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Lindström, Maria
Publications (8 of 8) Show all publications
Stenberg, G., Henje, C., Levi, R. & Lindström, M. (2016). Living with an electric wheelchair: the user perspective. Disability and Rehabilitation: Assistive Technology, 11(5), 385-394
Open this publication in new window or tab >>Living with an electric wheelchair: the user perspective
2016 (English)In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 11, no 5, p. 385-394Article in journal (Refereed) Published
Abstract [en]

Purpose: To explore the experiences of using an electric wheelchair in daily living. Methods: Fifteen participants, eight women and seven men, living in different parts of a Nordic country were interviewed. The interviews were conducted in the home or at the workplace. Open-ended questions were used. The data were collected and analyzed according to the grounded theory. Results: Analysis resulted in one core category: "Integrating the electric wheelchair - a manifold process", describing a process commencing from initial resistance against use of an electric wheelchair, to acceptance with various extent of integration. Six categories emerged that represent this core process: incorporating the electric wheelchair into the self-identity process, calculating functional consequences, encountering the reactions of others, facing duality in movability, using proactive strategies, and being at the mercy of the system. Findings indicate that the integration process is complex and manifold. Practical, personal, and social dimensions were intertwined and significantly involved. Conclusions: Integrating an electric wheelchair is a process closely connected to symbolic value, usability, community mobility and identity. These aspects should be considered in the production, prescription, and adaptation processes. Implications for Rehabilitation Integrating an electric wheelchair is a process closely connected to symbolic value, usability, community mobility, and identity. These aspects should be considered in the wheelchair production, prescription, and adaptation processes.

Keywords
Community mobility, daily life, embodiment, participation, qualitative research, social identity, wheelchair
National Category
Other Medical Sciences
Identifiers
urn:nbn:se:umu:diva-100820 (URN)10.3109/17483107.2014.968811 (DOI)000386457900004 ()25270614 (PubMedID)
Available from: 2015-03-11 Created: 2015-03-11 Last updated: 2018-06-07Bibliographically approved
Lindström, M., Sjöström, S. & Lindberg, M. (2013). Stories of rediscovering agency: home-based occupational therapy for people with severe psychiatric disability. Qualitative Health Research, 23(6), 728-740
Open this publication in new window or tab >>Stories of rediscovering agency: home-based occupational therapy for people with severe psychiatric disability
2013 (English)In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 23, no 6, p. 728-740Article in journal (Other academic) Published
Abstract [en]

As part of a larger study, we offered Everyday Life Rehabilitation (ELR) as a model for integrated occupational therapy in sheltered or supported housing facilities, to enable meaningful daily occupations for people with psychiatric disabilities. Our aim of this article was to understand how participants make sense of their occupational transformations in the context of their everyday life and life history. We carried out qualitative interviews and field observations with 16 participants with psychosis-related disorders. We used narrative analysis and disclosed stories of ‘rediscovering agency’, referring to occupational and identity transformations. A parallel outcome article has shown positive results for participants, and by narrative inquiry we contribute with a deeper understanding of the meaning-making of their transformations and mechanisms of the intervention; i.e. hope, extended value of reaching goals, re-entering the majority world, and transparency of process and attunement to the individual. The findings support the use of the ELR-intervention.

Place, publisher, year, edition, pages
Sage Publications, 2013
Keywords
community-based programs; daily occupation; disability; intervention programs; mental health and illness; narrative inquiry; rehabilitation
National Category
Medical and Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Occupational therapy
Identifiers
urn:nbn:se:umu:diva-50041 (URN)10.1177/1049732313482047 (DOI)000336257700002 ()
Projects
Everyday Life Rehabilitation
Available from: 2011-11-23 Created: 2011-11-23 Last updated: 2018-06-08Bibliographically approved
Lindström, M., Hariz, G.-M. & Bernspång, B. (2012). Dealing with real-life challenges: outcome of a home-based occupational therapy intervention for people with severe psychiatric disability. OTJR (Thorofare, N.J.), 32(2), 5-13
Open this publication in new window or tab >>Dealing with real-life challenges: outcome of a home-based occupational therapy intervention for people with severe psychiatric disability
2012 (English)In: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 32, no 2, p. 5-13Article in journal (Refereed) Published
Abstract [en]

