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  • 301.
    Lööf, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Markusson, Madeleine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Terapihund- en katalysator för delaktighet hos barn med Autismspektrumtillstånd: En litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Autismspektrumtillstånd (AST) är en diagnos vars kardinalsymtom bland annat innebär bristfällig förmåga till social interaktion och social kommunikation. På grund av detta riskerar personer med AST att inte bli eller känna sig delaktiga i samhällslivet då delaktighet förutsätter kommunikativa förmågor. Tidiga insatser är viktigt bland dessa individer för att öka chanserna till delaktighet. Djurassisterad terapi är en terapiform som har visat sig vara effektiv för att reducera autistiska symtom och hundar är ett vanligt förekommande djur inom denna terapiform. Syftet var att undersöka terapihundens effekter på sociala interaktionsfärdigheter hos barn med autismspektrumtillstånd (AST) för att främja delaktighet. En systematisk litteraturstudie genomfördes med litteratursökningar i databaserna Academic Search Elite, AMED, CINAHL, ERIC, psycINFO, PubMed, OT-seeker samt manuella sökningar, för att hitta den senaste forskningen inom området. Relevanta artiklar kvalitetsgranskades och resulterade i sju inkluderade studier. En integrerad analys enligt Kristenssons (2014) metodbok utfördes för att finna kategorier som motsvarade syftet. Resultatet visade på att terapihundar har förmågan att främja det positiva sociala beteendet, vilket innefattar sociala interaktionsfärdigheter. Några studier fann även att de negativa sociala beteendena minskade. Författarna anser att terapihundar bör vara en metod att överväga vid planering av interventioner till barn med AST då resultatet visar att terapihundar kan främja sociala interaktionsfärdigheter. Dock behövs mer forskning inom området för att säkerhetsställa dess evidens då flertalet genomförda studier har bristande kvalitet.

  • 302.
    Magnusson, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Bildterapi som behandlingsmetod vid alexitymi2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The objective of the thesis is to highlight how art therapists in Sweden work with clients with alexithymia/alexithymia conditions. Data collection was carried out through a directed questionnaire. One hundred and thirtythree questionnaires were sent out through e-mail and 33 answers were received. A descriptive method was chosen to analyse the answers. The results show that the respondents stress the importance of establishing contact between thought, feeling and body in order to be able to help clients with alexithymia. The art therapy room was emphasised as important to create a reliable alliance between art therapist and client, as well as providing space for imagination, play and humour in the treatment work. The respondents describe different techniques and themes, for example full size portrait and scribble exercise. The responses received from the art therapists highlight the fact that alexithymia does not exist as a diagnosis in the diagnostic system for psychiatric illnesses and that alexithymia often can exist in combination with other diagnoses.

  • 303.
    Magnusson, Monica
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Bildterapins betydelse: en beskrivning av 28 patienters upplevelse av bildterapi2007Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Denna retrospektiva studie beskriver upplevelsen av bildterapins betydelse samt verksamma faktorer ur ett patientperspektiv. Undersökningsmaterialet utgjordes av 28 enkäter, vilka besvarats av personer som avslutat sin bildterapi vid en vuxenpsykiatrisk verksamhet. Innehållsanalys av enkät-svaren visade bl.a. att samtliga respondenter var nöjda med bildterapi som metod och att 25 av dem hade uppnått ett bättre mående av bildterapin. Bildterapin bidrog till personlig utveckling och för de flesta även bestående läkning. De faktorer som, enl. respondenterna, påverkat behandlingsresultatet positivt, var bl.a. att skapa utan prestationskrav, stimulans till kommunikation, kontakt med tankar och känslor, bearbetning i bild, rummet, materialet samt relationen till bildterapeuten. Som den viktigaste faktorn framhölls bildterapeutens empatiska förmåga och för-hållningssätt. Samtalet och den terapeutiska relationen var betydelsefull och det kreativa skapandet i bildarbetet förde in ytterligare dimensioner i det terapeutiska arbetet. Tidsbrist, gruppsammansättning samt brister i vårdens organisation påverkade behandlingsresultatet negativt. Respondenternas beskrivning av metodens verksamma faktorer, var i hög grad samstämmig med de faktorer som omnämns i bildterapilitteraturen.

  • 304.
    Markstedt, Mina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Att leva med astma och allergi: Med fokus på individuella erfarenheter strategier och tillgänglighet2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Att leva med astma och allergi innebär  individuella begränsningar beroende  på vad  som orsakar den allergiska  reaktionen  och vilka symptom    det                   ger.     Syftet   var          därför att           ut ifrån                 ett tillgänglighetsperspektiv         belysa       individuella        erfarenheter   och aspekter  av att  leva med  astma och  allergi  samt strategier  för att hantera  symptomen.  En  studie  har  gjorts  där  fyra  personer  med astma och allergi har intervjuats.  Intervjuerna har analyserats  med kvalitativ  innehållsanalys. Analysen  gav följande huvudkategorier: Erfarenheter  av att leva med astma och allergi, Strategier för  att hantera symptom,  Erfarenheter  av tillgänglighet  och Erfarenheter av   samhällets uppmärksamhet     och         önskade förbättringar.                   I resultatet framkom bland annat att lukter och cigarettrök är det som orsakar  störst  svårigheter  och att bussar  och  parfymbutiker  är de besvärligaste   miljöerna   för   intervjupersonerna.   Astmatiska   och allergiska  besvär   är  en  funktionsnedsättning   som  har  bristande uppmärksamhet  i samhället. Attityder påverkar  intervjupersonernas möjligheter  och  hemmiljön  är  det  enda  stället  för  dem  att  kunna påverka och känna sig avslappnad.

  • 305.
    Meier, Claudia
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Thornell, Elin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Kvinnliga immigranters erfarenheter av förvärvsarbete i Sverige: En kvalitativ studie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Kvinnliga immigranter upplever i migrationsprocessen ofta en förlust av dagliga aktiviteter och blir tvingade att förändra sina roller, rutiner och vanor. I det nya landet möter de kvinnliga immigranterna ofta svårigheter i samband med förvärvsarbete. Samtidigt är förvärvsarbete en viktig förutsättning för att kunna etablera sig i det nya samhället. Syftet med studien var att belysa kvinnliga immigranters erfarenheter av att ha ett förvärvsarbete i Sverige under de fem första åren. En kvalitativ studie genomfördes och fem kvinnliga immigranter som ofrivilligt lämnat hemlandet intervjuades. Det insamlade materialet analyserades utifrån en kvalitativ innehållsanalys och resulterade i temat Arbete är nyckeln till etablering i det nya samhället samt kategorierna Arbete bidrar till förbättrade livsvillkor och Utmaningar och svårigheter i samband med arbete. Resultatet visade att kvinnorna upplevde stora utmaningar och aktivitetsorättvisor i relation till förvärvsarbete. Förvärvsarbete visade sig också vara nyckeln till en lyckad integration i det nya samhället. Det är av största vikt att kvinnliga immigranter får rätt stöd tidigt i migrationsprocessen för att uppnå egenmakt och kunna etablera sig i det nya samhället. Arbetsterapeuter är en yrkesgrupp som har kunskap och kompetens att motverka aktivitetsorättvisor samt att vara ett stöd för att möjliggöra immigranters etablering.

