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  • 2651.
    Wisten, Aase
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Krantz, Peter
    Stattin, Eva-Lena
    Unravelling the mystery behind sudden death in the young: a wake-up call for nationwide autopsy-based approach - Authors' reply2018In: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 20, p. F273-F274Article in journal (Refereed)
  • 2652.
    Wiström, Emma
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gustafsson, Linnea
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Motivation sitter i huvudet, inte i benen: Upplevelser av att gå på gåband under kontorsarbete2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Den fysiska inaktivitet som medföljer stillasittande har visats sig ha koppling med flertalet långvariga sjukdomar och medicinska tillstånd. Att införa aktiva arbetsstationer kan därför vara ett sätt att motverka stillasittande hos kontorsarbetare. För att undersöka om gåband är ett alternativ som aktiv arbetsstation behövs det först utvärderas.

    Syfte: Syftet med denna kandidatuppsats är att undersöka deltagarnas inställningar till och upplevelser av användandet av gåband i kontorsmiljö.

    Metod: Fem kontorsarbetare har under tretton månader gått på gåband under arbetstid i syfte att minska stillasittandet. Deltagarnas upplevelser undersöktes genom semistrukturerade intervjuer vilka analyserades med hjälp av Grounded theory.

    Resultat: Analysen av intervjuerna resulterade i fyra kategorier: hinder för och svårigheter med gåband, vinster med och förutsättningar för gåband, ambivalens samt coaching behöver individualiseras. Kategorierna kunde slutligen tillsammans kopplas ihop till huvudkategorin motivation – det sitter i huvudet, inte i benen som tolkas som grunden till ett långvarigt användande av gåbandet.

    Konklusion: Sammanfattningsvis finns det flertalet åtgärder att ta till för att underlätta och således optimera användandet av gåband. Den viktigaste åtgärden är att hitta strategier för att upprätthålla motivationen hos de enskilda informanterna. Vi tror att fysioterapeuter har nytta av att hjälpa patienter att hitta sin motivation för ökad följsamhet.

  • 2653.
    Wolpher, Nicole
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Att erbjuda skapande för att ersätta skadande: - en beskrivning av bildterapeuters erfarenheter av att behandla personer med självskadebeteende2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning:Syfte: Att beskriva bildterapeuters erfarenheter av att arbeta behandlande med personer med självskadebeteende.Metod: Fem kvalitativa intervjuer med bildterapeuter analyserades genom en induktiv kvalitativ innehållsanalys med syfte att lyfta fram variationer och likheter ur materialet. Urvalet skedde via bekvämlighetsurval, snöbollsurval och självselektion.Resultat: Bildterapeuternas erfarenheter av att behandla personer med självskadebeteende handlar om: - relationen mellan personen i behandling och bilden; att få utlopp för känslor och tankar samt att skapa förståelse, - relationen mellan personen i behandling och bildterapeuten; att arbeta med följsamhet, hitta en lagom nivå för behandlingsarbetet, att arbeta med nyansering, att hitta alternativa sätt att förhålla sig till självskadandet och att processen kräver samarbete, - förhållningssättet till behandlingens ramverk; att skapa trygghet genom ramar, att ha ett öppet och bekräftande förhållningssätt, att utforma meningsfulla teman, att förhålla sig till materialet och att arbeta med grupp,- förhållningssättet till övergripande faktorer; att hitta lämpliga gränser i samverkan med andra, att ha en mångsidig yrkesroll och att det är en utmanande problematik att arbeta med.Slutsats: Bildterapi ger personen en möjlighet till självbehandling. Bildterapeuterna behöver hålla en balans mellan att arbeta följsamt och att styra behandlingen för att hjälpa personen. De behöver också hålla en balans mellan formella krav och behandlingsprocessen. Det krävs en tillit till behandlingsmetoden för att använda bild även i krisskeden. Kollegor och anhöriga runt om kan vara viktiga för avlastning men kan också behöva begränsas i sin insyn i behandlingsprocessen. Det är ett svårt arbete där bilden kan underlätta.

  • 2654.
    Wänman, Johan
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Grabowski, Pawel
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Nyström, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafsson, Patrik
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Bergh, Anders
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Widmark, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Crnalic, Sead
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Metastatic spinal cord compression as the first sign of malignancy: Outcome after surgery in 69 patients2017In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 88, no 4, p. 457-462Article in journal (Refereed)
    Abstract [en]

    Background and purpose - Metastatic spinal cord compression (MSCC) as the initial manifestation of malignancy (IMM) limits the time for diagnostic workup; most often, treatment is required before the final primary tumor diagnosis. We evaluated neurological outcome, complications, survival, and the manner of diagnosing the primary tumor in patients who were operated for MSCC as the IMM.

    Patients and methods - Records of 69 consecutive patients (51 men) who underwent surgery for MSCC as the IMM were reviewed. The patients had no history of cancer when they presented with pain (n = 2) and/or neurological symptoms (n = 67).

    Results - The primary tumor was identified in 59 patients. In 10 patients, no specific diagnosis could be established, and they were therefore defined as having cancer of unknown primary tumor (CUP). At the end of the study, 16 patients were still alive (median follow-up 2.5 years). The overall survival time was 20 months. Patients with CUP had the shortest survival (3.5 months) whereas patients with prostate cancer (6 years) and myeloma (5 years) had the longest survival. 20 of the 39 patients who were non-ambulatory preoperatively regained walking ability, and 29 of the 30 ambulatory patients preoperatively retained their walking ability 1 month postoperatively. 15 of the 69 patients suffered from a total of 20 complications within 1 month postoperatively.

    Interpretation - Postoperative survival with MSCC as the IMM depends on the type of primary tumor. Surgery in these patients maintains and improves ambulatory function.

  • 2655. Wästberg, Birgitta A.
    et al.
    Sandström, Boel
    Pooremamali, Parvin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    A Turning Point Towards Recovery: An Interview Study with Participants in the Culture and Health Programme for Clients with Long-Term Mental Health Disorders in Sweden2019In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 40, no 5, p. 373-381Article in journal (Refereed)
    Abstract [en]

    The study aimed to explore participants' perceptions and experiences of the Culture and Health programme in Sweden for clients with long-term mental health disorders. A qualitative approach with interviews was applied. Grounded Theory guided the analysis and selection of informants. A total of 15 informants were interviewed. A core category 'A turning point in dealing with everyday life beyond the mental illness' with three categories: inner life, social life and occupational life emerged. A theory indicating the importance of asking clients about their expectations, was formulated. Further studies are warranted, including studies of effects.

  • 2656.
    Wågberg, Caroline
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Jakobsson, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Upplevelser av att leva med Multipel Sklerosrelaterad fatigue: En litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Fatigue är ett vanligt symptom för personer med Multipel Skleros (MS), trots det är förståelsen för symptomet och dess konsekvenser för dagligt liv bristfällig. Fatigue definieras som en känsla av trötthet som upplevs större än väntad, i förhållande till graden av utförd ansträngning. Symptomets konsekvenser beskrivs innebära stora begränsningar i det vardagliga livet för personer med MS-relaterad fatigue. Syftet med litteraturstudien var således att belysa upplevelser av fatigue samt dess betydelse för dagliga aktiviteter och delaktighet hos personer med Multipel Skleros. Studien utgör en granskning av nio kvalitativa vetenskapliga artiklar publicerade mellan 2004 och 2016. Litteratursökningen utfördes i databaserna CINAHL, PubMed och PsycINFO samt manuell sökning. Totalt nio studier inkluderades i litteraturstudien. Resultatet visade att fatigue är ett oförutsägbart symptom med negativ påverkan på arbete, skola och sociala relationer i det dagliga livet. Symptomet var svårt att förstå för andra, vilket innebar ett bristfälligt stöd för personerna i fråga. Vidare leder fatigue till delaktighetsinskränkningar och försämrad aktivitetsbalans. Arbetsterapeutisk kompetens är av stor vikt för att möjliggöra hantering av fatigue i vardagen hos personer med MS. Implementering av ett energibesparande arbetssätt och utbilding om fatigue, kan vara användbara strategier för hantering av fatigue.

