clinical trial for 12-weeks SSGT. We used mixed linear models to assess the association of being a CNV carrier, grouped by the effect and size of the CNVs and the primary response to SSGT, the parent-report Social Responsiveness Scale (SRS) measured at post-intervention and 3-months follow-up. Additionally, we analyzed the secondary outcome assessments included parent-rated adaptive behaviors (ABAS-II) and trainer-rated clinical global impression (CGI). We show that being a carrier of any size rare genic CNV did not impact on the SSGT outcome. However, when stratifying the groups by size of the CNVs, we identified that carriers of large CNVs (>500 kb) showed inferior SRS outcomes at post-intervention (β = 15.35, 95% CI 2.86-27.84, P=0.017) and follow-up (β = 14.19, 95% CI 1.68-26.70, P=0.028). Similar results were shown for the parent-rated secondary outcome. In contrast, the carriers of small CNVs had better outcome at post-intervention (β = -1.20, 95 % CI -2.0 - -0.4 P = 0.003) but not at follow-up for the trainer-rated secondary outcome CGI. These results remained when we tested the specificity of the effect by including the standard care group and adjusting for IQ levels. While our study suggests that being a carrier of any size rare genic CNV did not impact the outcome, it provides preliminary evidence that carriers of high-risk CNVs might not benefit on SSGT as much as non-carriers. Our results indicate that genetic information eventually might help guide personalized intervention planning in ASD. We additionally highlight that more research is needed to understand the intervention needs of autistic individuals with specified molecular alterations.

  • 719.
    Taylor, Susan
    et al.
    Faculty of Computing Health and Science, Edith Cowan University, Perth, Australia.
    McLean, B.
    School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. School of Occupational Therapy and Social work, Curtin University, Perth, Australia.
    Carey, L.
    Neurorehabilitation and Recovery, The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia.
    Girdler, S.
    School of Occupational Therapy and Social work, Curtin University, Perth, Australia.
    Elliott, C.
    School of Occupational Therapy and Social work, Curtin University, Perth, Australia.
    Blair, E.
    Population Sciences, Telethon Kids Institute, Perth, Australia.
    Does somatosensation change with age in children and adolescents? A systematic review.2016In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 42, no 6, p. 809-824Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Somatosensory modalities, such as touch, proprioception and haptic ability, greatly influence the achievement of developmental milestones for children. Describing somatosensory impairment, natural variability and typical or expected developmental changes across age groups will help establish frameworks for intervention in clinical populations. This systematic review aimed to determine how different somatosensory modalities develop across childhood into adolescence to use as a point of reference for children at risk of somatosensory impairment.

    METHODS: Searches of five electronic databases were undertaken through EBSCO-host (MEDLINE, CINAHL, PsycINFO, SPORTDiscus and ERIC) for studies measuring at least one somatosensory modality in typically developing individuals between birth and 18 years and analysed by age. Characteristics of studies were collected including country of origin, sample size, demographics and outcome measure used. Quality assessment and data extraction were performed by two independent reviewers.

    RESULTS: Twenty three cross-sectional studies were included from a total of 188 articles retrieved: 8 examined aspects of touch, 5 proprioception and 10 haptic ability. Variability of study designs and variation in assessment tools precluded any formal meta-analysis.

    CONCLUSIONS: Somatosensation matures through childhood into adolescence; however, the present review found the pattern of somatosensory development varied depending on the assessment tool used and the aspect of somatosensation being measured, making it difficult to describe typical performance. There is a need for comprehensive assessment batteries to measure the somatosensation, including touch, proprioception and haptic ability, of children at risk of somatosensory impairment to aid in the development of effective interventions.

  • 720.
    Thompson, Craig
    et al.
    Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, QLD, Australia.
    Bölte, Sven
    Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, QLD, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, QLD, Australia.
    Girdler, Sonya
    Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, QLD, Australia.
    To be understood: Transitioning to adult life for people with Autism Spectrum Disorder2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 3, article id e0194758Article in journal (Refereed)
    Abstract [en]

    Introduction: The purpose of this study was to explore the viewpoints of parents of young people with Autism Spectrum Disorder (ASD) in relation to their child's transition to adulthood.

    Methods: Data were collected during four structured focus groups with 19 parents of young people with ASD with average to high intellectual capacities. Condensed meaning units were identified and checked during focus groups, and were subsequently linked to the International Classification of Functioning, Disability and Health (ICF).

    Results: Three major themes emerged: to be understood, to understand the world and to succeed. The ICF domains of activity and participation and environmental factors emerged as having the greatest potential to influence transition outcomes.

    Conclusions: Policies and services should focus on strengths to maximise participation in higher education, employment and independent living amongst young people with ASD. Interventions targeting environmental factors could be effective in improving participation in adult life. Person-centred and individualised approaches could further complement this approach supporting the transition to adulthood for people with ASD, ultimately improving outcomes in adulthood. 

  • 721.
    Thompson, Craig
    et al.
    Cooperative Research Centre for Living with Autism (Autism CRC) , Long Pocket, Brisbane , Queensland , Australia.
    Bölte, Sven
    Cooperative Research Centre for Living with Autism (Autism CRC) , Long Pocket, Brisbane , Queensland , Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Cooperative Research Centre for Living with Autism (Autism CRC) , Long Pocket, Brisbane , Queensland , Australia.
    Girdler, Sonya
    Cooperative Research Centre for Living with Autism (Autism CRC) , Long Pocket, Brisbane , Queensland , Australia.
    Viewpoints on how students with autism can best navigate university.2019In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 26, no 4, p. 294-305Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Despite recognition of the challenges faced by students with autism spectrum disorders (ASD) there is limited understanding of the barriers and facilitators to participation in major life areas, such as being a university student.