     

    Sökord: arbetsterapi, integration, migration, etablering

  • 306.
    Mikhaltchouk, Inga
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Aktivitetsaspekter av drogmissbruk och övergång till ett drogfritt liv: Berättelser av tre före detta drogmissbrukare2014Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med denna studie är att identifiera aktivitetsaspekter av drogmissbruk samt belysa dessa i återgångsprocessen till ett drogfritt liv hos personer med tidigare missbruk.Metod: Studiens data insamlades genom kvalitativa intervjuer av tre deltagare som resulterade i tre berättelser med fokus på aktivitet. Data analyserades med kvalitativ komparativ metod.Resultat: Resultatet visade att under den intensiva bruksperioden var drogmissbruket en huvudaktivitet för deltagarna. Själva intaget samt bruksrelaterade aktiviteter visade sig vara rutinmässiga, och var inkluderade i deltagarnas ADL. Vidare uppvisar aktivitetsmönstret för systematiskt bruk en typisk cyklisk struktur; det uppstår förändringar i självuppfattning och olika koncept och värderingar. Analysen demonstrerade också att narkotikabruk kan ses som livets arena där egna sociala band skapas och bevaras, social roller spelas, individens behov tillfredsställs – allt genom diverse drogrelaterade aktiviteter. Det framkom att obalans i aktivitetsmönster kan leda till förändringar och ligga till grund för strävan att sluta med droger, samt kan leda till återfall under pågående försök att sluta. Utöver det konstaterade man att en lyckad övergång till ett drogfritt liv kännetecknades av närvaro av en positiv förebild i deltagarnas liv. Det drogfria livet karaktäriserades av att en ny identitet blev etablerad; i samband med det uppstod meningsfulla drogfria aktiviteter som tillfredsställde deltagarnas behov, stärkte självbilden och främjade självkännedom. Dessa uppvisade alla tecken på en engagerande aktivitet.

  • 307.
    Mikkelsen, Frida
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå universitet.
    Uddin, Ida
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå universitet.
    Identifierade konsekvenser av arbetslöshet på den psykiska hälsan hos arbetslösa i Sverige2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Vad människan gör det vill säga vilken aktivitet som utförs har länge haft en stor påverkan på hur människan ser på sig själv. I dagens samhälle identifierar sig många med sin yrkesroll vilket gör att arbetet har en stor betydelse för individen. Arbete ger möjlighet till personlig utveckling, social interaktion och trygghet medan arbetslöshet kan resultera i stressrelaterade konsekvenser. Syftet med denna litteraturstudie var att beskriva identifierade konsekvenser av arbetslöshet på den psykiska hälsan hos arbetslösa i Sverige. Litteraturstudien gjordes på kvalitetsgranskade kvantitativa vetenskapliga artiklar som togs fram genom olika sökkombinationer i sex olika databaser. Tio vetenskapliga artiklar valdes ut och analyserades. Resultatet indikerade en signifikant skillnad mellan arbetslösa personers psykiska hälsa och de personer som var i arbete. Olika faktorer visade sig ha en inverkan på arbetslösas psykiska hälsa, såsom ålder och kön. Arbetets betydelse visade sig ha en stor effekt på individers psykiska välmående. Arbetsterapeuter kan vara en resurs för att förbättra välmåendet hos arbetslösa individer genom att skapa nya idéer kring arbete och alternativ sysselsättning. Arbetsterapeuter arbetar alltid klientcentrerat och utgår alltid ifrån den enskilda individens behov.

    Sökord: Livskvalité, arbetets betydelse, påföljd, avsaknad, välmående.

  • 308.
    Mori, Yu
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Dohlin, Jenny
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Brukares behov av fritidsaktiviteter och hemtjänstpersonalens roll som aktivitetssamordnare2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Hemtjänstens insatser riktade mot sociala behov, som en del i brukarnas meningsfulla aktiviteter, har vid utvärderingar beskrivits som mindre tillfredsställande. Tidigare studier har visat att meningsfulla aktiviteter som fritidsaktiviteter har positiv effekt på de äldres hälsa och välmående. Studiens syfte var därför att belysa hemtjänstpersonalens uppfattningar om brukarnas behov av fritidsaktiviteter och hur de kan främja brukarnas deltagande av fritidsaktiviteter samt vad som kan försvåra eller underlätta för dem att stödja brukarna. Sex personer från hemtjänsten som arbetade inom Umeå kommun deltog i semistrukturerade intervjuer som sedan transkriberades och analyserades med kvalitativ innehållsanalys. I resultatet visade det sig att hemtjänstpersonalen upplever att brukarnas behov och möjlighet att vara aktiva är varierande samt att hemtjänstpersonalen har en roll som aktivitetssamordnare, men detta kan begränsas av den organisation och de riktlinjer som de befinner sig i. I studien framgår att hemtjänstpersonalens roll för brukarnas möjligheter till aktiviteter bör uppmärksammas, något som också är väsentligt för att främja brukarnas delaktighet.

  • 309.
    Munkholm, Michaela
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Occupational performance in school settings: evaluation and intervention using the school AMPS2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: This thesis is was designed to evaluate aspects of reliability and validity of the School Version of the Assessment of Motor and Process Skills (School AMPS) (Fisher, Bryze, Hume, & Griswold, 2007), an observation-based evaluation of quality of occupational performance when children perform schoolwork tasks in school settings. The long term goal was to contribute to knowledge about children at risk or with mild disabilities who experience difficulties with occupational performance in school settings, and describe how the School AMPS can be used when a true top−down process of planning and implementing school-based occupational therapy services is implemented in a Swedish context.

    Methods: In Study I, two different split-half methods and were used to estimate reliability of the School AMPS measures. These were cross-validated using Rasch equivalent of Cronbach’s alpha. The standard error of measurement (m) was also calculated. In Studies II and III, many-facet Rasch analyses and/or relevant inferential statistics (e.g., ANOVA, tests) were used to examine for evidence of validity based on (1) internal structure related to differential item functioning (DIF), (2) relations to other variables (sensitivity) in terms of comparing groups (typically-developing children vs. children with mild disabilities), and (3) consequences of testing (benefits of testing) in terms of test fairness. In Study IV, ANOVA and tests were used to examine relations to other variables in terms of sensitivity of the School AMPS measures for detecting change based on repeated School AMPS evaluations pre- and post-interventions.

    Results: The three methods for estimating reliability of the School AMPS measures yielded high reliability coefficient estimates (≥0.73) and low ms. Minimal DIF was identified, and despite minimal DIF, the School AMPS measures were found to be free of differential test functioning. The School AMPS measures were sensitive enough to detect differences between groups as well as changes following consultative occupational therapy services provided in natural school settings.

    Conclusions: The results support the reliability and validity of the School AMPS scales and measures when used to evaluate quality of occupational performance in school settings. The results are also of clinical importance as they provide evidence that occupational therapists can have confidence in the School AMPS measures when they are used in the process of making decisions about individual students, planning interventions, and later perform follow-up evaluations to measure the outcomes. We also have objective evidence that children with mild disabilities demonstrate diminished quality of "doing" when performing schoolwork tasks. The potential long term benefits of such evidence may be to support or justify the need for children with mild disabilities to receive occupational therapy services within school settings in Sweden; and through collaboration with teachers, plan and implement better targeted and more effective interventions.

  • 310.
    Munkholm, Michaela
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Berg, Brett
    AMPS Project International, Fort Collins, CO.
    Löfgren, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Fisher, Anne G.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Cross-regional validation of the school version of the assessment of motor and process skills2010In: American journal of occupational therapy, ISSN 0272-9490, Vol. 64, no 5, p. 768-775Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE.: The objective was to determine whether the School Version of the Assessment of Motor and Process Skills (School AMPS) is valid when used to evaluate students in different world regions.

    METHOD.: Participants were 984 students, ages 3–13 yr, from North America, Australia and New Zealand, United Kingdom, and the Nordic countries, matched for age and diagnoses. We used FACETS many-faceted Rasch analyses to generate item difficulty calibrations by region and evaluate for significant differential item functioning (DIF) and differential test functioning (DTF).

    RESULTS.: Four School AMPS items demonstrated DIF but resulted in no DTF.

    CONCLUSION.: This study provided support for occupational therapists using the School AMPS to evaluate students' quality of schoolwork task performances across regions because the School AMPS measures are free of bias associated with world region.