  • 2657.
    Yngve, Henny
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Edlund, Johannes
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Samstämmighet i bedömning av utfallssteg visuellt och med hjälp av videoanalysprogram2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning:Avvikande rörelsemönster kan medföra muskuloskeletala besvär. Därför är det viktigt att kunna göra noggranna bedömningar utav rörelser hos olika individer. Två-dimensionella videoanalysprogram är lättillgänglig teknik som kan underlätta för fysioterapeuten. Få studier till dags dato har undersökt reliabilitet och validitet hos dessa program. Syfte Syftet med undersökningen var att utvärdera överrensstämmelsen emellan och inom två bedömare som använder det två-dimensionella videoanalysprogrammet Kinovea i jämförelse med visuell bedömning på plats för att utvärdera om det kan användas som hjälpmedel vid rörelseanalys. Metod Deltagarna i studien var 15 kvinnor och 17 män (medelålder 23,5 år) Samtliga fick utföra två utfallsseg. Utfallsstegen observerades och filmades av videokamera framifrån och från sidan. Två bedömare gjorde varsin bedömning visuellt och en senare bedömning med Kinovea, samt två vinkelmätningar av knäled i Kinovea. Den procentuella överenstämmelsen och korrelationen emellan och inom bedömarna analyserades. Resultat Resultaten enligt bedömningsverktyget visade att överrensstämmelsen emellan bedömare var moderat till bra i visuellbedömning och moderat till utmärkt i Kinovea. Inom bedömare 1 var överenstämmelsen mellan visuell och Kinovea bedömning bra till utmärkt och för bedömare 2 moderat till bra. Vinkelmätning visade en medelavvikelse på 2 -6 grader och Pearson’s korrelation emellan och inom bedömare var hög (r=0,86-0,98). Konklusion Kinovea tycks kunna användas som hjälpmedel för att observera en dynamisk rörelse såsom ett utfallssteg även om felmarginalen kan vara uppemot 6 grader vid upprepade bedömningar.

  • 2658. Yoshimura, Eri
    et al.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Mia Paul, Pamela
    Aerts, Cyriel
    Chesky, Kris
    Risk factors for playing-related pain among piano teachers2008In: Medical problems of performing artists, ISSN 0885-1158, E-ISSN 1938-2766, Vol. 23, p. 107-113Article in journal (Refereed)
  • 2659.
    Zakariasson, Caroline
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Förslag till lag om dödsfallsutredning2011Student paper other, 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    Syftet med en dödsfallsutredning är bland annat att det ska kunna konstateras varför en människa avlidit, det vill säga vad som var orsaken till dödens inträffande. Detta är av speciellt intresse då man misstänker att ett brott har begåtts och en viktig del i anhörigas sorgprocess efter att en nära anhörig avlidit. Ett dödsfall kan vara naturligt eller onaturligt. Ett naturligt dödsfall är ett dödsfall som inträffat endast på grund av sjukdom medan ett onaturligt dödsfall är ett dödsfall som inträffat på grund av annat än enbart sjukdom[1]. I Sverige finns ett flertal lagar som behandlar frågor kring dödsfall, medan dessa frågor i andra länder ofta regleras inom en sammanhållen lagstiftning. Den svenska systematiken gör lagstiftningen svåröverblickbar.

    Syftet med den rättsmedicinska undersökningen är att upptäcka, utreda och utesluta att det är ett brott som är orsaken till att en människa avlidit[2]. Det blir polis och RMV:s uppgift att utreda om ett dödsfall som varit onaturligt har orsakats av skada eller förgiftning.[3]

    [1] Föreläsningsmaterial från 2010-10-13

    [2] Se punkt 1 SOSFS 1997:26 Rättsmedicinalverkets föreskrifter; Rättsmedicinska undersökningar av avlidna

    [3] RMV-rapport 2011:2, s. 12

  • 2660.
    Zeisig, Eva
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Fahlström, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Öhberg, Lars
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Alfredson, Håkan
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    A 2-year sonographic follow-up after intratendinous injection therapy in patients with tennis elbow2010In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 44, no 8, p. 584-587Article in journal (Refereed)
    Abstract [en]

    Background Tennis elbow is a tendinopathy affecting the upper extremity. Recent studies have shown high sensitivity for ultrasound (US) examination and high specificity for colour Doppler (CD) examination. There are no mid- or long-term follow-up investigations of the tendon structure and blood flow using these techniques.

    Objective To use US and CD to study structure and blood flow in the extensor origin in patients with tennis elbow treated with intratendinous injections.

    Design Follow-up study

    Setting Sports Medicine Unit, Umeå University.

    Patients 25 patients (28 elbows), mean age 46 years (range 27–66), treated with intratendinous injections due to chronic pain from tennis elbow.

    Method US and CD examination of the extensor origin was carried out at inclusion and at follow-up two years after intratendinous injection treatment with polidocanol and/or a local anaesthetic.

    Main outcome measurements US (structure) and CD (blood flow) findings.

    Results All patients had structural tendon changes and high blood flow at inclusion when given the injection treatment. At the two-year follow-up, structural tendon changes were seen in 20/28 elbows and high blood flow was seen in 4/28 elbows. The majority of patients with a good clinical result after treatment had no visible blood flow (17/20), but the structural changes showed no relation to a good result (13/20 remaining changes).

    Conclusions Doppler findings, but not structure, might be related to the clinical result after intratendinous injection treatment of tennis elbow.

  • 2661.
    Zeisig, Eva
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Fahlström, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Öhberg, Lars
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Alfredson, Håkan
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Pain relief after intratendinous injections in patients with tennis elbow: results of a randomised study2008In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 42, no 4, p. 267-271Article in journal (Refereed)
  • 2662.
    Zidén, Lena
    et al.
    Vårdalinstitutet, University of Gothenburg, Dep of Clinical Neuroscience and Rehabil, Sahlgrenska Academy Univerasity odf Gothenburg.
    Häggblom-Kronlöf, Greta
    Vårdalinstitutet, University of Gothenburg, Dep of Clinical Neuroscience and Rehabil, Sahlgrenska Academy Univerasity odf Gothenburg.
    Gustafsson, Susanne
    Vårdalinstitutet, University of Gothenburg, Dep of Clinical Neuroscience and Rehabil, Sahlgrenska Academy Univerasity odf Gothenburg.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Dahlin-Ivanoff, Synneve
    Vårdalinstitutet, University of Gothenburg, Dep of Clinical Neuroscience and Rehabil, Sahlgrenska Academy Univerasity odf Gothenburg.
    Physical Function and Fear of Falling 2 Years After the Health-Promoting Randomized Controlled Trial: Elderly Persons in the Risk Zone2014In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 54, no 3, p. 387-397Article in journal (Refereed)
    Abstract [en]

    Purpose of the study: To investigate the effects of 2 different health-promoting interventions on physical performance, fear of falling, and physical activity at 3-month, 1-year, and 2-year follow-ups of the study Elderly Persons in the Risk Zone.

    Design and Methods: A randomized, three-armed, single-blind, and controlled study in which 459 independent and community-dwelling people aged 80 years or older were included. A single preventive home visit including health-promoting information and advice and 4 weekly senior group meetings focused on health strategies and peer learning, with a follow-up home visit, were compared with control. Functional balance, walking speed, fear of falling, falls efficacy, and frequency of physical activities were measured 3 months, 1 year, and 2 years after baseline.

    Results There were no or limited differences between the groups at the 3-month and 1-year follow-ups. At 2 years, the odds ratio for having a total score of 48 or more on the Berg Balance scale compared with control was 1.80 (confidence interval 1.11-2.90) for a preventive home visit and 1.96 (confidence interval 1.21-3.17) for the senior meetings. A significantly larger proportion of intervention participants than controls maintained walking speed and reported higher falls efficacy. At 1 and 2 years, a significantly higher proportion of intervention participants performed regular physical activities than control.

    Implications: Both a preventive home visit and senior meetings reduced the deterioration in functional balance, walking speed, and falls efficacy after 2 years. The long-term effects of both interventions indicate a positive impact on postponement of physical frailty among independent older people.