    AIM/OBJECTIVE:

    This research aimed to examine viewpoints on what affects the success of Australian university students with ASD.

    MATERIAL AND METHOD:

    Q-methodology was used to describe the viewpoints of university students with ASD, their parents and their mentors, on success at university for students with ASD. A total of 57 participants completed the Q-sort.

    RESULTS/FINDINGS:

    Three viewpoints emerged; Individualised Support, Contextual Support and Social Support.

    CONCLUSIONS:

    This study highlighted that supports need to be individualized to the barriers and facilitators faced by Australian students with ASD. Supports also need to be contextualized to the built and social environments of universities.

    SIGNIFICANCE:

    This study supports the premise that environmental interventions can be effective in facilitating participation in major life areas, such as university education. Peer mentoring for students with ASD may have utility for this group, but should be extended to include social, emotional and psychological support.

  • 722.
    Thompson, Melanie
    et al.
    Curtin University.
    Elliott, Catherine
    Curtin University.
    Willis, Claire
    University of Western Australia.
    Ward, Roslyn
    University of Western Australia.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD. Curtin University.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Curtin University.
    Gubbay, Anna
    University of Western Australia.
    Girdler, Sonya
    Curtin University.
    Can, Want and Try: Parents’ Viewpoints Regarding the Participation of Their Child with an Acquired Brain Injury2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 7, article id e0157951Article in journal (Refereed)
    Abstract [en]

    Background 

    Acquired brain injury (ABI) is a leading cause of permanent disability, currently affecting 20,000 Australian children. Community participation is essential for childhood development and enjoyment, yet children with ABI can often experience barriers to participation. The factors which act as barriers and facilitators to community participation for children with an ABI are not well understood. 

    Aim

    To identify the viewpoints of parents of children with an ABI, regarding the barriers and facilitators most pertinent to community participation for their child. 

    Methods 

    Using Q-method, 41 parents of children with moderate/severe ABI sorted 37 statements regarding barriers and facilitators to community participation. Factor analysis identified three viewpoints. 

    Results 

    This study identified three distinct viewpoints, with the perceived ability to participate decreasing with a stepwise trend from parents who felt their child and family "can" participate in viewpoint one, to "want" in viewpoint two and "try" in viewpoint three. 

    Conclusions 

    Findings indicated good participation outcomes for most children and families, however some families who were motivated to participate experienced significant barriers. The most significant facilitators included child motivation, supportive relationships from immediate family and friends, and supportive community attitudes. The lack of supportive relationships and attitudes was perceived as a fundamental barrier to community participation. 

    Significance 

    This research begins to address the paucity of information regarding those factors that impact upon the participation of children with an ABI in Australia. Findings have implications for therapists, service providers and community organisations.

  • 723. Toorell, Elisabet
    et al.
    Elgmark Andersson, Elisabeth
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Life satisfaction after stroke in the middle of lifeManuscript (preprint) (Other academic)
  • 724.
    Ullenhag, Anna
    et al.
    Health Care Sciences Postgraduate School, Department of Women's and Children's Health, Karolinska Institutet Neuropediatric Unit, Astrid Lindgren Children's Hospital Q2:07, Solna, Sweden.
    Almqvist, Lena
    School of Sustainable Development of Society and Technology, Mälardalens University, Västerås, Sweden.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Krumlinde-Sundholm, Lena
    Health Care Sciences Postgraduate School, Department of Women's and Children's Health, Karolinska Institutet Neuropediatric Unit, Astrid Lindgren Children's Hospital Q2:07, Solna, Sweden.
    Cultural validity of the Children's assessment of participation and enjoyment/Preferences for activities of children (CAPE/PAC)2012In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 19, no 5, p. 428-438Article in journal (Refereed)
    Abstract [en]

    Objective: The aim was to evaluate whether the activity items of the Children's Assessment of Participation and Enjoyment/Preferences for Activities of Children (CAPE/PAC) were relevant for Swedish children.

    Subjects: A total of 337 typically developed children aged 6–17 years old.

    Methods: The CAPE/PAC was translated into Swedish in accordance with accepted translation procedures. By means of 14 group interviews with children with and without disabilities aged 6–15 years old and parents, available leisure activities were listed. These were matched to the items in the CAPE/PAC. Sixteen new potential activities were added and tested on 337 typical developed children from different regions of Sweden. A cutoff level of activities performed by >10% was set to identify relevant activities. Differences between the original and a proposed Swedish version were analysed using paired-samples t-tests of standardized mean scores.

    Results: Three new activity items were included, for 10 items new activity examples were added, and three not relevant items were excluded. In the Swedish version the outcome of standardized mean diversity score was significantly higher compared with the outcome of the original version. Conclusions:When using instruments in new contexts, it is not enough simply to translate; validation of the item relevance to the new context is essential.