  • 311.
    Munkholm, Michaela
    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.
    Differences in schoolwork performance between typcally-developing students and students with mild disabilities2008In: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 28, no 3, p. 121-132Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to examine whether students with mild disabilities differed from typically developing students in their ability to perform schoolwork tasks. The participants, selected from the School Assessment of Motor and Process Skills (School AMPS) database, comprised 175 students in each group. Their data were subjected to many-faceted Rasch analyses and then analyzed for statistically significant differences in mean school motor and school process abilities between groups. The relative and actual item difficulty calibration values were then compared to identify meaningful differences between groups. The results revealed a statistically significant mean difference in school motor and school process ability between groups (large effect sizes), essentially stable relative skill item hierarchies between groups, and actual hierarchies that differed such that some school motor and almost all school process skill items (occupational performance skills) were more difficult to perform for the mild disabilities group. The results of this study also provided evidence of validity for the use of the School AMPS measures to assist in identifying lower than expected schoolwork performance of students with mild disabilities.

  • 312.
    Munkholm, Michaela
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Löfgren, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Fisher, Anne G.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Improving quality of schoolwork task performance through consultative occupational therapy servicesManuscript (preprint) (Other academic)
  • 313.
    Munkholm, Michaela
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    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.
    Reliability of the School AMPS measures2012In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 19, no 1, p. 2-8Article in journal (Refereed)
    Abstract [en]

    Aim: The purpose of this study was to use a variety of methods to evaluate and cross-validate the reliability estimates of the quality of schoolwork performance measures in the School Version of the Assessment of Motor and Process Skills (School AMPS)(1).

    Methods: Split-half reliability was estimated based on School AMPS data from 6 194 students who had performed at least two school AMPS tasks. Two different split-half methods were used: splitting the School AMPS items vertically and splitting them horizontally. The Rasch equivalent of Cronbach’s alpha for the full School AMPS evaluation and standard error of measurement (SEm) were also considered.

    Results: All three methods yielded high reliability coefficient estimates (r ≤ 0.70) and overall SEm was low.

    Conclusions: From a practice perspective, the results of this study are of clinical importance as they provide evidence that occupational therapists can have confidence in the consistency of the School AMPS measures when they are used in the process of making decisions about individual students, planning interventions, and later performing followup evaluations to measure the outcome.

  • 314.
    Månsson Lexell, Eva
    et al.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Larsson Lund, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Iwarsson, Susanne
    Department of Health Sciences, Lund University, Lund, Sweden.
    Constantly changing lives: experiences of people with multiple sclerosis2009In: American Journal of Occupational Therapy, Vol. 63, no 6, p. 772-781Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to gain an enhanced understanding of how people with multiple sclerosis (MS) experience their engagement in occupations. We interviewed 10 people and then analyzed the data gathered using the constant comparative method of grounded theory. The findings encompassed the cothe category “essentials of a constantly changing life,” showing that along a continuum of change, the participants experienced a decreasing engagement in occupations that forced them to continuously struggle to maintain engagement. This struggle changed them and required them to construct a different life than before. Our findings suggest that professionals working in MS rehabilitation need to broaden   their repertoire of interventions relevant to conditions in clients' social environment, with the intention of influencing those occupations that are individually most meaningful. Occupational therapists should focus on the client's engagement in occupations and its consequences for the client's life and self-identity.

  • 315.
    N. Olsson, Ritva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Sorgbearbetning med bildterapeutiska verktyg för föräldrar som förlorat barn genom suicid.: Sorgen söker uttryck och utrymme.2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aims: Suicide research shows that parents who have lost a child through suicide face consequences in several areas of life: emotional, social and mental. Difficult emotions, attitudes about suicide in the surrounding society, psychic vulnerability, and stigmatization, often lead to the survivors being isolated. Research on the grieving process shows that the loss of a close relative through suicide is a complicated or traumatic loss. Community support offered to parents who have lost children through suicide is inadequate. If/when for various reasons grieving does not take place, or is obstructed, relatives may be afflicted by mental disorder that can become lasting, and even life-threatening. The purpose of this study is to describe a program in which art therapy is used to process the loss of a child through suicide.

     

    Methods: The theoretical frame of reference consists of qualitative and quantitative scientific studies concerning suicide, grief processing, trauma, and grief processing by means of art therapy. The data is empirical but secondary, gathered from articles and studies in available data bases, and not from direct observations.

     

    Results and conclusion: The program encompasses ten sessions in which art therapy is used to process suicidal loss. The  exercises hould be viewed as suggestions, modifiable in response to the needs of the client. This program is a ontribution to meeting the needs of parents, who har lost a child through suicide. 

  • 316.
    Namutosi, Elisabeth
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Occupational Therapy Interventions towards Generalized Anxiety Syndrome: Literature review2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Having difficulties in dealing with daily activities is one of the signs experienced by individuals with a chronic anxiety termed as Generalized Anxiety Disorder (GAD). There is little research about how Occupational Therapists can work with persons with this type of anxiety. The aim was to describe occupational therapists’ interventions towards individuals with generalized anxiety disorder (GAD). The method used was a literature review study, and the articles were collected from Amed, Academic Search Elite, Cinahl, medline, PsycInfo and some were manually searched. The years ranged between 2000-2015. 6 quantitative and 12 qualitative articles were critically analyzed and later categorized under four different sub-topics. Which include healthy habits and physical exercises, good relationships, identity development and meaning in life. Occupational Therapy interventions gave positive effects in mitigating anxiety, improving activities of daily living (ADL) and fulfilling the concepts in the model of lifestyle balance. The result can be helpful to the Swedish health system and to patients. More research on a specific gender, research basing on qualitative and quantitative separately are encouraged for more research on GAD. Occupational Therapy interventions for persons with GAD become more effective through a combination of multi interventional methods. 

     

                 Keywords: Occupational therapy, GAD, lifestyle balance and activities.

        

     

  • 317.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Hälsofrämjande aktiviteter för äldre2014In: Hälsa och aktivitet i vardagen: ur ett arbetsterapeutiskt perspektiv / [ed] Ulla Kroksmark, Förbundet Sveriges Arbetsterapeuter , 2014, 1, p. 41-55Chapter in book (Other academic)
  • 318.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Leisure among older people: differences between three age groups2009In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 86, no 2, p. 167-174Article in journal (Refereed)
    Abstract [en]

    This study targets the leisure repertoire and differences between gender and age-groups among older people. Data was collected from a population-based survey among the oldest-old in northern Sweden as well as from two senior citizens’ organizations in northern Sweden. In total 286 older people between 65 and 98 voluntary participated. Leisure repertoire was described by using Rasch analysis on the data from the MNPS interest check list. The results show that the most likely to find on older peoples repertoire was social activities, cultural activities and watch TV. Least likely, older people describe ballgames and equipment sports as a part of their repertoire. Men and women had significant different repertoire, which could be related to traditional gender issues. Differences were also found related to age.

  • 319.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Äldres inklusion och delaktighet i samhället genom Internet2011In: E-hälsa inom rehabilitering / [ed] Melander Wikman, A., & Gard, G., Studentlitteratur , 2011Chapter in book (Other academic)
  • 320.
    Nilsson, Ingeborg
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Argentzell, Elisabeth
    Sandlund, Mikael
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Leufstadius, Christel
    Eklund, Mona
    Measuring perceived meaningfulness in day centres for persons with mental illness2011In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 18, no 4, p. 312-320Article in journal (Refereed)
    Abstract [en]

    Rationale: As support in leading a meaningful and active life, a person with mental illness is often given the opportunity to attend a day centre. However, few studies have investigated the meaningfulness perceived by the person visiting a day centre. For such a purpose, a self-report instrument was developed.