  • 2663. Zijlstra, A
    et al.
    Ufkes, T
    Skelton, D A
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Zijlstra, W
    Do dual tasks have an added value over single tasks for balance assessment in fall prevention programs? A mini-review.2008In: Gerontology, ISSN 1423-0003, Vol. 54, no 1, p. 40-9Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The Prevention of Falls Network Europe (ProFaNE) aims to bring together European researchers and clinicians to focus on the development of effective falls prevention programs for older people. One of the objectives is to identify suitable balance assessment tools. Assessment procedures that combine a balance task with a cognitive task may be relevant since part of all falls occurs during dual-task performance of walking or other balance activities. OBJECTIVE: To evaluate whether dual-task balance assessments are more sensitive than single balance tasks in predicting falls and detecting changes in balance performance after fall interventions. METHODS: A systematic literature search was performed in the databases PubMed, EMBASE, CINAHL, AMED, PsycINFO and Cochrane. Articles were selected according to the following inclusion criteria: (1) population: older adults (mean age > or =65 years), (2) assessment tool: dual task combining gait or other balance task with a cognitive task, (3) design: prospective or retrospective data collection of falls, or intervention study. Analysis of papers focused on measures of predictive ability or sensitivity-to-change for both tasks during dual-task performance as well as for the single balance and cognitive task. RESULTS: Out of 114 dual-task studies in older people, 19 articles matched the inclusion criteria. Fourteen studies had sample sizes of 60 subjects or less; the studied populations, task combinations as well as other methodological aspects varied. None of the articles reported the same statistical measures for both tasks during dual-task performance as well as single balance and cognitive task. In two studies with prospective data collection of falls, higher odds ratios were found for the dual compared to the single balance task. CONCLUSIONS: Upon the available literature, conclusions for an added value of dual balance tasks for fall prediction or assessing fall intervention effects cannot be made due to incomplete comparisons of single and dual balance tasks. Nevertheless, two studies do provide an indication that dual balance tasks may have added value for fall prediction.

  • 2664.
    Zingmark, Magnus
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Occupation-focused and occupation-based interventions for community-dwelling older people: Intervention effects in relation to facets of occupational engagement and cost effectiveness2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background

     Occupation-focused and occupation-based interventions can potentially promote occupational engagement among community-dwelling older people, but there is limited evidence to identify the most effective and cost-effective interventions. For independent-living older people, there is a lack of evidence to determine if occupation-focused and occupation-based interventions have an effect on their occupational engagement. For older people who need assistance because of bathing disabilities, there is limited evidence of the effects of occupation-focused and occupation-based interventions on their occupational engagement or for reducing or omitting their need for assistance. Finally, there is limited evidence to determine if occupation-focused and occupation-based interventions implemented for community-dwelling older people are cost effective.

    Aim

    The aim of this thesis was to evaluate the effects and cost effectiveness of occupation-focused and occupation-based interventions for two groups of community-dwelling older people, independent-living, community-dwelling older people and older people with bathing disabilities.

    Method

    Studies I and II were based on an exploratory randomized controlled trial. One hundred and seventy seven persons, 77–82 years, single living, and without need for home help were randomized to a no-intervention control group or to one of three occupational therapy interventions focused on promoting occupational engagement: an individual intervention, an activity group or a discussion group. In study I, effect sizes for leisure engagement and ability to perform activities of daily living (ADL) tasks were estimated for each intervention in relation to the control group to identify the most effective intervention at 3 and 12 months after baseline. In study II, the effects on quality adjusted life years (QALYs) and the total costs for the intervention, social services provided by the municipality and health care were used evaluate cost-effectiveness.

    Study III was a quasi-experimental clinical trial and included 95 persons, 65+, who had applied for municipality-based home help with bathing. For participants in the intervention group, occupational therapists implemented occupation-focused and occupation-based interventions. No occupational therapy intervention was implemented for those in the control group, but they were allocated home help services if judged to need it based on an assessment by a municipality care manager. Evaluations of ADL ability, self-rated health and allocated home help were implemented at baseline and after 15 weeks.

    Study IV involved the use of decision-modeling based on a five state Markov model that included levels of dependency in ADLs, place of residency and death. Probabilities for transitions between states in the model, QoL scores and societal costs for each state were derived from previous research. Overall, the model was based on research indicating that more severe levels of dependency reduced QALY scores and increased societal costs. Previous trials have provided evidence that an occupation-focused and occupation-based intervention implemented to reduce bathing disabilities increased the probability of independence of home help. The Markov model was used to evaluate cost-effectiveness over 8 years for an intervention compared to no intervention.

    Results

    The results of study I indicated that each intervention had a small positive effect on minimizing a decline in leisure engagement and/or ADL, but no intervention was clearly superior. In study II, the results indicated that the interventions delivered in a group format positively affected self-rated health. The discussion group was the most cost-effective intervention. The results of study III indicated that the intervention had no effect on ADL ability or self-rated health. There was, however, a large difference in the allocation of home help at follow up, indicating that the intervention was effective in reducing dependency on home help for bathing. The results of study IV indicated that compared to no intervention, the intervention resulted in a positive accumulation of QALYs and lower costs for every year during the entire 8 year period.

    Conclusion

    This thesis provides evidence to support the implementation of occupation-focused and occupation-based interventions for independent-living, community-dwelling older people in order to reduce their decline in occupational engagement and improve their self-rated health; the interventions also have the potential to be cost effective. This thesis also provides evidence that an occupation-focused and occupation-based intervention implemented for older people with bathing disabilities was effective in promoting independence from home help for bathing. Finally, an occupation-focused and occupation-based intervention that increased the probability of being independent of home help for bathing had a positive impact on the long term accumulation of QALYs and reduced societal costs and, therefore, can be considered very cost effective.

  • 2665.
    Zingmark, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Community Care Administration, Municipality of Östersund, Östersund.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Meeting the needs of elderly with bathing disability2011In: Australian Occupational Therapy Journal, ISSN 0045-0766, E-ISSN 1440-1630, Vol. 58, no 3, p. 164-71Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/AIMS: Difficulties with bathing are frequent among older people and are associated with an increasing need for societal support. As loss of independence has a negative impact on health and wellbeing, it is important to study interventions that can provide the required support for people to be able to remain independent. Occupational therapy interventions can improve clients' abilities enabling them to bathe themselves, thus reducing the need for other, more long-term societal support from, e.g. a home help. In this study, two groups of elderly people with difficulties in bathing were compared; the clients in the intervention group were engaged in occupational therapy.

    METHODS: A quasi-experimental non-equivalent control group design was used, in which participants with reported difficulties in bathing were recruited consecutively from two municipalities. The clients in the intervention group routinely received occupational therapy, whereas clients in the control group received assistance from a home help for bathing. Activities of daily living, quality of life and home-help allocation were assessed at the baseline and after 15 weeks.

    RESULTS: Clients in the intervention group received less than three home visits on average, with majority of interventions consisting of graded activity and the use of an encouraging approach. Seventy per cent of the interventions were adaptive. Activities of daily living and quality of life of both groups improved, but the differences of being allocated a home help were significant.

    CONCLUSION: Occupational therapy interventions seem beneficial in terms of supporting older people in becoming independent of home help in bathing but the results must be interpreted with caution as there were differences at baseline between the groups.

  • 2666.
    Zingmark, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Fisher, Anne G.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Rocklöv, Joacim
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Occupation-focused interventions for well older people: an exploratory randomized controlled trial2014In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, no 6, p. 447-457Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this exploratory randomised controlled trial (RCT) was to evaluate three different occupation-focused interventions for well older people by estimating effect sizes for leisure engagement and ability in activities of daily living (ADL) and thereby identifying the most effective interventions.

    Methods: One hundred and seventy seven persons, 77-82 years old, living alone and without home help, were randomized to a control group (CG), an individual intervention (IG), an activity group (AG), and a one-meeting discussion group (DG). All interventions focused on occupational engagement and how persons can cope with age-related activity restrictions in order to enhance occupational engagement. Data were collected by blinded research assistants at baseline, three, and 12 months. Ordinal outcome data were converted, using Rasch measurement methods, to linear measures of leisure engagement and ADL ability. Standardized between-group effect sizes, Cohen's d, were calculated.