  • 725.
    Ullenhag, Anna
    et al.
    Department of Women's and Children's Health, Karolinska Institutet, Neuropediatric unit, Astrid Lindgren Children's Hospital, Stockholm, Sweden.
    Bult, Maureen
    Rudolf Magnus Institute of Neuroscience and Center of Excellence for Rehabilitation Medicine, University Medical Center, Utrecht and Rehabilitation Center De Hoogstraat-Network for Childhood Disability Research in the Netherlands, Utrecht, the Netherlands.
    Nyquist, Anna
    Norwegian School of Sport Science, Department of Physical Education and Beitostølen Healthsport Centre, Beitostølen, Norway.
    Ketelaar, Marie
    Rudolf Magnus Institute of Neuroscience and Center of Excellence for Rehabilitation Medicine, University Medical Center, Utrecht and Rehabilitation Center De Hoogstraat-Network for Childhood Disability Research in the Netherlands, Utrecht, the Netherlands.
    Jahnsen, Ranvig
    Oslo University Hospital, Department of Neuroscience for children, Rikshospitalet, Oslo, Norway.
    Krumlinde-Sundholm, Lena
    Department of Women's and Children's Health, Karolinska Institutet, Neuropediatric unit, Astrid Lindgren Children's Hospital, Stockholm, Sweden.
    Almqvist, Lena
    Jönköping University, School of Education and Communication, HLK, CHILD. School of Health, Care and Social Welfare, Mälardalens University, Västerås, Sweden.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    An international comparison of patterns of participation in leisure activities for children with and without disabilities in Sweden, Norway and the Netherlands2012In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 15, no 5, p. 369-385Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate whether there are differences in participation in leisure activities between children with and without disabilities in Sweden, Norway and the Netherlands and how much personal and environmental factors explain leisure performance.

    Methods: In a cross-sectional analytic design, the Children's Assessment of Participation and Enjoyment, CAPE, was performed with 278 children with disabilities and 599 children without disabilities aged 6–17 years. A one-way between-groups ANOVA explored the differences in participation between the countries. Hierarchical multiple regression analysis assessed if age, gender, educational level, living area and country of residence explained the variance in participation.

    Results: Scandinavian children with disabilities participated in more activities with higher frequency compared to Dutch children. The strongest predictor was country of residence. For children without disabilities, differences existed in informal activities, the strongest predictor was gender.

    Conclusion: Differences in school- and support systems between the countries seem to influence patterns of participation, affecting children with disabilities most.

  • 726.
    Ullenhag, Anna
    et al.
    Department of Women’s and Children’s Health, Karolinska Institutet, Neuropediatric Unit, Stockholm, Sweden.
    Krumlinde-Sundholm, Lena
    Department of Women’s and Children’s Health, Karolinska Institutet, Neuropediatric Unit, Stockholm, Sweden.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Almqvist, Lena
    Jönköping University, School of Education and Communication, HLK, CHILD. School of Sustainable Development of Society and Technology, Mälardalen University, Västerås, Sweden.
    Differences in patterns of participation in leisure activities in Swedish children with and without disabilities2014In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, no 6, p. 464-471Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 727.
    Vaz, Sharmila
    et al.
    School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Cordier, Reinie
    School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Boyes, Mark
    School of Psychology, Speech Pathology Curtin University, Perth, WA, Australia.
    Parsons, Richard
    School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Joosten, Annette
    School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Ciccarelli, Marina
    School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD. School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Is using the strengths and difficulties questionnaire in a community sample the optimal way to assess mental health functioning?2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 1, article id 0144039Article in journal (Refereed)
    Abstract [en]

    An important characteristic of a screening tool is its discriminant ability or the measure's accuracy to distinguish between those with and without mental health problems. The current study examined the inter-rater agreement and screening concordance of the parent and teacher versions of SDQ at scale, subscale and item-levels, with the view of identifying the items that have the most informant discrepancies; and determining whether the concordance between parent and teacher reports on some items has the potential to influence decision making. Cross-sectional data from parent and teacher reports of the mental health functioning of a community sample of 299 students with and without disabilities from 75 different primary schools in Perth, Western Australia were analysed. The study found that: a) Intraclass correlations between parent and teacher ratings of children's mental health using the SDQ at person level was fair on individual child level; b) The SDQ only demonstrated clinical utility when there was agreement between teacher and parent reports using the possible or 90% dichotomisation system; and c) Three individual items had positive likelihood ratio scores indicating clinical utility. Of note was the finding that the negative likelihood ratio or likelihood of disregarding the absence of a condition when both parents and teachers rate the item as absent was not significant. Taken together, these findings suggest that the SDQ is not optimised for use in community samples and that further psychometric evaluation of the SDQ in this context is clearly warranted.

  • 728.
    Vaz, Sharmila
    et al.
    Curtin University, Perth, Australia.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Ciccarelli, Marina
    Curtin University, Perth, Australia.
    Passmore, Anne
    Curtin University, Perth, Australia.
    Parsons, Richard
    Curtin University, Perth, Australia.
    Black, Melissa
    Curtin University, Perth, Australia.
    Cuomo, Belinda
    Curtin University, Perth, Australia.
    Tan, Tele
    Curtin University, Perth, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Curtin University, Perth, Australia.
    Belongingness in Early Secondary School: Key Factors that Primary and Secondary Schools Need to Consider2015In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 9, article id e0136053Article in journal (Refereed)
    Abstract [en]

    It is unknown if, and how, students redefine their sense of school belongingness after negotiating the transition to secondary school. The current study used longitudinal data from 266 students with, and without, disabilities who negotiated the transition from 52 primary schools to 152 secondary schools. The study presents the 13 most significant personal student and contextual factors associated with belongingness in the first year of secondary school. Student perception of school belongingness was found to be stable across the transition. No variability in school belongingness due to gender, disability or household-socio-economic status (SES) was noted. Primary school belongingness accounted for 22% of the variability in secondary school belongingness. Several personal student factors (competence, coping skills) and school factors (low-level classroom task-goal orientation), which influenced belongingness in primary school, continued to influence belongingness in secondary school. In secondary school, effort-goal orientation of the student and perception of their school's tolerance to disability were each associated with perception of school belongingness. Family factors did not influence belongingness in secondary school. Findings of the current study highlight the need for primary schools to foster belongingness among their students at an early age, and transfer students' belongingness profiles as part of the handover documentation. Most of the factors that influenced school belongingness before and after the transition to secondary are amenable to change.