    Aims: To explore whether perceived meaningfulness, as expressed in the recently developed instrument Evaluation of Perceived Meaning in Day Centers (EPM-DC), could be viewed as one dimension and also to investigate the psychometric properties of this instrument.

    Methods: Persons with mental illness attending five day centres in Sweden participated and completed the questionnaire. The data were analysed by Rasch analysis.

    Major findings: The study showed that the concept captured in the instrument could be viewed as unidimensional and the result gave preliminary evidence for sound psychometric properties.

    Principal conclusion: The results indicate promising signs of validity and reliability, but the suitability of self-reporting may be questioned.

  • 321.
    Nilsson, Ingeborg
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Aktivitetsengagmang under åldrandet2012In: Det goda åldrandet / [ed] Santamäki Fisher, R., Lundman, B., Norberg, A., Lund: Studentlitteratur, 2012, 1, p. 217-232Chapter in book (Other academic)
  • 322.
    Nilsson, Ingeborg
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Bernspång, Birgitta
    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.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Löfgren, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Occupational engagement and life satisfaction in the oldest old: the Umeå 85+ study2007In: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 27, no 4, p. 131-139Article in journal (Refereed)
    Abstract [en]

    This study was designed to evaluate whether the level of occupational engagement is relatedto life satisfaction among the oldest-old. The study was performed as part of a cross-sectionalstudy of individuals 85 years and older in northern Sweden. The results revealed significantcorrelations between life satisfaction and engagement in both leisure and activities of daily living,and the effect sizes were interpreted as medium. This study adds some support to earlierfindings that a higher level of task performance is related to a higher level of life satisfaction.The results also give some clinical evidence to support a client-centered approach that includesconsideration of leisure tasks a person is motivated to perform.

  • 323.
    Nilsson, Ingeborg
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Blanchard, M
    Wicks, A
    Occupational engagement among community dwelling older people: a time-geographic perspective2015In: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, Vol. 30, no 3, p. 484-494Article in journal (Refereed)
    Abstract [en]

    How older people spend their time in different occupations could contribute to our understanding of everyday life in healthy ageing. This study adopted a time-geographic method and occupational perspective to explore the occupational engagement of community dwelling older people. The term occupational engagement encompasses what people do, where and with whom they spend their time and the perceived level of competence and meaningfulness of their time use. Nineteen volunteers born between 1932 and 1933, living alone in an urban area in northern Sweden and receiving no home care services, completed open time-geographic diaries for 5 days in May 2010. The diary data were analyzed using Daily Life software program. The study revealed the complexity and the diversity of the older people's occupational engagement and that most of their time was spent alone in their home. The older people reported they were very good at doing almost half of the occupations in which they engaged and that their occupations were primarily either very meaningful or meaningful. While some methodological limitations were identified, time-geographic studies of community dwelling older people living independently are considered to have potential to contribute to community and social planning for older people as they can provide interesting insights to older persons' time use and occupational needs.

  • 324.
    Nilsson, Ingeborg
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Fischl, Caroline
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Larsson, Ellinor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Finns det inga gränser: ska arbetsterapeuten vara teknisk support också!?2015In: Arbetsterapiforum 15-16 april 2015, 2015Conference paper (Other (popular science, discussion, etc.))
    Abstract [en]

    Bakgrund: Samhällets utveckling har inneburit att internet och sociala medier nu spelar en viktig roll för att vara aktiv, social och delaktig i samhället. För den äldre delen av befolkningen har dock tekniken ännu inte fått ett stort genomslag och hur detta nya aktivitetsområde fokuseras bland arbetsterapeuter som jobbar med äldre är tämligen oklart. 

    Syfte med workshopen: Syfte med workshopen är att beskriva kunskapsläget när det gäller möjligheter och hinder för äldre att vara aktiva genom modern teknologi och genom debatt dela erfarenheter om vilken roll arbetsterapeuten bör ha inom detta aktivitetsområde samt vilken kompetens som krävs.

    Tillvägagångssätt vid workshopen: Workshopen inleds med en litteraturgenomgång i området samt exempel från pågående forskningsprojekt därefter delas gruppen upp för att diskutera givna frågeställningar om arbetsterapeutens roll, tillvägagångssätt och hur kompetensförsörjningen inom området bör se ut.

    Förväntat resultat av deltagandet workshopen: Deltagarna förväntas, som ett resultat av workshopen, få grundläggande förståelse för de vetenskapliga belägg som finns om hur aktivitet bland äldre kan påverkas av att använda modern teknologi. Vidare förväntas deltagarna genom diskussionerna fått dela med sig av sina erfarenheter och fått inspiration och idéer som kan bidra till utvecklingen av utbildningsprogrammen liksom det professionella arbetet. Det är väsentligt att detta relativt nya aktivitetsområde belyses så att arbetsterapeutens roll kan tydliggöras.

  • 325.
    Nilsson, Ingeborg
    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.
    Evaluating leisure activities in the oldest old2006In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 13, no 1, p. 31-37Article in journal (Refereed)
    Abstract [en]

    Aim. To determine whether the Modified NPS Interest Checklist (MNPS) could be developed as a tool with linear measures of four dimensions of leisure: Interest, Performance, Motivation, and Well-being.

    Methods. A cross-sectional descriptive study including 156 volunteers born between 1904 and 1917 and living in urban or rural northern Sweden. Each participant was individually interviewed at her/his place of residence. Subsequent data were subjected to a series of Rasch analyses using FACETS.

    Major findings. The items and persons demonstrated acceptable goodness-of-fit across all four dimensions in the MNPS checklist. The Rasch equivalent of Cronbach's alpha was 0.98 for items, and ranged from 0.66 to 0.75 for persons.

    Principal conclusion. The MNPS shows evidence for acceptable internal scale validity, person response validity, and scale reliability. This study provides initial evidence that the MNPS is a valid tool for measuring leisure among the oldest old. While this study provides the first psychometric examination of an assessment designed to evaluate different dimensions of leisure, more research is needed to further assess validity and reliability of this tool with the elderly and with other groups.

  • 326.
    Nilsson, Ingeborg
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Forsberg, Ellinor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Lindgren, Helena
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Att som äldre använda Internet: En studie om delaktighet och personligt datoriserat aktivitetsstöd2009Report (Other (popular science, discussion, etc.))
  • 327.
    Nilsson, Ingeborg
    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).
    Häggström Lundevaller, Erling
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Fisher, Anne G.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Colorado State University, College of Applied Human Sciences, Department of Occupational Therapy, Fort Collins, CO.
    The Reationship between Engagement in Leisure Activities and Self-Rated Health in Later Life2017In: Activities, Adaptation & Aging, ISSN 0192-4788, E-ISSN 1544-4368, Vol. 41, no 2, p. 175-190Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine leisure engagement among people in later life and the potential relationship between leisure engagement and self-rated health. A population-representative sample of 5,435 persons between 65 and 80 years of age, living in northern Sweden and Finland were included. Data were collected by a posted questionnaire survey. Results revealed that levels of leisure engagement decreased progressively between the youngest and the oldest age groups. A significant relationship was found between leisure engagement and self-rated health. The relationship between leisure engagement and health as well as implications for developing health promotion programs are discussed.

  • 328.
    Nilsson, Ingeborg
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Luborsky, Mark
    Rosenberg, Lena
    Sandberg, Linda
    Bostrom, Anne-Marie
    Borell, Lena
    Perpetuating harms from isolation among older adults with cognitive impairment: observed discrepancies in homecare service documentation, assessment and approval practices2018In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, article id 800Article in journal (Refereed)
    Abstract [en]

    Background: Older persons with cognitive impairment (CI) risk social isolation. Strong evidence shows that perceived loneliness, or inadequate social networks, triggers and increases health problems. How homecare systems address social participation remains unknown; anecdotal data suggests there are significant gaps. This study's objective was to identify and describe how the assessors of homecare needs document social participation among persons with CI and how their documentation corresponds with the services actually provided to meet social needs. The research questions were: How and what kinds of social participation needs are documented on need assessment forms? What types of homecare services (with a social focus) are documented and approved? How are specified needs in social participation profiles addressed by a homecare service?