the authors offered home-based occupational therapy integrated into supported or sheltered housing to help individuals with severe psychiatric disability identify their specific needs of engagement in meaningful occupation. This study aimed to evaluate the client outcomes in activities of daily living (ADL) ability and health factors following their participation in occupation-centered interventions in home and community settings. Seventeen participants (7 women) between the ages of 27 to 66 years, living in sheltered or supported housing participated in the intervention project based on the Everyday Life Rehabilitation (ELR). The following instruments were administered before and after the intervention and at a six-month follow-up: Goal Attainment Scaling, Assessment of Motor and Process Skills, Assessment of Social Interaction, Satisfaction with Daily Occupations, ADL-taxonomy with an effort-scale, and the Symptom Check List-90. Pretest, posttest, and follow-up differences in test scores on goal attainment, occupation, and health-related factors indicate that important progress was made.  These findings support the use of the intervention and suggest that larger randomized clinical trials are needed.

Place, publisher, year, edition, pages
Thorofare: Slack Inc, 2012
Keywords
mental health, activity and participation, psychiatric rehabilitation
National Category
Medical and Health Sciences
Research subject
Occupational therapy
Identifiers
urn:nbn:se:umu:diva-50040 (URN)10.3928/15394492-20110819-01 (DOI)000302274400002 ()
Projects
Everyday Life Rehabilitation
Available from: 2011-11-23 Created: 2011-11-23 Last updated: 2018-06-08Bibliographically approved
Lindström, M., Lindberg, M. & Sjöström, S. (2011). Home bittersweet home: the significance of home for occupational transformations. International Journal of Social Psychiatry, 57(3), 284-299
Open this publication in new window or tab >>Home bittersweet home: the significance of home for occupational transformations
2011 (English)In: International Journal of Social Psychiatry, ISSN 0020-7640, E-ISSN 1741-2854, Vol. 57, no 3, p. 284-299Article in journal (Refereed) Published
Abstract [en]

Background: The study illuminated how persons with psychiatric disabilities experienced the processes of change in a residential context.

Material: Qualitative interviews with residents living in supported housing were conducted and analyzed using constant comparative analysis.

Discussion: Residential conditions appear to provide a complex structure that facilitates rehabilitative interactions, in which ‘progressive tensions’ arise between opposing values, such as authentic versus artificial, and independence versus dependence, both of which are important in the process of change.

Conclusions: A client-centred approach could be taken further if clients are engaged in productive discussions about challenging these ‘progressive tensions’. Awareness of the meaning of home also emerged as central.

Place, publisher, year, edition, pages
Sage Publications, 2011
Keywords
occupational change, home- and community-based rehabilitation, psychiatric disability, supported housing
National Category
Occupational Therapy Psychiatry
Identifiers
urn:nbn:se:umu:diva-31271 (URN)10.1177/0020764009354834 (DOI)000290434500007 ()
Available from: 2010-02-04 Created: 2010-02-04 Last updated: 2018-06-08Bibliographically approved
Lindström, M. (2011). Promoting agency among people with severe psychiatric disability: occupation-oriented interventions in home and community settings. (Doctoral dissertation). Umeå: Umeå university
Open this publication in new window or tab >>Promoting agency among people with severe psychiatric disability: occupation-oriented interventions in home and community settings
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Att främja aktörskap hos personer med svårt psykiskt funktionshinder : Aktivitetsinriktade interventioner i hem- och närmiljö
Abstract [en]

In general, people with severe psychiatric disability living in sheltered or supported housing lead passive, solitary lives. Current rehabilitative approaches often neglect considering an agentic perspective of the residents in sheltered or supported housing. Furthermore, the outreach and societal contexts are often not considered. Thus, practitioners tend to overlook the potential in providing support and rehabilitation that is adapted to their individual, collective and changing needs.

My approach was to develop a model for Everyday Life Rehabilitation (ELR), which has a potential to promote agency while targeting recovery, meaningful daily occupations, social participation, and person-driven goals. We employed two occupational therapists (OT) and offered an intervention with ELR in a medium-sized municipality in northernSwedenand evaluated this intervention from the perspectives of residents and community care workers (CCW), using a combination of quantitative and qualitative methods.

This thesis comprises four studies that focus on a home and community context, late rehabilitation efforts, daily occupations, and client-centredness. The overall aim is to understand and evaluate the impact of recovery- and occupation-oriented interventions in a home context for people with severe psychiatric disability. The study settings are sheltered and supported housing facilities.