  • 729.
    Vaz, Sharmila
    et al.
    School of Occupational Therapy and Social Work, Centre for Research into Disability and Society, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD. School of Occupational Therapy and Social Work, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia.
    Parsons, Richard
    School of Occupational Therapy and Social Work, and School of Pharmacy, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia.
    Passmore, Anne Elizabeth
    School of Occupational Therapy and Social Work, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia.
    Parkin, Timothy
    School of Occupational Therapy and Social Work, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    School belongingness and mental health functioning across the primary-secondary transition in a mainstream sample: Multi-group cross-lagged analyses2014In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 6(e99576), p. 1-10Article in journal (Refereed)
    Abstract [en]

    The relationship between school belongingness and mental health functioning before and after the primary-secondary school transition has not been previously investigated in students with and without disabilities. This study used a prospective longitudinal design to test the bi-directional relationships between these constructs, by surveying 266 students with and without disabilities and their parents, 6-months before and after the transition to secondary school. Cross-lagged multi-group analyses found student perception of belongingness in the final year of primary school to contribute to change in their mental health functioning a year later. The beneficial longitudinal effects of school belongingness on subsequent mental health functioning were evident in all student subgroups; even after accounting for prior mental health scores and the cross-time stability in mental health functioning and school belongingness scores. Findings of the current study substantiate the role of school contextual influences on early adolescent mental health functioning. They highlight the importance for primary and secondary schools to assess students' school belongingness and mental health functioning and transfer these records as part of the transition process, so that appropriate scaffolds are in place to support those in need. Longer term longitudinal studies are needed to increase the understanding of the temporal sequencing between school belongingness and mental health functioning of all mainstream students.

  • 730.
    Vaz, Sharmila
    et al.
    School of Occupational Therapy and Social Work, Centre for Research into Disability and Society, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia.
    Parsons, Richard
    School of Pharmacy, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Passmore, Anne Elizabeth
    School of Occupational Therapy and Social Work, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD.
    The impact of personal background and school contextual factors on academic competence and mental health functioning across the primary-secondary school transition2014In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 3, p. 1-13, article id e89874Article in journal (Refereed)
    Abstract [en]

    Students negotiate the transition to secondary school in different ways. While some thrive on the opportunity, others are challenged. A prospective longitudinal design was used to determine the contribution of personal background and school contextual factors on academic competence (AC) and mental health functioning (MHF) of 266 students, 6-months before and after the transition to secondary school. Data from 197 typically developing students and 69 students with a disability were analysed using hierarchical linear regression modelling. Both in primary and secondary school, students with a disability and from socially disadvantaged backgrounds gained poorer scores for AC and MHF than their typically developing and more affluent counterparts. Students who attended independent and mid-range sized primary schools had the highest concurrent AC. Those from independent primary schools had the lowest MHF. The primary school organisational model significantly influenced post-transition AC scores; with students from Kindergarten--Year 7 schools reporting the lowest scores, while those from the Kindergarten--Year 12 structure without middle school having the highest scores. Attending a school which used the Kindergarten--Year 12 with middle school structure was associated with a reduction in AC scores across the transition. Personal background factors accounted for the majority of the variability in post-transition AC and MHF. The contribution of school contextual factors was relatively minor. There is a potential opportunity for schools to provide support to disadvantaged students before the transition to secondary school, as they continue to be at a disadvantage after the transition.

  • 731.
    Vinçon, Sabine
    et al.
    Clinic for Child Neurology and Social Pediatrics, Child Centre Maulbronn, Maulbronn, Germany.
    Green, Dido
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD. Department of Sport and Health Sciences, Oxford Brookes University, Oxford, United Kingdom.
    Blank, Rainer
    Clinic for Child Neurology and Social Pediatrics, Child Centre Maulbronn, Maulbronn, Germany.
    Jenetzky, Ekkehart
    Clinic for Child Neurology and Social Pediatrics, Child Centre Maulbronn, Maulbronn, Germany.
    Ecological validity of the German Bruininks-Oseretsky Test of Motor Proficiency – 2nd Edition2017In: Human Movement Science, ISSN 0167-9457, E-ISSN 1872-7646, Vol. 53, p. 45-54Article in journal (Refereed)
    Abstract [en]