    Methods: Descriptive data from need assessment forms and their attached care plans for all applicants aged 65+ were collected during a 2 month period from a large homecare agency serving a municipality in Sweden. Persons with documented CI (n = 43) in the group were identified. Qualitative data analysis was conducted to examine the research questions.

    Results: Social participation factors were not documented consistently. The relationship between recognition of limitations to social participation and approval of service eligibility was not consistent. Social participation was designated by references to social status, sometimes by social network size, and occasionally by limitations to social participation. The range of approved homecare services (with social focus) covered services such as day care center visits or companionship. Three profiles of social participation were identified: clients with, (a) no participation limitations; (b) potential limitations; and (c) marked limitations.

    Conclusion: Given the known health harms from social isolation and the high risk of isolation among older persons with CI, this novel study's documentation of inadequate and inconsistent information in homecare social need assessments and services is sobering. The findings suggest a pressing need for initiatives to formulate best practices and standards to ensure alignment of care service systems to the health needs of the growing group of aging individuals with CI.

  • 329.
    Nilsson, Ingeborg
    et al.
    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.
    Lundgren, Anna Sofia
    Umeå University, Faculty of Arts, Department of culture and media studies. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Meaning-making around experiences in interventions: Identifying meaningfulness in a group based occupational therapy intervention targeting older people2018In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 38, no 9, p. 1887-1911Article in journal (Refereed)
    Abstract [en]

    There is a need to understand the underlying mechanisms at work within health promotion and occupational therapy interventions. The aim of this article was, therefore, to explore and describe how the participants of a group-based occupational therapy intervention with positive health outcomes created meaning of and around their experiences of the intervention. The studied intervention was part of the evaluation of a single-blinded, exploratory randomised controlled trial of three different interventions. A total of 19 participants between 77 and 82 years of age with experiences from the group-based intervention were interviewed, and the transcribed interviews were analysed from a constructivist approach. The results showed five different perspectives of meaning, including enjoyment, usefulness, togetherness, respect for individuality and self-reflection. Based on our findings, we argue that the possibility of getting information, sharing with others and having fun, and the ability to adjust the activities in the intervention so that they met the individual's needs, created meaning for the participants. Moreover, meeting with others supported the participants’ perspectives of themselves. The results are discussed in relation to the pervasive discourse of successful ageing, including how it was present but also challenged within the participants’ accounts of the intervention.

  • 330.
    Nilsson, Ingeborg
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Center for Population Studies, Ageing and Living Conditions Programme, Sweden.
    Lundgren, Anna Sofia
    Umeå University, Faculty of Arts, Department of culture and media studies. Center for Population Studies, Ageing and Living Conditions Programme, Sweden .
    Liliequist, Marianne
    Umeå University, Faculty of Arts, Department of culture and media studies. Center for Population Studies, Ageing and Living Conditions Programme, Sweden .
    Occupational well-being among the very old2012In: Journal of Occupational Science, ISSN 1442-7591, E-ISSN 2158-1576, Vol. 19, no 2, p. 115-126Article in journal (Refereed)
    Abstract [en]

    Background: Limited knowledge is available on how very old people orchestrate and carry out their occupational life to achieve a sense of occupational well-being.

    Study objectives: To highlight very old persons’ ways of describing and discussing their occupational engagement in relation to a sense of occupational well-being.

    Methods: Qualitative interviews were conducted with 48 men and women between 90 and 98 years of age in their urban homes. Data were analysed using qualitative content analysis.

    Results: The results show that occupational engagement in relation to the surrounding world and occupational engagement unconstrained by space and time were important in achieving occupational well-being. The surrounding world involves having contact with family, friends, and society as well as living up to a shared norm of being independent. Unconstrained by space and time includes thinking, planning and creating a narrative of life based on the past, present and future.

    Limitations: The present study contributes to the body of knowledge focusing on occupational engagement and how it is linked to health through occupational well-being among older people, however; it is not known to what degree the respondents were experiencing healthy ageing.

    Recommendations: Future studies should further develop the understanding of doing in relation to being among older people.

  • 331.
    Nilsson, Ingeborg
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    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.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Focus on leisure repertoire in the oldest old: the Umeå 85+ study2006In: Journal of Applied Gerontology, ISSN 0733-4648, E-ISSN 1552-4523, Vol. 25, no 5, p. 391-405Article in journal (Refereed)
    Abstract [en]

    This study elucidates the oldest olds’ leisure repertoire and how this repertoire varies due to gender, where they live, and cognitive status. A validated 20-item leisure interest checklist with four subscales was used to measure leisure participation and investigate the leisure repertoire among participants. The oldest old were most likely to be interested in, perform, be motivated for, and perceive well-being from social activities, cultural activities, and TV/video/movies. The respondents were least likely to be interested in, perform, be motivated for, and perceive well-being from equipment sports and ball games. Some gender, geographic differences, and differences in cognitive status were found. The oldest old were more likely to endorse the same activities across all subscales of the checklist, but the linear magnitude varied across sub-scales. The relationships between performance and the other subscales suggested that a sense of engagement or participation is related to actual performance.

  • 332.
    Nilsson, Ingeborg
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Nyqvist, Fredrika
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Nygård, Mikael
    Leisure engagement: Medical conditions, functional limitation and disability - A later life perspective2015In: Journal of Aging Research, ISSN 2090-2204, E-ISSN 2090-2212Article in journal (Refereed)
    Abstract [en]

    Objectives. This study aims to investigate the impact of medical conditions, mobility difficulties, and activity limitations on older people's engagement in leisure activities. Methods. The analyses are based on a cross regional survey carried out in 2010 in the Bothnia region (Northern Sweden and Western Finland). A posted questionnaire, which included questions on different aspects of leisure engagement, medical history, and health, was sent out to older persons in the region. The final sample consisted of 5435 persons aged 65, 70, 75, and 80 years. The data was analyzed by using ordinary least squares (OLS) multivariate regression. Results. The most important predictor of leisure engagement abstention among older people is the prevalence of activity limitations, whereas mobility difficulties and medical conditions play less important roles. The strong negative association between activity limitations and leisure engagement remains significant even after we control for individual, sociodemographic characteristics, and country. Discussion. This study provides a window into leisure engagement in later life and factors influencing the magnitude of engagement in leisure activities.

  • 333.
    Nilsson, Ingeborg
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Townsend, Elizabeth
    School of Occupational Therapy, Dalhousie University, Halifax, Canada.
    Occupational justice: bridging theory and practice2014In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, no suppl 1, p. 64-70Article in journal (Refereed)
    Abstract [en]

    The evolving theory of occupational justice links the concept to social justice and to concerns for a justice of difference: a justice that recognizes occupational rights to inclusive participation in everyday occupations for all persons in society, regardless of age, ability, gender, social class, or other differences. The purpose of this descriptive paper is to inspire and empower health professionals to build a theoretical bridge to practice with an occupational justice lens. Using illustrations from a study of leisure and the use of everyday technology in the lives of very old people in Northern Sweden, the authors argue that an occupational justice lens may inspire and empower health professionals to engage in critical dialogue on occupational justice; use global thinking about occupation, health, justice, and the environment; and combine population and individualized approaches. The authors propose that taking these initiatives to bridge theory and practice will energize health professionals to enable inclusive participation in everyday occupations in diverse contexts.