    Results: While all groups showed a decline in leisure engagement and ADL over time, the IG and the DG were somewhat effective in minimizing the decline at both three and 12 months. However, the effect sizes were small.

    Conclusions: The findings indicate that occupation-focused interventions intended to minimize a decline in leisure engagement and ADL were sufficiently promising to warrant their further research.

  • 2667.
    Zingmark, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Nilsson, Ingeborg
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Fisher, Anne G.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Department of Occupational Therapy, College of Health and Human Sciences, Colorado State University, Fort Collins, USA.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Occupation-focused health promotion for well older people: a cost-effectiveness analysis2016In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 79, no 3, p. 153-162Article in journal (Refereed)
    Abstract [en]

    Introduction The aim of this study was to evaluate three occupational therapy interventions, focused on supporting continued engagement in occupation among older people, to determine which intervention was most cost effective, evaluated as the incremental cost/quality adjusted life year gained. Method The study was based on an exploratory randomized controlled trial. Participants were 77-82 years, single living and without home help. One hundred and seventy seven persons were randomized to an individual intervention, an activity group, a discussion group or a no intervention control group. All interventions focused on supporting the participants to maintain or improve occupational engagement. Outcomes were evaluated at baseline, three and 12 months and included general health and costs (intervention, municipality and health care). Based on linear regression models, we evaluated how outcomes had changed at each follow-up for each intervention group in relation to the control group. Results Both group interventions resulted in quality adjusted life years gained at three months. A sustained effect on quality adjusted life years gained and lower total costs indicated that the discussion group was the most cost-effective intervention. Conclusion Short-term, occupation-focused occupational therapy intervention delivered in group formats for well older people resulted in quality-adjusted life years gained. A one-session discussion group was most cost effective.

  • 2668.
    Zingmark, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Fisher, Anne
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Occupation-focused health promotion for well older people - a cost-effectiveness analysisIn: Article in journal (Other academic)
  • 2669.
    Zingmark, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Community Care Administration, Municipality of Östersund, 83182 Östersund, Sweden.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Norström, Fredrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Sahlén, Klas-Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Medicine, Department of Nursing.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Cost effectiveness of an intervention focused on reducing bathing disability2017In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 14, no 3, p. 233-241Article in journal (Refereed)
    Abstract [en]

    The onset of bathing disability among older people is critical for a decline in functioning and has implications for both the individuals’ quality of life and societal costs. The aim of this study was to evaluate longterm cost effectiveness of an intervention targeting bathing disability among older people. For hypothetical cohorts of community-dwelling older people with bathing disability, transitions between states of dependency and death were modelled over 8 years including societal costs. A five-state Markov model based on states of dependency was used to evaluate Quality-adjusted life years (QALYs) and costs from a societal perspective. An intervention group was compared with a no intervention control group. The intervention focused on promoting safe and independent performance of bathing-related tasks. The intervention effect, based on previously published trials, was applied in the model as a 1.4 increased probability of recovery during the first year. Over the full follow-up period, the intervention resulted in QALY gains and reduced societal cost. After 8 years, the intervention resulted in 0.052 QALYs gained and reduced societal costs by €2410 per person. In comparison to the intervention cost, the intervention effect was a more important factor for the magnitude of QALY gains and long-term societal costs. The intervention cost had only minor impact on societal costs. The conclusion was that an intervention targeting bathing disability among older people presents a cost-effective use of resources and leads to both QALY gains and reduced societal costs over 8 years.

  • 2670.
    Árnadóttir, Guðrún
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Measuring the impact of body functions on occupational performance: validation of the ADL-focused occupation-based neurobehavioral evaluation (A-ONE)2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Among the instruments commonly used by occupational therapists working in the area of rehabilitation of persons with neurological disorders are evaluations of both occupation, such as activities of daily living (ADL), and body functions. While persons with neurological diagnoses typically have symptoms that represent diminished neurobehavioral functions, the resulting pattern of neurobehavioral impairments affecting ADL performance often differs among diagnostic groups. Usually, neurobehavioral impairments are evaluated in a context that is separate from and not natural for ADL task performance. The A-ONE is a unique instrument that can be used to evaluate both ADL performance (ADL scale) and, in the natural context of the ADL task performance, the underlying neurobehaviors that cause diminished ADL task performance among persons with neurological disorders (Neurobehavioral scale). The scales of the instrument are of ordinal type, and in their existing form, do not have measurement properties. Measurement properties are a requirement of evidence-based and quality assured rehabilitation services.

    The overall aim of this doctoral study was to further develop and validate the A-ONE. This included (a) internal validation to explore the potential for converting the ordinal scales of the instrument to interval scales, (b) examination of which of the neurobehavioral items would be most beneficial and clinically useful for constructing a new Neurobehavioral Impact (NBI) scale for evaluating persons with different neurological diagnoses, and (c) exploration of whether persons with right and left cerebrovascular accidents (RCVA, LCVA) differ in mean NBI measures.

     Methods: This thesis is comprised of four studies which all contribute in different ways to the validation of the scales of the A-ONE. In the first three studies, Rasch analyses, a widely accepted modern test theory methodology, was used to examine internal validity of the scales and the reliability of the A-ONE measures. In the fourth study, ANCOVA was used to explore between group differences, and Pearson correlation coefficients were used to explore relations between person measures from the different A-ONE scales.

    Results: The first study of 209 persons diagnosed with CVA and dementia provided support for converting the ordinal ADL scale to an interval scale that has potential to be used to measure change in ADL performance over time. The second and third studies, including 206 and 422 persons respectively, indicated that it is possible to construct several unidimensional versions of a new NBI scale from the neurobehavioral items of the instrument, each with different item content and hierarchical item structure. Further, some of these NBI scales could be used across different diagnostic groups. When exploring differences between 215 persons with RCVA and LCVA on the NBI scale developed for CVA, results of the ANCOVA (with ADL ability as a covariate) indicated that there is no significant difference between groups in their mean NBI measures, despite known differences in patterns of neurobehavioral impairments.

    Conclusions: The results of this thesis indicate that the A-ONE, although developed by traditional psychometric methods for the purpose of providing useful information for intervention planning, now also has the potential to be used to measure change and compare diagnostic groups. This additional feature will likely enhance both clinical and research potential of the instrument. In order to make the results of the study accessible for clinicians, conversion tables need to be developed.

  • 2671.
    Árnadóttir, Guðrún
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. 1Occupational Therapy Unit, Grensás, Landspítali University Hospital, Reykjavík; 2Division of Occupational Therapy, Faculty of Health, University of Akureyri, Akureyri, Iceland.
    Löfgren, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Fisher, Anne G
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Difference in impact of neurobehavioural dysfunction on Activities of Daily Living performance between right and left hemispheric stroke2010In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 42, no 10, p. 903-907Article in journal (Refereed)
    Abstract [en]

    Objective: To explore whether persons with right- and left-sided cerebrovascular accidents differ significantly in mean impact of neurobehavioural impairments on ability to perform activities of daily living. Design and subjects: Retrospective study of data from 215 persons (103 right-sided, 112 left-sided cerebrovascular accident). The Activities of daily living-focused Occupation-based Neurobehavioral Evaluation was used to evaluate ability on an activities of daily living scale and the impact of neurobehavioural impairment on ability on another scale. Methods: To control for possible differences in activities of daily living ability between groups, analysis of covariance, with activities of daily living ability as a covariate, was used to test for a significant difference in impact of neurobehavioural impairments on activities of daily living ability between groups. Results: Expected moderate correlation (r=-0.57) was obtained between activities of daily living ability and neurobehavioural impact measures, and there was no difference in mean neurobehavioural impact measures between groups (F [1, 212] = 2.910,p = 0.090). Conclusion: This study is the first: to explore directly the impact of neurobehavioural impairment on activities of daily living ability. While persons with right-sided and left-sided cerebrovascular accidents may differ in type of neurobehavioural impairments, direct evaluation of the impact of such impairments on activities of daily living ability reveals no difference between groups.