    The diagnosis of Developmental Coordination Disorder (DCD) is based on poor motor coordination in the absence of other neurological disorders. In order to identify the presence of movement difficulties, a standardised motor assessment is recommended to determine the extent of movement problems which may contribute to deficits in daily task performance. A German version of the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (German BOT-2) was recently published. This study aimed to determine the ecological validity of the German BOT-2 by considering the relationship between assessment of fundamental motor skills with the BOT-2 and performance of everyday motor activities as evaluated by parents. This study used data obtained from the German BOT-2 standardisation study (n = 1.177). Subtests were compared with theoretically corresponding tasks via parental ratings of overall fine and gross motor abilities and performance in six typical motor activities. Non-parametric Jonckheere Terpstra test was used to identify differences in ordered contrasts. Subtests reflecting ‘Strength’, ‘Running Speed and Agility’, ‘Upper-Limb Coordination’, ‘Balance’, and ‘Fine Motor Precision’ were associated with parental evaluation of gross motor skills (p < 0.001). The subtest ‘Fine Motor Integration’ significantly correlated with parental ratings of females’ fine motor skills. Parental ratings of males’ fine motor skills were associated with three further subtests. Regarding everyday motor activities, the first three fine motor BOT-2 subtests were associated with parent evaluations of drawing, writing and arts and crafts (p < 0.001). Gross motor subtests of ‘Bilateral Coordination’ and ‘Balance’ showed no relationship to bike riding or performance in sports. Subtests of ‘Upper-Limb Coordination’ and ‘Strength’ showed significant correlations with sports, ball games and cycling. The results of this study suggest that the closer the proximity in the nature of the motor skills assessed in the German BOT-2 to daily motor tasks, the stronger the relationship between the clinical test and parental report of everyday performance of their child. The body functions tested in the German BOT-2, and hypothesized to underpin certain skills, were not automatically relevant for specific activities undertaken by German children. Future research should investigate the relationships of the various BOT-2 constructs for diagnosis of DCD.

  • 732. von Essen, L
    et al.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Important aspects of care and assistance for siblings of children treated for cancer: a parent and nurse perspective2003In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 26, no 3, p. 203-210Article in journal (Refereed)
  • 733. von Essen, L
    et al.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Haglund, K
    Hedström, M
    Skolin, I
    Important aspects of care and assistance for children 0-7 years of age being treated for cancer: Parent and nurse perceptions.2002In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 10, no 8, p. 601-612Article in journal (Refereed)
  • 734. von Essen, L
    et al.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Kreuger, A
    Larsson, B
    Sjödén, PO
    Self-esteem, depression and anxiety among Swedish children and adolescents on and off cancer treatment2000In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 89, no 2, p. 229-236Article in journal (Refereed)
  • 735. von Essen, L
    et al.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Skolin, I
    Important aspects of care and assistance for parents of children, 0-18 years of age, on or off treatment for cancer: Parent and nurse perceptions.2001In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 5, no 4, p. 254-264Article in journal (Refereed)
    Abstract [en]

    Important aspects of care and assistance for parents of children (0–18 years) diagnosed with cancer were investigated. Parents (N=114) and nurses (N=121) were asked the following questions: ‘What caring aspects are important for you/the parent to feel cared for?’ and ‘What help, if any, do you/the parent need outside the hospital?’ Nurses were asked to answer for a certain parent. Data were analyzed by content analysis. The following aspects of care were identified: accessible care, clinical competence, continuity, emotional support, information, participation in care, participation in decision making, physical ambience, shift in parenting roles, social competence, temporary assistance, own child is well cared for, and time. Most parents mentioned the importance of social competence and information, most nurses mentioned the importance of information and emotional support. The following aspects of assistance were identified: accessible care, emotional support, financial support, instrumental support, and support to live a normal family/social life. A third of the parents and a fourth of the nurses were of the opinion that the parent did not need any assistance. Most parents who mentioned a need of assistance mentioned a need for emotional and instrumental support. Most nurses mentioned a parental need for emotional support and accessible care.

  • 736.
    Wadensten, Barbro
    et al.
    Department of Public Health and Caring, Uppsala University, Uppsala, Sweden.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    The struggle for dignity by people with severe functional disabilities2009In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 16, no 4, p. 453-465Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to investigate what strategies people with severe functional disabilities who receive personal assistance in their homes use in their daily life to achieve autonomy, integrity, influence and participation. Qualitative interviews were carried out and subjected to qualitative latent content analysis. The main finding was expressed in terms of six subthemes: trying to keep a private sphere; striving to communicate; searching for possibilities; taking the initiative; striving to gain insight; and using one's temperament. These generated the overall theme: maintaining dignity in close relationships. This study contributes an understanding of the strategies used by people who are dependent on personal assistance. Future efforts in nursing must focus on supporting personal assistants with ethical knowledge and guidance in order that people with severe functional disabilities are empowered to achieve autonomy, integrity, influence and participation in their daily lives.

  • 737.
    Weinstein, Maya
    et al.
    Centre for Rehabilitation, Oxford Brookes University, Oxford, UK.
    Green, Dido
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD. Centre for Rehabilitation, Oxford Brookes University, Oxford, UK.
    Rudisch, Julian
    Centre for Rehabilitation, Oxford Brookes University, Oxford, UK.
    Zielinski, Ingar M.
    Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
    Benthem-Muñiz, Marta
    Department of Neuroimaging, King's College London, London, UK.
    Jongsma, Marijtje L. A.
    Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
    McClelland, Verity
    Department of Basic and Clinical Neuroscience, King's College London, UK.
    Steenbergen, Bert
    Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
    Shiran, Shelly
    Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
    Ben Bashat, Dafna
    The Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
    Barker, Gareth J.
    Department of Neuroimaging, King's College London, London, UK.
    Understanding the relationship between brain and upper limb function in children with unilateral motor impairments: A multimodal approach2018In: European journal of paediatric neurology, ISSN 1090-3798, E-ISSN 1532-2130, Vol. 22, no 1, p. 143-154Article in journal (Refereed)
    Abstract [en]

    Atypical brain development and early brain injury have profound and long lasting impact on the development, skill acquisition, and subsequent independence of a child. Heterogeneity is present at the brain level and at the motor level; particularly with respect to phenomena of bilateral activation and mirrored movements (MMs). In this multiple case study we consider the feasibility of using several modalities to explore the relationship between brain structure and/or activity and hand function: Electroencephalography (EEG), both structural and functional Magnetic Resonance Imaging (sMRI, fMRI), diffusion tensor imaging (DTI), transcranial magnetic stimulation (TMS), Electromyography (EMG) and hand function assessments.