  • 334.
    Nilsson, Ingeborg
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Townsend, Elizabeth
    Dalhousie University.
    Occupational justice: bridging theory and practice2010In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 17, no 1, p. 57-63Article in journal (Refereed)
    Abstract [en]

    The evolving theory of occupational justice links the concept to social justice and to concerns for a justice of difference: a justice that recognizes occupational rights to inclusive participation in everyday occupations for all persons in society, regardless of age, ability, gender, social class, or other differences. The purpose of this descriptive paper is to inspire and empower health professionals to build a theoretical bridge to practice with an occupational justice lens. Using illustrations from a study of leisure and the use of everyday technology in the lives of very old people in Northern Sweden, the authors argue that an occupational justice lens may inspire and empower health professionals to engage in critical dialogue on occupational justice; use global thinking about occupation, health, justice, and the environment; and combine population and individualized approaches. The authors propose that taking these initiatives to bridge theory and practice will energize health professionals to enable inclusive participation in everyday occupations in diverse contexts.

  • 335. Nilsson, Maria H
    et al.
    Hariz, Gun-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Iwarsson, Susanne
    Hagell, Peter
    Walking ability is a major contributor to fear of falling in people with Parkinson's disease: implications for rehabilitation2012In: Parkinson's Disease, ISSN 2090-8083, E-ISSN 2042-0080, Vol. 2012, p. 713236-Article in journal (Refereed)
    Abstract [en]

    Although fear of falling (FOF) is common in people with Parkinson's disease (PD), there is a lack of research investigating potential predictors of FOF. This study explored the impact of motor, nonmotor, and demographic factors as well as complications of drug therapy on FOF among people with PD. Postal survey data (including the Falls Efficacy Scale, FES) from 154 nondemented people with PD were analyzed using multiple regression analyses. Five significant independent variables were identified explaining 74% of the variance in FES scores. The strongest contributing factor to FOF was walking difficulties (explaining 68%), followed by fatigue, turning hesitations, need for help in daily activities, and motor fluctuations. Exploring specific aspects of walking identified three significant variables explaining 59% of FOF: balance problems, limited ability to climb stairs, and turning hesitations. These results have implications for rehabilitation clinicians and suggest that walking ability is the primary target in order to reduce FOF. Specifically, balance, climbing stairs, and turning seem to be of particular importance.

  • 336.
    Norberg, Eva-Britt
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Dagliga aktiviteter bland äldre personer med kronisk hjärtsvikt: begränsningar och möjligheter2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Chronic Heart Failure (CHF) is known to have a substantial impact on activities of daily living (ADL) and symptoms such as breathlessness and fatigue are characteristic. Despite this, research in occupational therapy concerning people with CHF is rare. The overall aim of this thesis was to increase the knowledge of ADL ability and fatigue among those with CHF, to describe experiences of limitations in occupational performance and the strategies that these elderly people use to manage their daily activities and also to describe a programme including energy conservation for clients with CHF in primary healthcare.

    Method Three groups of older people with a verified diagnosis of CHF and one group of occupational therapists (OTs), all recruited from primary healthcare, were analyzed. The ADL ability of 40 participants was described, with reference to dependence on others, perceived strain and quality of occupational performance. The association between ADL ability and the New York Heart Association Classification (NYHA), a functional classification for people with CHF, was analyzed. Fatigue and its association to ADL ability, use of assistive devices and community support were also analyzed. Ten respondents were then interviewed and asked to describe the strategies they used to manage ADL. The interview results were combined with the current body of research and CHF guidelines to form a base for the development of an intervention programme, including energy conservation, for people with CHF. The programme, based on the Occupational Therapy Intervention Process Model (OTIPM), was used by OTs in primary healthcare, and the clients’ ADL, goal achievements and use of energy conservation strategies were described, as well as the five clients’ and two OTs’ experiences of the program.

    Results Most participants were independent in personal ADL activities (PADL). A majority was dependent in one or more instrumental ADL activities (IADL) and perceived strain when performing the activities independently. The Assessment of Motor and Process Skills (AMPS) showed a reduced quality of occupational performance compared with healthy people of the same age. Age had a significant impact on ADL performance. Despite this, participants in NYHA III/IV showed significantly increased effort (under motor cutoff) when performing ADL tasks compared with those in NYHA I/II. Fatigue was common and greater fatigue was associated significant with increased dependence and decreased quality of occupational performance, with the exception of shopping. Participants who used assistive devices and home care estimated higher physical fatigue, but no correlation was found with community mobility services. Comorbidities, which can affect occupational performance, were common in all the studies.

    The participants experiences of limitations in occupational performance and the strategies that they used to manage their daily activities were described as redefining an active life, aware of one’s impaired body and planning activities and balancing the degree of effort.

    During the interventions according to the programme the clients’ increased their participation and independence in daily activities, consciously gave up what were less meaningful activities for them and deteriorated because of the progression of the CHF. Most goals were achieved and many energy conservation strategies were used by the clients. The clients’ experiences were described as working in collaboration to manage daily activities and using professional support from OTs to enhance their activities. The OTs’ experiences of the programme were described as being supported with specific knowledge and a structured way of working and finding clinical benefits from working according to the program, but doubt the possibilitiy of using it, due to constraints in clinical practice.

    Discussion The participants' physical fatigue and breathlessness had a negative impact on their ADL-ability. Age affected ADL performance, but the impact of a more severe CHF remained adjusted for age. An ongoing process of occupational adaptation due to periodical physical decline and fluctuating day-to-day ability was described. Many of the strategies used by the participants to handle daily activities could be described as energy conservation strategies, an indication that occupational therapy interventions including energy conservation management would be beneficial for clients with CHF. Both the OTs and the clients described that the specialized programme provided structure for the OTs’ work, knowledge about CHF and about valuable energy conservation strategies. The programme seemed to support the OTs to work in a more comprehensive client-centered way.

    Conclusion The work with this thesis has increased the limited existing knowledge about elderly people with CHF and their ADL ability, fatigue and the adaptation of occupational performance that they use to manage their daily activities. The experiences indicated that a specialized programme including energy conservation for occupational therapy in primary healthcare seemed to support the OTs work in a more comprehensive client-centered way. The programme needs to be further evaluated.

  • 337.
    Norberg, Eva-Britt
    et al.
    Skellefteå County Hospital, Skellefteå.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Department of Medicine, Skellefteå County Hospital, Skellefteå.
    Löfgren, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Activities of daily living for old persons in primary health care with chronic heart failure2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 2, p. 203-210Article in journal (Refereed)
    Abstract [en]

    Chronic heart failure (CHF) is a common condition among Europe's aging population. Findings indicate that CHF patients must make significant changes in many aspects of daily life. Previous studies of older primary health-care participants and their activities of daily living (ADL)-ability are rare. The aim of this study was to describe ADL-ability in older people with CHF syndrome. The factors considered were dependence on others, perceived strain, quality of performance, and the association between The New York Heart Association classification (NYHA) and ADL-ability. The participants, recruited from a primary health-care centre, had symptoms indicating CHF and were diagnosed by a cardiologist. Forty persons over 65 years (mean age 81), participated in the study and self-reported co-morbidity was frequent. The Assessment of Motor and Process Skills (AMPS) and the Staircase of ADL were used to describe ADL-ability. Most participants were independent with respect to personal activities of daily living (PADL), and 75% were dependent in one or more instrumental activities of daily living (IADL), usually shopping. Most participants perceived strain, and only three could perform all ADL without strain. Age had a significant impact on ADL performance (motor measures: OR 7.11, CI 1.19-42.32, p = 0.031 and process measures: OR 8.49, CI 1.86-38.79, p = 0.006). However, participants showed lower ADL motor and process ability in AMPS compared with well persons of the same age. Participants in NYHA III/IV (adjusted for age), had significantly increased effort (under motor cut-off) when performing ADL-tasks (OR: 15.5, CI 2.40-100.1, p = 0.004) compared to those in NYHA I/II. Older persons in primary health care with CHF exhibit a high amount of dependence, perceived strain and increased effort during performance of ADL. There is an association between NYHA class III/IV and a decreased ADL-ability (AMPS motor ability) even when adjusted for age.