The first study (n=6) explores the significance of home for occupational transformations. The analysis reveals how residential conditions facilitate rehabilitative interactions, generating occupational transformations such as increasing social competence and taking charge of daily occupations. The second study evaluates occupation- and health-related outcomes of the ELR-intervention for residents (n=17). Pre-, post-, and follow-up differences in tests scores on goal attainment, occupation, and health-related factors indicate that important progress is made. The third study explores residents’ (n=16) narratives about occupational transformations in the context of everyday life and life history. Narrative analysis discloses stories of ‘rediscovering agency’, referring to occupational and identity transformations. The fourth study illuminates community care workers’ (n=21) experiences of collaborating with residents and OTs, using ELR. The CCW’ view on residents, rehabilitation, and the own role, along with organisational conditions in the housing facility, seem to characterise different outlooks influencing the CCWs responsiveness or resistance to the intervention.

In conclusion, rehabilitation in a supported housing context appears paradoxical due to tensions between opposing values such as authentic versus artificial, and independence versus dependence. However, if residents are engaged in challenging these tensions, they can function as ‘progressive tensions’ generating change. Considering the personal and social meaning of home also appears to be valuable. The intervention studies on ELR, demonstrate its value for participants and indicates that a recovery approach applying ELR would promote shared perspectives among residents, CCWs, and OTs, while facilitating ‘agent-supported rehabilitation’ and ‘out-of-housing strategies’. The thesis provides initial support for the use of ELR-interventions and proposes continued research.

Place, publisher, year, edition, pages
Umeå: Umeå university, 2011. p. 107
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1456
Keywords
Mental health, Psychotic disorders, Activities of daily living, Social participation, Recovery, Occupational therapy, Rehabilitation, Client centered, Residential facilities, Supported housing, Sheltered housing, Outcome assessment, Qualitative research
National Category
Medical and Health Sciences
Research subject
Occupational therapy
Identifiers
urn:nbn:se:umu:diva-50038 (URN)978-91-7459-324-2 (ISBN)
Public defence
2011-12-16, Aulan, Vårdvetarhuset, Umeå Universitet, Umeå, 10:00 (Swedish)
Opponent
Supervisors
Projects
Vardagslivets Rehabilitering (Everyday Life Rehabilitation)
Available from: 2011-11-25 Created: 2011-11-23 Last updated: 2018-06-08Bibliographically approved
Lindström, M. (2007). Vardagslivets Rehabilitering – Del A: Modellverksamhet för rehabilitering inom socialpsykiatri: Pilotprojekt i svensk kommun med modellverksamhet baserad på OTIPM (Occupational Therapy Intervention Process Model). Umeå: Umeå Universitet
Open this publication in new window or tab >>Vardagslivets Rehabilitering – Del A: Modellverksamhet för rehabilitering inom socialpsykiatri: Pilotprojekt i svensk kommun med modellverksamhet baserad på OTIPM (Occupational Therapy Intervention Process Model)
2007 (Swedish)Report (Other (popular science, discussion, etc.))
Abstract [sv]

Att tala om vardagslivets rehabilitering är angeläget då begreppet rehabilitering ofta förknippas med arbete och återgång till arbete. Rehabilitering kan vara mer än så. Meningsfulla vardagsaktiviteter i reell miljö utgör en viktig plattform för utveckling vid psykiskt funktionshinder och bör vara utgångspunkt i basal rehabilitering.

Rehabilitering och ett rehabiliterande förhållningssätt är ett ansvar för både kommuner och landsting enligt hälso- och sjukvårdslagen (HSL). Det är viktigt att rehabilitering utgår från ett individperspektiv och hennes resurser och begränsningar i aktivitet och delaktighet i det dagliga livet.

Projektidén utgår dels från ett brukarperspektiv och dels från ett arbetsterapiperspektiv, mot bakgrund av att arbetsterapeuter uttalats vara en underutnyttjad resurs i socialpsykiatri. Den främsta drivkraften är att erbjuda brukare systematiskt prövade rehabiliteringsinsatser, på brukarens villkor och i de miljöer och aktiviteter som brukaren vill nå ökad självständighet inom.