    Methods: 15 children with unilateral CP (ages: 9.4 ± 2.5 years) undertook hand function assessments and at least two additional neuroimaging and/or neurophysiological procedures: MRI/DTI/fMRI (n = 13), TMS (n = 11), and/or EEG/EMG (n = 8). During the fMRI scans and EEG measurements, a motor task was performed to study cortical motor control activity during simple hand movements. DTI tractography analysis was used to study the corpus-callosum (CC) and cortico-spinal tracts (CST). TMS was used to study cortico-spinal connectivity pattern.

    Results: Type and range of severity of brain injury was evident across all levels of manual ability with the highest radiological scores corresponded to children poorer manual ability. Evidence of MMs was found in 7 children, mostly detected when moving the affected hand, and not necessarily corresponding to bilateral brain activation. When moving the affected hand, bilateral brain activation was seen in 6/11 children while 3/11 demonstrated unilateral activation in the contralateral hemisphere, and one child demonstrated motor activation predominantly in the supplementary motor area (SMA). TMS revealed three types of connectivity patterns from the cortex to the affected hand: a contralateral (n = 3), an ipsilateral (n = 4) and a mixed (n = 1) connectivity pattern; again without clear association with MMs. No differences were found between children with and without MMs in lesion scores, motor fMRI laterality indices, CST diffusivity values, and upper limb function. In the genu, midbody, and splenium of the CC, higher fractional anisotropy values were found in children with MMs compared to children without MMs. The EEG data indicated a stronger mu-restoration above the contralateral hemisphere in 6/8 children and above the ipsilateral hemisphere in 2/8 children.

    Conclusion: The current results demonstrate benefits from the use of different modalities when studying upper-limb function in children with CP; not least to accommodate to the variations in tolerance and feasibility of implementation of the differing methods. These exposed multiple individual brain-reorganization patterns corresponding to different functional motor abilities. Additional research is warranted to understand the transactional influences of early brain injury, neuroplasticity and developmental and environmental factors on hand function in order to develop targeted interventions. 

  • 738.
    Wennick, Anne
    et al.
    Faculty of Health and Society, Malmö University, Malmö, Sweden.
    Huus, Karina
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    What it is like being a sibling of a child newly diagnosed with type 1 diabetes: an interview study2012In: European Diabetes Nursing, ISSN 1551-7853, E-ISSN 1551-7861, Vol. 9, no 3, p. 88-92Article in journal (Refereed)
    Abstract [en]

    Although previous studies have stressed that having a brother or sister with a chronic condition may affect the healthy sibling, few have specifically focused on healthy siblings of children with type 1 diabetes.

    Hence, this study aimed to illuminate what it is like to be a brother or sister of a child newly diagnosed with type 1 diabetes.

    Individual interviews were conducted with seven siblings aged 10–17 years (median=12) from six different families. Each interview was analysed using content analysis.

    Three different categories emerged – Living differently, Being concerned and Participating in caring for the affected child – indicating that, for the healthy sibling, the illness entails a transformed everyday life including worry about the affected child and the need to help in the home.

    In conclusion, the paediatric health care service may need to develop new strategies to meet the siblings' desired level of knowledge in educational team sessions related to diabetes. As the sibling relationship is probably the longest one that an affected child will experience in her/his lifetime, it is worth investing in it to promote this long-term support resource.

  • 739.
    Wigert, Helena
    et al.
    Institute of Health and Care Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Fors, Andreas
    Institute of Health and Care Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Nilsson, Stefan
    Institute of Health and Care Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Dalenius, Kristina
    Lerums Kommun, Sektor lärande, Lerum, Sweden.
    Golsäter, Marie
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD. Child Health Care and Futurum, Region Jönköping County, Barnhälsovården, Jönköping, Sweden.
    A person-centred approach when encountering students with recurrent pain: School nurses’ experiences2019In: Journal of School Nursing, ISSN 1059-8405, E-ISSN 1546-8364Article in journal (Refereed)
    Abstract [en]

    Stress has a negative impact on students' daily lives and can be associated with recurrent pain. School nurses play a key role in supporting young people with stress-related pain. The purpose of this qualitative interview study was to elucidate school nurses' experiences of encountering students with recurrent pain when practicing person-centred care. The school nurses were based at public and private schools and worked with students aged 12-19. Data were collected through interviews with 18 school nurses and analyzed with deductive content analysis. The school nurses felt that actively listening to the students' narratives about daily life with recurrent pain, and co-creation of a health plan, encouraged the students to participate as partners in their own care and strengthened their relation with the students. The application of a person-centred approach in school health care meant that traditional knowledge transfer was replaced with a dialogue that reflects both the student's and school nurse's perspective.

  • 740.
    Wigston, Christine
    et al.
    Curtin University, Perth, Western Australia, Australia.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD. Curtin University, Perth, Western Australia, Australia.
    Vaz, Sharmila
    Curtin University, Perth, Western Australia, Australia.
    Parsons, Richard
    Curtin University, Perth, Western Australia, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Curtin University, Perth, Western Australia, Australia.
    Participation in extracurricular activities for children with and without siblings with autism spectrum disorder2017In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, no 1, p. 25-39Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    To compare the number, frequency, enjoyment and performance in extracurricular activities of siblings of children with autism spectrum disorders (ASD) to their typically developing (TD) peers, and to identify differences between actual and desired participation.