  • 2672. Åberg, Anna Cristina
    et al.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fall och fallskador. Åtgärder för att förebygga.2011Report (Other academic)
  • 2673. Åberg, Anna Cristina
    et al.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Implementation of evidence-based prevention of falls in rehabilitation units: a staff's interactive approach.2009In: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine, ISSN 1651-2081, Vol. 41, no 13, p. 1034-1040Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To provide strategies to assist healthcare professionals in the area of rehabilitation to improve prevention of falls. DESIGN: A conceptual framework is described as a foundation for the proposal of 2 intertwined strategies, of intervention and implementation, which target the questions: Which strategies for intervention represent the current best evidence? and: How can these strategies be implemented and continuously developed? RESULTS: Strategies for multifactorial and multiprofessional fall preventive interventions are presented in terms of a "fall prevention pyramid model", including general, individualized, and acute interventions. A systematic global fall risk rating by the staff is recommended as an initial procedure. Fall event recording and follow-up are stressed as important components of local learning and safety improvement. Development of implementation strategies in 3 phases, focusing on interaction, facilitation and organizational culture, is described. CONCLUSION: A well-developed patient safety culture focusing on prevention of falls will, when successfully achieved, be seen by staff, patients and their significant others as being characteristic of the organization, and will be evident in attitudes, routines and actions. Moreover, it provides potential for positive side-effects concerning organizational and clinical improvements in additional areas.

  • 2674.
    Åberg, Joel
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hallin, Madelene
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Har busschaufförer sämre höftledsrörlighet än vård och fritidspersonal?2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Det är idag välkänt att långvarigt stillasittande har många negativa effekter på vår hälsa. Forskare menar att långvarigt stillasittande ökar risken för hjärt- och kärlsjukdomar, depression och diabetes. Konsekvenserna av långvarigt stillasittande i förhållande till höftledsrörlighet är relativt okända.

    Syfte: Att undersöka samband mellan långvarigt sittande arbete, ländryggsbesvär och rörlighet i höftleder.

    Metod: Fem höftrörlighetstester genomfördes på 15 deltagare. Åtta av deltagarna var busschaufförer och tillhörde den stillasittande yrkeskategorin och sju av deltagarna var fritids/vårdpersonal och tillhörde en yrkeskategori med mer varierad arbetsposition under dagen. För att mäta höftrörligheten användes Thomas test, passiv straight leg raise test, passiv höftflexion, passiv höftextension, passiv höft utåt och inåtrotation. Resultat: I jämförelse mellan grupperna hade busschaufförerna en signifikant lägre rörlighet i straight leg raise och höftinåtrotation på båda benen samt på vänster ben i höftextension. I resterande test fanns det ingen signifikant skillnad mellan grupperna. I samtliga test visade personer med ryggsmärta lägre höftrörlighet men det fanns endast en signifikant skillnad i straight leg raise mellan personer med ryggsmärta och utan ryggsmärta. Slutsats: Resultatet visade att långvarigt stillasittande kan vara en bidragande faktor till minskad höftrörlighet och att ett lågt resultat i straight leg rasie test är vanligt förekommande hos personer med ryggsmärta. Skillnad mellan grupperna avseende, ryggsmärta och ålder samt det låga antalet deltagare gör dock att resultatet måste betraktas som osäkert. 

  • 2675. Åberg, K
    et al.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Disparata yrkesfunktioner och ett okänt team: uppfattningar från äldreomsorgen2004In: Nordisk fysioterapi, ISSN 1402-3024, Vol. 8, p. 3-11Article in journal (Refereed)
  • 2676.
    Åberg, Karin
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Disparata yrkesfunktioner och ett okänt team: Sjuksköterskors och boendechefers uppfattning om sin egen, sjukgymnastens och arbetsterapeutens yrkesfunktion i äldreomsorgen2004In: Nordisk Fysioterapi, Vol. 8, no 1, p. 3-11Article in journal (Other academic)
  • 2677.
    Åberg, Simon
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Spelpositionens effekt på riktningsförändring och löphastighet i samband med smålagspel.: En observationsstudie på svenska manliga elitfotbollsspelare.2018Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Football today is all about high intensity actions with high intensity running and change of direction as two of the markers related to performance in football. What is still relatively unclear is the players position on the field and the demands that follows with that position. 24 swedish male elite footballplayers took part in a 6 week observation during the swedish pre-season. Using GPS equipment data was collected during small sided games (SSG) 3v3, 6v6 and 9v9 in the teams regular trainingschedule. The aim of this observation was to better understand the role of player position (defender, midfielder and forward) assosiated with the frequency and force produced in changes of direction and the distance in speedzones. The result showed that strikers performed fewer changes of direction in the lowest forcezone compared to both defenders and midfielders in all of the SSGs. No significant difference was observed regarding distance in the speedzones in any SSG. In conclusion further researsch is needed to better understand the role of player positioning during SSG in elite football.

  • 2678.
    Åberg Viklund, Michél
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Skadefrekvens och riskfaktorer hos svenska volleybollspelare: En enkätstudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Volleyboll är en av världens största lagidrotter där risken för skada ofta anses vara låg. Likväl existerar det ett flertal vanligt förekommande skador hos volleybollspelare. Den vanligaste skada att drabba volleybollspelare är fotledsdistorsion följt av överbelasstningskador i patellarsenan och i skulderpartiet. Det finns i dagsläget inga evidensbaserade interventioner mot dessa skador, endast riktlinjer för hur de preventiva åtgärderna kan se ut. Det finns ett fortsatt behov av att kartlägga förekomsten av skador och riskfaktorer bland svenska volleybollspelare.

     

    Syfte:  Studiens övergripande syfte var att undersöka vilka och hur många skador som drabbar spelarna under en åtta veckors period. Mer ingående syftade studien till att undersöka vilken skada som var vanligast, när skada uppkom och om det är skillnad på skadefrekvensen beroende på faktorer som kön, exponering i form av speltimmar, tidigare skada och spelarposition.

     

    Metod:  Tre lag inkluderades i studien. Ett damlag i Elitserien, ett herrlag i Superettan och ett damlag i Divsion 1. De deltagande lagen fick efter första kontakten ett bakgrundsformulär via post att ifylla. Skadeformulär fylldes i vid uppkomst av skada. Respektive lagansvarig fyllde i närvarorapporter för träning och match. Resultaten analyserades deskriptivt samt med Chi-2 analys

     

    Resultat: Av 34 inkluderade spelare rapporterade 16 att de vid studiens start hade en skada eller besvär. Antalet nya skador uppgick till 12 stycken. Skadefrekvensen för alla lag och skador tillsammans uppgick till 6.8 skador/1000 speltimmar (12 skador/1758.5 speltimmar). Akuta skador var måttligt vanligare än överbelastningsskador. Antalet speltimmar visade på ett positivt samband med nyuppkommna skador. Akuta skador var mer än fyra gånger vanligare vid match än vid träning.

     

    Konklusion:  Studien indikerar att skador är relativt vanligt förekommande inom volleyboll i Sverige. De skador som rapporterades överenstämde generellt med tidigare kartlagda riskfaktorer och olika spelarpositioner förefaller vara utsatta för olika typer av skador.

  • 2679.
    Ådén, Emma
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Carlsson, Maine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Poortvliet, Eric
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Linder, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology.
    Edström, Mona
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology.
    Forsgren, Lars
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology.
    Håglin, Lena
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Dietary intake and olfactory function in patients with newly diagnosed Parkinson's disease: a case-control study.2011In: Nutritional neuroscience, ISSN 1476-8305, Vol. 14, no 1, p. 25-31Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate energy and nutrient intake in newly diagnosed Parkinson's disease (PD) patients and association between olfaction and nutrient density of the diet.

    DESIGN: Baseline data from a prospective cohort study.

    SUBJECTS: Eighty-seven patients and 28 age- and sex-matched controls participated in the study.

    METHODS: Dietary intake was assessed by using 3-day dietary records and 24-hour dietary recalls. The Brief Smell Identification Test (B-SIT) was used to test olfaction.