  • 338.
    Norberg, Eva-Britt
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Löfgren, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Impact of fatigue on everyday life among older people with chronic heart failure2010In: Australian Occupational Therapy Journal, ISSN 0045-0766, E-ISSN 1440-1630, Vol. 57, no 1, p. 34-41Article in journal (Refereed)
    Abstract [en]

    Fatigue had a negative impact on ADL mainly from physical rather than from mental causes. Improved energy conservation strategies to reduce the consequences of fatigue are needed.

  • 339.
    Norberg, Eva-Britt
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Brännström, Margareta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Wennberg, Patrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Löfgren, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Experiences of a programme for occupational therapy for people with chronic heart failure: a case studyManuscript (preprint) (Other academic)
  • 340.
    Norberg, Eva-Britt
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Löfgren, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Brännström, Margareta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Occupational performance and strategies for manageing daily life among elderly with heart failureManuscript (preprint) (Other academic)
  • 341.
    Norberg, Eva-Britt
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Löfgren, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Wennberg, Patrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Brännström, Margareta
    Umeå University, Faculty of Medicine, Department of Nursing.
    A client-centred programme focusing energy conservation for people with heart failure2017In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 24, no 6, p. 455-467Article in journal (Refereed)
    Abstract [en]

    AIM: The purpose of this study was to describe clients and occupational therapists (OTs) experiences of a home-based programme focusing energy conservation strategies (ECS) for clients with chronic heart failure (CHF).

    METHODS: The programme, based on occupational therapy intervention process model (OTIPM), was led by two OTs in primary health care. Five clients' self-reported activities of daily living (ADL), fatigue, depression, goal achievements and use of ECS. Furthermore, both clients and OTs were individually interviewed.

    RESULTS: The clients reported mild depression, severe fatigue and both increased and decreased independence in ADL. Most goals were achieved, and multiple ECS were used. Clients perceived that they worked collaboratively with the OTs and gained professional support to enhance daily activities. The OTs experienced knowledge and structure and found benefits from the programme, but doubted the possibility of using it in clinical practice.

    CONCLUSIONS: This study, despite having few participants, indicates that both the OTs and the clients experienced that the specialized programme gave structure to the OTs work, provided knowledge about CHF and valuable energy conservation strategies. The programme supported the OTs in working in a more comprehensive client-centred way. However, its feasibility needs to be further evaluated.

  • 342.
    Norberg, Monika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Magnusson, Eva
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Thyme, Karin Egberg
    Åström, Sture
    Umeå University, Faculty of Medicine, Department of Nursing. Institutionen för Omvårdnad, kultur och hälsa, Universitet West, Trollhättan.
    Lindh, Jack
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Öster, Inger
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Breast Cancer Survivorship: Intersecting Gendered Discourses in a 5-Year Follow-Up Study2015In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 36, no 5, p. 617-633Article in journal (Refereed)
    Abstract [en]

    In this article we present a follow-up study of women's interview narratives about life five to seven years after a breast cancer operation. The women had taken part in a study during the six-month post-operation period. Art therapy contributed to well-being, including strengthening personal boundaries. In the new study, interview analysis informed by critical discursive psychology indicated three problematic discourses that the women still struggled with several years after the operation: the female survivor, the "good woman", individual responsibility. We concluded that many women with a history of breast cancer need support several years after their medical treatment is finished.

  • 343.
    Nordbrandt, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Delaktighet i gymnasieskolan: En intervjustudie med elever med neuropsykiatriska funktionsnedsättningar2017Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction: Reserch indicates limited participation for students with diasbilities.   

    Purpose: The purpose of this study is to describe how highschool students with neuropsychiatric disorders experience participation.

    Method: Participants were recruited by convenience sampling. 18 interviews were conducted utilizing the School Setting Interview (SSI). Results were analyzed based on theorybased quantitative analysis comparing six forms of participation; recognition, accessibility, autonomy, engagement, collaboration and belonging. These themes are described in more detail with subcategories.

    Results: The participants describe a need for recognition and understanding to get the support they need. Adaptations to their environment creates accessibility and collaboration.

    Strategies, assistant devices and personal support is perceived to promote autonomy.

    Interest, difficulty level, clear purposes and the ability to make choices are described as important factors of engagement along with routines and the students state of mind.

    Lack of participation occurs when students do not feel recognized or a sense of belonging, have difficulty concentrating, are disorganized or do not receive adequate information.

    Conclusion: The various ways in which participaton is described by the students may contribute to the understanding of needs for students with neuropsychiatric disorders. 

    The study indicates the importance of a studentcentered approach in schools where the students themselves are involved in assessing their needs for support.

  • 344.
    Nordlund, Malin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Sparv, Sonja
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Arbetsterapeuters erfarenheter av att arbeta med stressrelaterad ohälsa: En kvalitativ studie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Stress är ett stort och växande samhällsproblem och personer med stressrelaterad ohälsa upplever ofta obalans i vardagen. Aktivitetsbalans är ett begrepp som används flitigt inom arbetsterapi eftersom arbetsterapeuten tillsammans med klienten har som mål att skapa aktivitetsbalans. Syfte: Syftet med studien var att belysa arbetsterapeutens erfarenheter av arbetsterapeutiska interventioner vid stressrelaterad ohälsa. Metod: En semistrukturerad telefonintervju med stöd av egenkonstruerad intervjuguide användes som datainsamlingsmetod och materialet analyserades genom kvalitativ innehållsanalys. Resultat: Studien resulterade i två huvudkategorier: ”arbetsterapeutens rehabiliteringsinsatser utifrån ett holistiskt perspektiv” och ”arbetsterapeutens utmaning med att fullgöra sin yrkesroll”. Arbetsterapeuterna uppgav att de genom ett klientcentrerat arbetssätt fungerade som vägledare och hjälpte patienterna med att uppnå aktivitetsbalans genom att strukturera, planera och prioritera vardagsaktiviteter. De ansåg arbetsterapeutiska interventioner som en viktig del i rehabiliteringen hos personer med stressrelaterad ohälsa. Slutsats: Generellt ansåg arbetsterapeuterna att arbetsterapeutiska insatser vid stressrelaterad ohälsa som adekvat. Arbetsterapi upplevdes ge bra effekt tack vare individanpassade interventioner och konkreta resultat samt övervägande nöjda patienter.

  • 345.
    Norrlid, Niclas
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Joakim, Svanhult
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Aktivitetens betydelse för immigranter vid integration till svenska samhället: En kvalitativ studie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Migrationen till Sverige har sedan 2014 ökat markant och ställer större krav på det svenska samhället än tidigare, avseende resurser och kunskap inom integrationsprocessen. För att hålla den svenska integrationspolitikens målsättning där alla svenska medborgare ska ha samma rättigheter, möjligheter och skyldigheter i Sverige, krävs ett effektivare tillvägagångssätt i integrationsprocessen för nyanlända. Syftet var att belysa förhållanden som av immigranter upplevs påverka möjligheterna till integrationsfrämjande aktiviteter. Studien utgår från en kvalitativ ansats med semistrukturerade intervjuer. Sammanlagt intervjuades sex personer varav en kvinna och fem män i åldrarna 22 – 37 år. Den insamlade datan analyserades med hjälp av en kvalitativ innehållsanalys och resulterade i två huvudteman och nio teman. Resultatet visar att immigranter upplever asylperioden som en hindrande tid där tillgång till meningsfulla aktiviteter, möjligheterna till arbete, utbildning och social interaktion med svenskar är begränsade. De nyanlända menar att aktiviteter har varit betydelsefullt för deras upplevelse av delaktighet, meningsfullhet, hälsa och integration till det svenska samhället. Arbetsterapeuten kan ha en nyckelroll till att möta immigranternas upplevelser av hinder i början av integrationsprocessen och möjliggöra en god integration till samhället genom  meningsfulla aktiviteter.