    METHODS:

    A case-control study with 30 siblings of children with ASD and 30 siblings of TD children was conducted using the Paediatric Interest Profiles and a questionnaire.

    RESULTS:

    Siblings of children with ASD participated in fewer extracurricular activities than those with TD siblings. ASD symptoms were significantly associated with the sibling participating in fewer extracurricular activities. Children with TD siblings had higher enjoyment scores in relaxation activities than children with siblings with ASD.

    CONCLUSION:

    While results were mainly positive, some differences indicated that having a sibling with ASD may impact participation in extracurricular activities. Assessments of participation barriers, as well as support to minimise participation restrictions among siblings of children with ASD are required.

  • 741. Wilder, J
    et al.
    Axelsson, C
    Granlund, Mats
    Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health Science, HHJ. CHILD.
    Parent-child interaction: A comparison of parents' perceptions in three groups2004In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 26, no 21-22, p. 1313-1322Article in journal (Refereed)
  • 742. Wilder, J
    et al.
    Granlund, Mats
    Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health Science, HHJ. CHILD.
    Behaviour style and interaction between seven children with multiple disabilities and their caregivers2003In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 29, no 6, p. 559-567Article in journal (Refereed)
  • 743. Wilder, J
    et al.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Presymbolic children in Sweden: interaction, family accommodation and social networks2006In: Proceedings from the 12th Isaac research conference, Düsseldorf, August, 2006Conference paper (Other academic)
  • 744.
    Wilder, Jenny
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Axelsson, Anna Karin
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Carlsson, Maggan
    Föreningen JAG.
    Jag är med! Om personlig assistans och barns delaktighet i familjeaktiviteter2013Book (Other academic)
  • 745.
    Wilder, Jenny
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Mälardalens Högskola.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Stability and change in sustainability of daily routines and social networks in families of children with profound intellectual and multiple disabilities2015In: JARID: Journal of applied research in intellectual disabilities, ISSN 1360-2322, E-ISSN 1468-3148, Vol. 28, no 2, p. 133-144Article in journal (Refereed)
    Abstract [en]

    Background

    Children with profound intellectual and multiple disabilities (PIMD) demand intense family accommodations from birth and onwards. This study used an exploratory and qualitative study design to investigate stability and change in sustainability of daily routines and social networks of Swedish families of children with PIMD.

    Materials and methods

    Eight families participated over two years in eco-cultural family interviews and social networks interviews collected at home visits. Data were analyzed descriptively and by manifest contents analysis.

    Results

    Results showed variations in sustainability of daily routines over time across families. The sustainability was linked to fathers' involvement, couples' connectedness and emotional support. Stability and change of social networks were characterized by low overlap between the child and family networks, the children's communicative dependency and low density of able communication partners.

    Conclusions

    The results indicate that patterns of stability and change were linked both to family resources and child characteristics.

  • 746.
    Wilder, Jenny
    et al.
    Mälardalen University, School of Education and Communication, CHILD.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Björck-Åkesson, Eva
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Cooperación entre professionales y familias de niños con pluridiscapacidad2012In: Pluridiscapacidad y contextos de intervención / [ed] Emili Soro-Camats, Carme Basil, Carme Rosell, Barcelona: Institut de Ciències de l'Educació (ICE) , 2012, p. 149-162Chapter in book (Other academic)
  • 747.
    Wu, Xi Vivien
    et al.
    Jönköping University, School of Health and Welfare. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Heng, D. G. N.
    Nursing Education, National University Hospital, Singapore.
    Pua, L. H.
    Department of Education and Practice, Nursing Service, Tan Tock Seng Hospital, Singapore.
    Wang, W.
    Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore.
    The perspectives of preceptors regarding clinical assessment for undergraduate nursing students2016In: International Nursing Review, ISSN 0020-8132, E-ISSN 1466-7657, Vol. 63, no 3, p. 473-481Article in journal (Refereed)
    Abstract [en]

    AIM: To explore the perspectives of preceptors about clinical assessment for undergraduate nursing students in transition to practice.

    BACKGROUND: The assessment of clinical competence is a complex process due to the diverse nature of nursing practice. As such, nurse preceptors play a crucial role in clinical assessment for nursing students. Although preceptors may enjoy the process of clinical teaching and assessment, they face challenges that need to be addressed to facilitate students' clinical learning and assessment.

    METHODS: An exploratory qualitative approach was adopted. A purposive sample of 17 preceptors from two tertiary hospitals in Singapore was recruited to participate in three focus group discussions from March to July 2014.

    FINDINGS: Five themes emerged from the data analysis: the need for a valid and reliable clinical assessment tool; meaningful reflection and feedback; varied methods in clinical assessment; high level of commitment and struggles with dual roles and the need to enhance the support system for preceptors.

    CONCLUSIONS: There is no doubt that a valid and reliable clinical assessment tool can serve as a guide for preceptors to enhance their clarity in assessment and feedback. It is essential for all stakeholders to be involved in the development of the clinical assessment tool. Workload, time, support system and formal educational programmes for preceptors influenced their preparation and self-confidence.

    IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY: The themes that emerged from the focus group discussions could assist in the development of a more reliable and valid clinical assessment tool to evaluate the clinical competence of nursing students in transition to practice. Clinical and educational institutions could collaborate closely to develop an educational programme and a preceptorship handbook, focusing on pedagogical contents for clinical education and assessment.