    RESULTS: Patients, compared with controls, had lower intake of polyunsaturated fatty acids (P = 0.024) and a higher intake of carbohydrates (P = 0.027) in energy percent (E%). Lower intake of protein (E%) (P = 0.045), and a low nutrient density of folate (P = 0.022), magnesium (P = 0.012), and phosphorus (P = 0.029) were associated with lower B-SIT score in both patients and controls. PD patients had a lower B-SIT score than controls (P < 0.001).

    CONCLUSION: The results indicate a higher relative contribution of energy from carbohydrates in PD patients. An association between low protein, folate, magnesium, and phosphorus density of the diet and olfaction was seen in the whole population.

  • 2680.
    Ågren, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Öhman, Isabell
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Skillnad i kraftutveckling mellan rak- och diagonal axelflexion: En laboratoriestudie2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund/syfte: Proprioceptiv Neuromuskulär Facilitering (PNF) är ett koncept inom sjukgymnastik där diagonala rörelsemönster har en betydande roll. En av grundtankarna är att muskler utvecklar mer styrka i diagonalerna. Tidigare forskning har visat att PNF ger goda effekter avseende både muskelstyrka och motorisk prestationsförmåga. Syftet med denna studie är att jämföra isokinetisk kraftutveckling mellan rak axelflexion och diagonal axelflexion och undersöka vad den diagonala rörelsekomponenten har för påverkan på muskelstyrka i axeln. Metod: 30 försökspersoner (17 kvinnor och 13 män) mellan 20 och 30 år deltog i studien och genomförde isokinetiska styrketest. PEAK (högsta värdet)- och MEAN (medelvärdet) styrka uppmättes under utförande av rak- och diagonal axelflexion vid två olika hastigheter, 30° /sek och 90° /sek. Parade T-Test användes för de statistiska analyserna. Resultat: Mätningarna visade att rak axelflexion gav ett signifikant (p < 0.001) högre PEAK- och MEAN värde än diagonal axelflexion i båda hastigheterna. Slutsats: Under rak axelflexion utvecklas högre muskelkraft än under diagonal axelflexion. Den diagonala rörelsekomponenten, som beskrivs inom PNF, bidrar i sig inte till en högre kraftutveckling jämfört med en rak axelflexion.

  • 2681.
    Åhlin, Johan
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ericson-Lidman, Eva
    Umeå University, Faculty of Medicine, Department of Nursing.
    Eriksson, Sture
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Strandberg, Gunilla
    Umeå University, Faculty of Medicine, Department of Nursing.
    Longitudinal relationships between stress of conscience and concepts of importance2013In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 20, no 8, p. 927-942Article in journal (Refereed)
    Abstract [en]

    The aim of this observational longitudinal cohort study was to describe relationships over time between degrees of stress of conscience, perceptions of conscience, burnout scores and assessments of person-centred climate and social support among healthcare personnel working in municipal care of older people. This study was performed among registered nurses and nurse assistants (n = 488). Data were collected on two occasions. Results show that perceiving one's conscience as a burden, having feelings of emotional exhaustion and depersonalization and noticing disturbing conflicts between co-workers were positively associated with stress of conscience. No significant changes were observed during the year under study, but degrees of stress of conscience and burnout scores were higher than in previous studies, suggesting that downsizing and increased workloads can negatively affect healthcare personnel. Following and expressing one's conscience in one's work, and perceiving social support from superiors are of importance in buffering the effects of stress of conscience.

  • 2682.
    Åhman, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Long-term Follow-up of Patients with Mild Traumatic Brain Injury: A Mixed-method Study2012Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 2683.
    Åhman, Sara
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Styrke, Johan
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Stålnacke, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Long-term follow-up of patients with mild traumatic brain injury: a mixed-methods study2013In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, no 8, p. 758-764Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To characterize the long-term consequences of mild traumatic brain injury regarding post-concussion symptoms, post-traumatic stress, and quality of life; and to investigate differences between men and women.

    DESIGN: Retrospective mixed-methods study.Subjects/patients and methods: Of 214 patients with mild traumatic brain injury seeking acute care, 163 answered questionnaires concerning post-concussion symptoms (Rivermead Post-Concussion Symptoms Questionnaire; RPQ), post-traumatic stress (Impact of Event Scale; IES), and quality of life (Short Form Health Survey; SF-36) 3 years post-injury. A total of 21 patients underwent a medical examination in connection with the survey. The patients were contacted 11 years later, and 10 were interviewed. Interview data were analysed with content analysis.

    RESULTS: The mean total RPQ score was 12.7 (standard deviation; SD 12.9); 10.5 (SD 11.9) for men and 15.9 (SD 13.8) for women (p = 0.006). The 5 most common symptoms were fatigue (53.4%), poor memory (52.5%), headache (50.9%), frustration (47.9%) and depression (47.2%). The mean total IES score was 9.6 (SD 12.9) 7.1 (SD 10.3) for men and 13.0 (SD 15.2) for women (p = 0.004). In general, the studied population had low scores on the Short Form Health Survey (SF-36). The interviews revealed that some patients still had disabling post-concussion symptoms and consequences in many areas of life 11 years after the injury event.

    CONCLUSION: Long-term consequences were present for approximately 50% of the patients 3 years after mild traumatic brain injury and were also reported 11 years after mild traumatic brain injury. This needs to be taken into account by healthcare professionals and society in general when dealing with people who have undergone mild traumatic brain injury.

  • 2684.
    Åhman, Sofia
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Stålnacke, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Post-traumatic stress, depression, and anxiety in patients with injury-related chronic pain: a pilot study2008In: Neuropsychiatric Disease and Treatment, ISSN 1176-6328, E-ISSN 1178-2021, Vol. 4, no 6, p. 1245-1249Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate, in patients with injury-related chronic pain, pain intensity, levels of post-traumatic stress, anxiety and depressions. Methods: One hundred and sixty patients aged 17–62 years, admitted for assessment to the Pain Rehabilitation Clinic at the Umeå University Hospital, Umeå Sweden, for chronic pain caused by an injury, answered a set of questionnaires to assess post-traumatic stress (Impact of Event Scale [IES]), pain intensity (VAS), depression, and anxiety (Hospital Anxiety and Depression Scale [HAD]). Results: Moderate to severe post-traumatic stress was reported by 48.1% of the patients. Possible–probable anxiety on the HAD was scored by 44.5% and possible–probable depression by 45.2%. Pain intensity (VAS) was significantly correlated to post-traumatic stress (r = 0.183, p = 0.022), the HAD-scores anxiety (r = 0.186, p = 0.0021), and depression (r = 0.252, p = 0.002). No statistically significant differences were found between genders for post-traumatic stress, pain intensity, anxiety, or depression. Participants with moderate to severe stress reaction reported statistically significant higher anxiety scores on the HAD (p = 0.030) in comparison with patients with mild stress. Conclusion: The findings of relationships between pain intensity, post-traumatic stress, depression, and anxiety may have implications for clinicians and underline the importance of considering all these factors when managing patients with injury-related chronic pain.

  • 2685.
    Åkerlund, Britt Mari
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Nursing.
    Dementia care in an ethical perspective: an exploratory study of caregivers' experiences of ethical conflicts when feeding severely demented patients1990Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this study was to explore how caregivers caring for severely demented patients experience ethical conflict situations. Feeding patients in a late state of dementia was chosen as focus. Special attention was paid to analyses of the caregivers' experiences with regard to their feelings, use of force, interpretations of the patients' behaviour and their ethical reasoning.

    The study was carried out in five separate parts, presented as five papers. A phenomenological - hermeneutic approach was consistent. Personal interviews, a projective defence mechanism test, the Meta Contrast Technique and an analysis of patient/caregiver behaviour as shown in video taped feeding sessions were the methods used.

    Study participants were forty-one caregivers in psychogeriatric care, registered nurses, licensed practical nurses and nurses' assistants.

    The result indicated that, when facing ethical decisions the caregivers were caught in a double bind conflict due to the contradicting ethical demands "Keep the patient alive!" and "Don't cause the patient suffering!". The difficulty to interpret what the patients experienced and the impossibility to know for sure what actions would be right or wrong were sources of anxiety. They defined force feeding individually, yet a pattern was found. Some caregivers defined force feeding according to the amount of persuasiveness or violence they had to perform. Some regarded force feeding from a patient wish perspective. A majority combined the two dimensions.