Modellverksamhetens grundtanke är att en arbetsterapeut i kommunpsykiatrisk organisation ska samverka med närstående och/eller baspersonal för att, via ett pedagogiskt och terapeutisk sätt, vägleda personer med psykiskt funktionshinder till att lättare självständigt kunna utföra meningsfulla aktiviteter i vardagen och uppleva delaktighet i livssituationer och omgivande samhälle.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2007. p. 55
Keywords
socialpsykiatri, psykiskt funktionshinder, psykos, hem, boende, supported housing, boende med särskild service, rehabilitering
National Category
Medical and Health Sciences
Research subject
Occupational therapy
Identifiers
urn:nbn:se:umu:diva-50037 (URN)
Projects
Vardagslivets Rehabilitering (Everyday Life Rehabilitation)
Available from: 2011-11-24 Created: 2011-11-23 Last updated: 2018-06-08Bibliographically approved
Lindström, M. (2007). Vardagslivets Rehabilitering - Del B: Vy över arbetsterapeutiska insatser i svensk psykiatri. Umeå: Umeå Universitet
Open this publication in new window or tab >>Vardagslivets Rehabilitering - Del B: Vy över arbetsterapeutiska insatser i svensk psykiatri
2007 (Swedish)Report (Other (popular science, discussion, etc.))
Abstract [sv]

Slutrapporten är skriven utifrån direktivet ”en överblick av vad som görs i Sverige när det gäller rehabilitering i vardagslivets aktiviteter för personer med psykiskt funktionshinder”. Intentionen har varit att belysa aktuellt kunskapsläge från verksamhetsnära till vetenskaplig nivå via kanaler som strategiskt utvalda rehabiliteringsverksamheter i kommuner och landsting, olika universitet/högskolor, fackliga nätverk och liknande. Rapporten utger sig inte för att vara en heltäckande inventering utan en överblick med nedslag i vissa kommuner/landsting över spridda landsändar, publikationer och några goda exempel. Rapporten ger en nulägesbild av svensk arbetsterapi i psykiatri med särskilt fokus på utvecklingspotential i kommunal psykiatri.

Ökade krav ställs generellt på alla yrkesgrupper med efterfrågan om ett mer evidensbaserat arbetssätt. Arbetsterapeutisk professionalitet handlar om att kunna förena teori och praktik i ett väl avvägt förhållningssätt, baserat på bästa tillgängliga evidens, med fokus på människors utförande av meningsfulla uppgifter. Arbetsterapeuter har genom sin forskning och utveckling specialiserat sig på att förstå och möjliggöra meningsfulla vardagsaktiviteter hos enskilda individer, trots sjukdom eller funktionshinder.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2007. p. 39
Keywords
arbetsterapi, psykiatri
National Category
Occupational Therapy
Identifiers
urn:nbn:se:umu:diva-54439 (URN)
Projects
Vardagslivets Rehabilitering
Available from: 2012-04-26 Created: 2012-04-26 Last updated: 2018-06-08Bibliographically approved
Lindström, M., Lindberg, M. & Sjöström, S.Responsiveness or resistance: views of community care workers encountering a new rehabilitation model.
Open this publication in new window or tab >>Responsiveness or resistance: views of community care workers encountering a new rehabilitation model
(English)Manuscript (preprint) (Other academic)
Abstract [en]

The importance of engagement in meaningful occupations and participation in life situations of people with psychiatric disabilities is well known. Therefore, community care workers (CCWs) in sheltered or supported housing are a key resource in the facility context. Yet, the role and views of CCWs, in facilitating or inhibiting rehabilitative opportunities for residents, is only beginning to be understood. We offered an intervention project using the Everyday Life Rehabilitation (ELR), to integrate recovery- and occupation-oriented interventions, including collaboration between occupational therapists (OT) and CCWs, into supported or sheltered housing. As one part of the intervention project, focus group interviews were conducted with 21 CCWs involved in the intervention project. The aim was to illuminate the views of CCWs working with residents partaking the Everyday Life Rehabilitation. Qualitative content analysis revealed seven categories, with associated subcategories. These categories relate to two different disability ideologies: a stabilisation oriented, and a recovery oriented approach to rehabilitation. Related to organisational aspects, we have also identified two different tensions to change: resistance, and responsiveness to the intervention. The findings have implications for the forthcoming development of housing facilities, personnel development, and rehabilitative efforts for people with severe psychiatric disability.

Keywords
psychiatric disability, psychotic disorders, supported housing, occupational therapy, recovery
National Category
Medical and Health Sciences
Research subject
Occupational therapy
Identifiers
urn:nbn:se:umu:diva-50042 (URN)
Projects
Everyday Life Rehabilitation
Available from: 2011-11-23 Created: 2011-11-23 Last updated: 2018-06-08Bibliographically approved
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