  • 748.
    Wu, Xi Vivien
    et al.
    Jönköping University, School of Health and Welfare. Alice Centre for Nursing Studies, Singapore.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Lee, Cindy Ching Siang
    Alice Centre for Nursing Studies, Singapore.
    Wang, Wenru
    Alice Centre for Nursing Studies, Singapore.
    A systematic review of clinical assessment for undergraduate nursing students2015In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 35, no 2, p. 347-359Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: Consolidated clinical practicum prepares pre-registration nursing students to function as beginning practitioners. The clinical competencies of final-year nursing students provide a key indication of professional standards of practice and patient safety. Thus, clinical assessment of nursing students is a crucial issue for educators and administrators.

    OBJECTIVE: The aim of this systematic review was to explore the clinical competency assessment for undergraduate nursing students.

    DATA SOURCES: PubMed, CINAHL, ScienceDirect, Web of Science, and EBSCO were systematically searched from January 2000 to December 2013.

    METHODS: The systematic review was in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Published quantitative and qualitative studies that examined clinical assessment practices and tools used in clinical nursing education were retrieved. Quality assessment, data extraction, and analysis were completed on all included studies.

    RESULTS: This review screened 2073 titles, abstracts and full-text records, resulting in 33 included studies. Two reviewers assessed the quality of the included studies. Fourteen quantitative and qualitative studies were identified for this evaluation. The evidence was ordered into emergent themes; the overarching themes were current practices in clinical assessment, issues of learning and assessment, development of assessment tools, and reliability and validity of assessment tools.

    CONCLUSION: There is a need to develop a holistic clinical assessment tool with reasonable level of validity and reliability. Clinical assessment is a robust activity and requires collaboration between clinical partners and academia to enhance the clinical experiences of students, the professional development of preceptors, and the clinical credibility of academics.

  • 749.
    Wu, Xi Vivien
    et al.
    Jönköping University, School of Health and Welfare. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Pua, Lay Hoon
    Department of Education and Practice, Nursing Service, Tan Tock Seng Hospital, Singapore.
    Heng, Doreen Gek Noi
    Nursing Education, National University Hospital, Singapore.
    Wang, Wenru
    Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
    Clinical nurse leaders’ and academics’ perspectives on clinical assessment of final-year nursing students: a qualitative study2017In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 19, no 3, p. 287-293Article in journal (Refereed)
    Abstract [en]

    The nature of nursing practice is diverse; therefore, clinical assessment is a complex process. This study explores the perceptions of clinical nurse leaders and academics on clinical assessment for undergraduate nursing education during transition to practice. An explorative qualitative approach was applied. Eight nurse managers, six clinical nurse educators, and eight academics from two tertiary hospitals and a university in Singapore participated in four focus group discussions. Thematic analysis was conducted. Four overriding themes were revealed: the need for a valid and reliable clinical assessment tool, preceptors' competency in clinical assessment, challenges encountered by the students in clinical assessment, and the need for close academic and clinical collaboration to support preceptors and students. Closer academic-clinical partnership is recommended to review the clinical education curriculum. Clinical and educational institutions need to work closely to design a learning program to enhance preceptors' competence in clinical pedagogy and assessment. Furthermore, a stress management program could build students' resiliency in coping with unfamiliar clinical environments. Ongoing support needs to be provided for both preceptors and students to enrich the preceptorship and learning experiences.

  • 750.
    Wu, Xi Vivien
    et al.
    Jönköping University, School of Health and Welfare. National University of Singapore.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Pua, Lay Hoon
    Tan Tock Seng Hospital, Singapore.
    Heng, Doreen Gek Noi
    National University Hospital, Singapore.
    Wang, Wenru
    National University of Singapore.
    Development and psychometric testing of Holistic Clinical Assessment Tool (HCAT) for undergraduate nursing students2016In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 16, p. 1-9, article id 248Article in journal (Refereed)
    Abstract [en]

    Background:A major focus in nursing education is on the judgement of clinical performance, and it is a complexprocess due to the diverse nature of nursing practice. A holistic approach in assessment of competency is advocated.Difficulties in the development of valid and reliable assessment measures in nursing competency have resulted in thedevelopment of assessment instruments with an increase in face and content validity, but few studies have testedthese instruments psychometrically. It is essential to develop a holistic assessment tool to meet the needs of the clinicaleducation. The study aims to develop a Holistic Clinical Assessment Tool (HCAT) and test its psychometric properties.

    Methods:The HCAT was developed based on the systematic literature review and the findings of qualitative studies.An expert panel was invited to evaluate the content validity of the tool. A total of 130 final-year nursing undergraduatestudents were recruited to evaluate the psychometric properties (i.e. factor structure, internal consistency and test-retestreliability) of the tool.

    Results:The HCAT has good content validity with content validity index of .979. The exploratory factor analysis revealsa four-factor structure of the tool. The internal consistency and test-retest reliability of the HCAT are satisfactory withCronbach alpha ranging from .789 to .965 and Intraclass Correlation Coefficient ranging from .881 to .979 for the foursubscales and total scale.

    Conclusions:HCAT has the potential to be used as a valid measure to evaluate clinical competence in nursingstudents, and provide specific and ongoing feedback to enhance the holistic clinical learning experience. In addition,HCAT functions as a tool for self-reflection, peer-assessment and guides preceptors in clinical teaching and assessment.

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