    The caregivers' ethical reasoning showed that their decision making was to be regarded as a process grounded on ethical rules. Interdependence in the relation caregiver/patient made them develop their reasoning in a direction of existential reasoning.

  • 2686.
    Åkesson, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Könsrelaterade skillnader avseende utfall av artrosskola: En registerstudie2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning: 

    Bakgrund och syfte: Artros är en vanlig kronisk degenerativ ledsjukdom i hela världen. Det finns ingen botande behandling i dagsläget. Behandlingsrekommendationerna inriktas på symtomlindring. Patientutbildning, viktminskning samt träning rekommenderas som primär behandling. I Sverige finns ett nationellt kvalitetsregister, Bättre Omhändertagande av patienter med Artros (BOA), för utvärdering av behandling av patienter med artros i höft och knä. Ett program som inkluderar utbildning och träning har utvecklats av BOA för patienter med artros. Syftet med studien var att kartlägga om det fanns några könskillnader avseende utfall av artrosskola enligt BOA med hänsyn till fysisk aktivitet och livskvalitet (EQ5D).

     

    Metod: En retrospektiv studie av BOA registret utfördes. Data för registreringar vid baselinje och uppföljningar efter 3 respektive 12 månader (n=7628) för åren mellan 2008 till 2013 analyserades. Utfallsvariabler var fysisk aktivitet och EQ5D index.

     

    Resultat: Både män och kvinnor var fysiskt aktiva > 150 minuter/vecka vid baselinje. Den fysiska aktivitetsnivån samt livskvaliteten ökade efter 3 månader för både män och kvinnor. Efter 12 månader minskade både män och kvinnors fysiska aktivitetsnivå jämfört med baseline och deras livskvalitet jämfört med 3 månaders uppföljningen. Kvinnor var statistiskt signifikant mer fysiskt aktiva än män vid baseline (p=0,00) samt uppföljning efter 12 månader (p=0,04).

     

    Slutsats: Det fanns ingen skillnad mellan män och kvinnor vad gäller utfallet av artrosskolan efter 3 respektive 12 månader med hänsyn till fysisk aktivitet och livskvalitet (EQ5D).

     

     

     

  • 2687.
    Åkesson, Kerstin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Bimanuell intensiv handträning vid cervical ryggmärgsskada Kvarstående effekt egter tre månader?: Tre "Single Subject Studies"2011Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
  • 2688.
    Åström, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Effects of vibration on muscles in the neck and upper limbs: with focus on occupational terrain vehicle drivers2008Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Introduction: Occupational drivers of terrain vehicles are exposed to several risk factors associated with musculoskeletal symptoms in the lower back as well as in the neck and upper limbs. Vibration has been suggested to be a main risk factor. These drivers are exposed to both whole-body vibration (WBV) and hand-arm vibration (HAV). Aim: This study establishes the association between driving terrain vehicles and musculoskeletal disorders (MSDs) in the neck and upper limbs as well as hand-arm vibration syndrome (HAVS). In addition, this study examines the effect on muscles in the neck and upper limbs of the type of vibration exposure that occurs in occupational driving of terrain vehicles. Methods and results: In Paper I, a cross-sectional questionnaire study on occupational drivers of terrain vehicles, increased Prevalence Odds Ratios (POR) were found for numbness, sensation of cold and white fingers (POR 1.5-3.9) and for MSDs in the neck (POR 2.1-3.9), shoulder (POR 1.8-2.6) and wrist (POR 1.7-2.6). For the shoulders, neck and elbow, there appears to be a pattern of increased odds with increasing exposure time. In Paper II, an experimental study on the trapezius muscle, which included 20 men and 17 women, the mean frequency of the electromyography signal (EMGMNF) decreased significantly more in a three minute sub-maximal contraction without vibration (-3.71Hz and -4.37Hz) compared to with induced vibration (-3.54Hz and -1.48Hz). In Paper III, a higher initial increase of the mean of the root-mean-square of the electromyography signal (EMGRMS) was seen in a three minute sub-maximal contraction with vibration exposure compared to without vibration (0.096% vs. 0.045%). There was a larger mean EMGMNF decrease for NV compared to V in the total three minutes, and a larger decrease also in the first time period was seen for the NV compared to V. A small gender effect was also noticed. In Paper IV, the combination of HAV and WBV was studied in laboratory settings and resulted in a higher trapezius EMGRMS compared to the HAV and WBV separately. Conclusion: Occupational drivers of terrain vehicles are likely to experience symptoms related to HAVS and musculoskeletal symptoms in the neck and upper limbs. Local vibration does not seem to have any negative acute effects on trapezius muscle fatigue. Vibration exposure seems to cause an initial increase in muscle activity in the trapezius that could be related to recruitment on new motor-units. A combination of HAV and WBV causes a larger muscular demand on the trapezius muscle.

  • 2689.
    Åström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation.
    Lindkvist, Markus
    Burström, Lage
    Karlsson, Stefan
    Sundelin, Gunnevi
    Trapezius muscle activity during simultaneous exposure to local vibration and static muscle load: a study of acute effectsManuscript (Other academic)
  • 2690.
    Åström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindkvist, Markus
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Burström, Lage
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Karlsson, J Stefan
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Changes in EMG activity in the upper trapezius muscle due to local vibration exposure.2009In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 19, no 3, p. 407-415Article in journal (Refereed)
    Abstract [en]

    Exposure to vibration is suggested as a risk factor for developing neck and shoulder disorders in working life. Mechanical vibration applied to a muscle belly or a tendon can elicit a reflex muscle contraction, also called tonic vibration reflex, but the mechanisms behind how vibration could cause musculoskeletal disorders has not yet been described. One suggestion has been that the vibration causes muscular fatigue. This study investigates whether vibration exposure changes the development of muscular fatigue in the trapezius muscle. Thirty-seven volunteers (men and women) performed a sub-maximal isometric shoulder elevation for 3min. This was repeated four times, two times with induced vibration and two times without. Muscle activity was measured before and after each 3-min period to look at changes in the electromyography parameters. The result showed a significantly smaller mean frequency decrease when performing the shoulder elevation with vibration (-2.51Hz) compared to without vibration (-4.04Hz). There was also a slightly higher increase in the root mean square when exposed to vibration (5.7% of maximal voluntary contraction) compared to without (3.8% of maximal voluntary contraction); however, this was not statistically significant. The results of the present study indicate that short-time exposure to vibration has no negative acute effects on the fatiguing of upper trapezius muscle.

  • 2691.
    Åström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Neuromusculoskeletal symptoms in the trunk and upper extremities among proffessional drivers of all-terrain vehicles in Sweden2007Conference paper (Other academic)
  • 2692.
    Åström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Burström, Lage
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hand-arm vibration syndrome (HAVS) and musculoskeletal symptoms in the neck and the upper limbs in professional drivers of terrain vehicles: a cross sectional study2006In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 37, no 6, p. 793-799Article in journal (Refereed)
  • 2693.
    Åström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation.
    Sundelin, Gunnevi
    Karlsson, Stefan
    Lindkvist, Markus
    Burström, Lage
    The effect of a combined hand-arm and whole-body vibration exposure on muscular activity in neck, lower back and armsManuscript (Other academic)
  • 2694.
    Åström, Emma
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundström, Vilhelm
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Arm Muscle Activation During Different Types of Isometric Loading in Stroke Subjects: A pilot study2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Tidigare studier har visat att personer med stroke har svårigheter att uppnå de resultat som förväntas av traditionell styrketräning. Isometrisk träning är en form av styrketräning, som kan utföras genom att muskeln utvecklar kraft mot ett fast motstånd och jobbar mot förkortning (koncentriskt) eller genom att en pålagd vikt gör att muskeln jobbar mot förlängning (excentriskt). Dessa former av kontraktioner kallas även Overcoming isometric och Yielding isometric.

    Syfte: Syftet var att jämföra EMG- amplitud mellan en isometriskt koncentrisk övning (Overcoming isometric) och en isometriskt excentrisk övning (Yielding isometric).

    Metod: Fyra personer med stroke och fyra friska kontroller deltog i studien. Belastningen till Overcoming isometric och Yielding isometric fastställdes genom att studera vilken belastning armen utsattes för i fyrfotastående, en övning kallad Dog to Cobra. Varje övning utfördes 10 gånger med fem sekunder arbete och fem sekunder vila. Muskelaktivering av valda muskler och medelkraft analyserades och jämfördes inom individerna och mellan grupperna.

    Resultat: Ingen utmärkande skillnad kunde ses mellan övningarna eller grupperna när EMG- amplitud analyserades. En något högre grad av ko-kontraktioner uppvisades i Overcoming isometric hos personerna med stroke.

    Konklusion: Resultaten visar en tendens mot att Yielding isometric skulle kunna vara fördelaktigt för personer med stroke men inga konkreta slutsatser kan dras.

  • 2695.
    Åström, Sture
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Nursing. Department of Geriatric Medicine, Karolinska Institute, Huddinge Hospital, Huddinge, Sweden.
    Attitudes, empathy and burnout among staff in geriatric and psychogeriatric care1990Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This study concerned assessments of attitudes towards demented patients among students and nursing staff as well as attitudes towards active euthanasia, wish to transfer to other jobs, ability of empathy and experience of burnout among nursing staff. The study aimed also to relate experience of burnout to attitudes towards demented patients, ability of empathy and experience of work with demented patients. The study was performed by use of questionnaires, scales measuring attitudes towards demented patients, experience of burnout and ability of empathy. Tape-recorded interviews were also included aiming to explore the staffs experience at work.

    The results showed that a majority of the students and staff held positive attitudes towards demented patients. A small proportion intended to work solely with demented patients. Staff working in psychogeriatric care and somatic long-term care held more positive attitudes than staff working in acute medical care. Proportions of staff with positive attitudes varied depending on age, duration of employment, education and place of work. A larger proportion of staff in geriatric care than in acute care reported a wish to transfer to another job. LPN’s in nursing homes to the largest proportion stated this wish to transfer.

    A majority of both students and staff expressed negative attitudes towards active euthanasia to severely demented patients in the finale stage of life. However, most favourable attitudes towards active euthanasia were found among students with shorter health care education and among nurse's aides and LPN’s.

    The staffs empathy was judged as moderately high and there were no differences found in relation to sex, staff category or place of work.

    Experience of burnout /tedium varied with the place of work and category of staff. Largest proportions at risk to develop burnout were found among those working in somatic long-term care and psychogeriatric care. RN’s showed lower burnout scores than nurse's aides and LPN’s.

    Experience of burnout was correlated to attitudes towards demented patients, indicating that the lower burnout score the staff have the more positive are the attitudes. Burnout was also related to the staffs ability of empathy i.e. the lower degree of burnout the higher is the empathie ability. Regression analysis showed that "Experience of feed-back at work” and "Time spent at present place of work" were the most important factors for the staffs experience of burnout.

  • 2696.
    Åström, Sture
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Karlsson, Stig
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Sandvide, Asa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Eisemann, Martin
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Staff's experience of and the management of violent incidents in elderly care.2004In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, Vol. 18, no 4, p. 410-6Article in journal (Refereed)
  • 2697.
    Åström, William
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Knee kinematics during a novel hop test with an unanticipated change of direction for female floorball athletes and controls: Evaluation of within-session and test-retest reliability and assessment of knee function2016Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction: The incidence of anterior cruciate ligament (ACL) injuries in female floorball is relativley high, and the risk for sustaining a second ACL injury is greater compared to previously uninjured. Existing evaluation tests in rehabilition may not be discriminative enough to guide decisions on return to sport Aim: To evaluate the withinAsession and testAretest reliability of knee kinematics in floorball athletes and controls during a hop encompassing a sudden unanticipated change of direction. A second aim was to investigate the discriminative validity by comparing the test outcomes between the athletes and a control group of nonAathletes. Method: 11 elite floorball athletes and 8 controls were tested on two occassions separated by one to three weeks. Knee kinematics, ground contact time and number of succesfull hops were analyzed. Relative reliability was quantifyed by Intraclass correlation coefficient (ICC) and absolute reliability by standard error of measurement (SEM). Results: ICCs for knee kinematics withinAsession reliability were excellent (0.83A0.96) for athletes and poor to excellent (0.40A0.94) for the controls. For the testAretest reliability, the athletes had good to excellent (0.56A0.96) reliability and the controls had poor to excellent (0.26A0.93) reliability. Only two measured kinematic variables were significantly different between the groups. Conclusion: This pilot study indictate good to excellent reliability for the majority of the kinematic variables tested and, therefore, it could be assumed to be adequatley reliable. Discriminative validity needs to be further evaluated in a larger material.  

  • 2698.
    Åström, William
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nymark, Conny
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    A systematic review of assessment methods of knee joint proprioception2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: For measuring knee proprioception there are different tests used, but it is not known which of them that has the best reliability. The importance of proprioception and the relationship with knee functions is not known, and for measuring this, a reliable and stable proprioceptive test is needed.

    Aim: The aim was to explore which tests that is used to exam proprioception in the knee, and how reliable they are. Also to see which test could be applied in a movement lab for testing ACL injured patients.

    Method: Five different databases were searched until 5 september 2014. Studies assessing the reliability of well described proprioceptive knee tests were included in the systematic review. The methological quality of the studies were assessed by a modified version of the STARD checklist.

    Results: 19 studies assessing the reliability of four different type of proprioceptive tests were included in the review. The four tests were joint position sense (JPS), treshold to detect passive motion (TTDPM), velocity replication and velocity treshold hunting paradigm. TTDPM presents the best reliability with an ICC median of 0,77.

    Conclusion: TTDPM is likely to be the most reliable of the existing tests for measuring knee proprioception, and is also the test we would recommend for use in a movement lab for testing ACL-patients.

  • 2699. Öhberg, F
    et al.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nilsson, K-G
    Edström, U
    Gustavsson, O
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundström, R
    Gait analysis using a portable motion sensor system: measurements in subjects with hip implants as compared with healthy controls2012Conference paper (Other academic)
  • 2700.
    Öhberg, Fredrik
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Blomberg, Anders
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Claesson, Kenji
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Edström, Urban
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Holmner, Åsa
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Home-based system for recording pulmonary function and disease-related symptoms in patients with chronic obstructive pulmonary disease, COPD: a pilot study2016In: SM Journal of Pulmonary Medicine, ISSN 2574-240X, Vol. 2, no 1, article id 1011Article in journal (Refereed)
    Abstract [en]

    Introduction: Many patients with Chronic Obstructive Pulmonary Disease (COPD) suffer from acute exacerbations characterized by an increase in symptoms beyond normal day-to-day variation. The prognosis of patients with frequent exacerbations is poor and effort to curb these worsening episodes has great potential to improve the patient’s quality of life and to reduce associated costs. Telemonitoring has been proposed as a promising strategy in this respect. However, information on what physical signs or symptoms that should be recorded and how recorded data should be interpreted is largely missing in the literature.

    Methods: A new home-based system, based on a tablet computer, which can guide COPD patients to perform spirometry (inspiratory capacity, IC and forced expiratory volume in one and six seconds, FEV1 and FEV6) and record symptoms (COPD assessment test, CAT) was developed. The system was evaluated for 8-12 weeks in four patients with moderate to severe COPD with the aims to; i) assess the feasibility of the system to be used unsupervised by COPD patients and, ii) to evaluate the quality and ability of recorded parameters to reveal early signs of an exacerbation. Pearson bivariate correlation was performed between all outcome measures and descriptive information about inherent subject properties were presented.

    Results: The system was well accepted by all study subjects and the study generated a total of 253 measurements of which 94.5% were considered acceptable for analysis. One of the subjects developed an acute exacerbation towards the end of the study, whereas the other three subjects remained stable. Descriptive analysis of the data suggest that trends in the CAT score may indicate changes in health status and that IC tends to be more responsive to these changes compared to FEV1.

    Conclusion: The system developed in this study is well suited to be used unsupervised by COPD patients. Recorded data, in particular CAT, may be sensitive enough to detect early signs of an acute COPD exacerbation, although more data is needed to fully resolve the nature of such an association.

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