  • 346.
    Nygren, Ulla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. Umeå University, Faculty of Social Sciences, Department of Social Work.
    Individual placement and support (IPS) i en socialpsykiatrisk kontext: en väg till arbete för personer med psykiskt funktionshinder?2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [sv]

    Introduktion

    Delaktighet i arbete är för de allra flesta människor en önskad och viktig aktivitet av många olika anledningar, men för personer med en psykisk sjukdom är inklusionen i arbetslivet begränsad. I Sverige är en psykiatrisk diagnos den vanligaste orsaken till sjukskrivning och värst är situationen för unga personer (2011). Det finns ett mycket stort behov av rehabilitering till arbete för personer med en psykisk sjukdom. En metod för detta är Individual Placement and Support (IPS), som internationellt betraktas som den mest effektiva insatsen för att hjälpa dessa personer till anställning. Syftet med denna avhandling är att undersöka IPS i en socialpsykiatrisk kontext med avseende på arbetsrelaterade och icke arbetsrelaterade utfall, prediktorer för anställning och deltagarnas uppfattning om kompetens i vardagen. Ett ytterligare syfte var att beskriva det kvalitativa innehållet i IPS-insatsen ur klienternas och IPS-coachernas perspektiv.  

    Metod

    Forskningsprojektets kontext utgjordes av två IPS-verksamheter, vilka var organiserade i respektive kommuns socialtjänst som tidsbegränsade projekt. Sextiofem män och kvinnor med olika psykiska sjukdomar som deltog i verksamheternas IPS-program inkluderades i studien. Arbetsrelaterade data rapporterades varannan månad av IPS-coacherna under två års uppföljning och innefattade: typ av sysselsättning och omfattning, typ och omfattning av IPS-insats, samt beskrivningar av vad som underlättat respektive försvårat i arbetet med klienterna. Icke arbetsrelaterade data samlades in vid baseline, vid 12 månader och vid 24 månader: psykiatriska symtom, självkänsla, livskvalitet, generellt psykosocialt fungerande, aktivitetskompetens och aktivitetsvärdering, samt delaktighet. Deltagarna intervjuades också vid 12 och 24 månader. Data analyserades i olika kombinationer i de fyra delstudier som är inkluderade i avhandlingen. Mest användes icke-parametrisk statistik, men också Rasch-analyser. I den sista delstudien tillämpades en kvalitativ fallstudiemetodik.

    Resultat

    Tjugofem procent var vid något tillfälle under det första året i anställning och ytterligare 14 procent var engagerade i reguljära studier. Alla utom fyra av deltagarna var vid något tillfälle i sysselsättning i någon form, mestadels i arbetsträning på vanlig arbetsplats. Omfattningen av anställning, studier och arbetsträning under det första året varierade mellan endast en vecka till 41 veckor. En liknande variation fanns i antalet timmar i sysselsättning. Deltagare i någon form av sysselsättning vid 12 månader visade positiva förändringar över tid med avseende på psykiatriska symtom (p=0.000) och psykosocialt fungerande (p=0.000). Dessa personer var också mer tillfredsställda med sin sysselsättningssituation (p=0.009). Tre potentiella prediktorer för anställning kunde identifieras, men bara psykiatriska symtom kvarstod som signifikant på en nivå av p<0.05. En lägre grad av psykiatriska symtom ökade oddset med 5.5 för att uppnå anställning under ett år. Generellt skattade deltagarna värdet av att kunna utföra olika aktiviteter i vardagen högre än hur de skattade sin förmåga att utföra dessa. Kliniskt meningsfulla glapp återfanns bland de mest värderade som handlade om att kunna sköta sin ekonomi och sina grundläggande behov, samt att kunna göra det man tycker om att göra. Flera av de aktiviteter som uppfattades som svårast att utföra är relaterade till förmågor av betydelse för att uppnå anställning. Fallstudien illustrerade komplexa processer i IPS-interventionen. En av dessa visade på betydelsen av reflekterade erfarenheter för klienters omkonstruktion av sina aktivitetsidentiteter och betydelsen av kontinuitet för att kunna göra det.

    Diskussion

    Deltagandet i IPS-programmen resulterade i sysselsättningsförändringar för de allra flesta av deltagarna, men proportionen i anställning var låg i jämförelse med de allra flesta internationella resultat. Komplexa processer uppstod på vägen i riktning mot arbete och både i de framgångsrika och mindre framgångsrika fallen, avseende anställning, förändrades personernas upplevelse av sig själva som aktörer. IPS är betraktad som evidensbaserad för personer med allvarlig psykisk sjukdom, vilket vanligen inkluderar personer med schizofreni och andra psykossjukdomar, men den undersökta gruppen av deltagare dominerades av personer med olika tillstånd av ångest och depression och relativt många personer hade neuropsykiatriska diagnoser. I kontrast till många andra studier av IPS, identifierades en lägre grad av psykiatriska symtom utgöra en prediktor för att bli anställd. Deltagarnas uppfattning om aktivitetskompetens och värdering av kompetens visade att det fanns glapp däremellan, som är viktiga att uppmärksamma när insatser ges i syfte att främja utvecklingen av värderad kompetens bland personer med psykiskt funktionshinder.

    Slutsats

    Denna avhandling representerar ett av de första försöken att studera IPS i en svensk kontext som kännetecknas av att det är socialtjänsten som är delvis ansvarig för psykiatrisk rehabilitering. Interventionen kan betraktas som användbar, men designen på denna studie tillåter inte att dra slutsatser om dess effektivitet. Genom att samla mer detaljerad information från klienters och IPS-coachers erfarenheter är det möjligt att få syn på processer som uppstår i en IPS-intervention och några av de komponenter som är av speciell betydelse för denna. Konsekvenserna av att ha högre grad av psykiatriska symtom tycks vara en barriär mot att bli anställd. En viktig förutsättning för att kunna förverkliga IPS uppfattas vara koordinerade samarbeten mellan de involverade aktörerna.

  • 347.
    Nygren, Ulla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Markström, Urban
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Processes towards employment among persons with psychiatric disabilities: a study of two individual placement and support programmes in Sweden2016In: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 18, no 1, p. 32-51Article in journal (Refereed)
    Abstract [en]

    Individual placement and support (IPS) has been found to be an effective intervention for rehabilitation to work in the field of mental health. Being as the principles used in IPS reflect core values in the concept of personal recovery, several other outcomes than just the percentage of clients gaining employment are of interest. The purpose of the study was to describe a number of unique processes and analyze these with a special concern for circumstances perceived as important for the individual IPS process. A collective instrumental case-study design was used and five cases were included. Data from three different sources were collected, both quantitative and qualitative. The findings illustrate how a relationship characterized by curiosity, interest and engagement in the individual client, positive risk-taking and time for reflected experiences resulted in processes of change. It was concluded that providing IPS is a type of specialized relationship-based work that includes advanced problem solving.

  • 348.
    Nygren, Ulla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Markström, Urban
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Unique processes towards employment within an IPS-programme: illustrated by five casesManuscript (preprint) (Other academic)
    Abstract [en]

    Individual Placement and Support (IPS) is a well known intervention for rehabilitation to work in the field of psychiatric rehabilitation. The development of high fidelity IPS-programmes is of great importance for getting successful outcomes in terms of the percentage of clients competitively employed. Since the philosophy used in IPS reflects core values in the concept of personal recovery, several other outcomes would also be of interest and importance for improving the quality of IPS. The purpose was to analyse and describe a number of unique processes with special concern to situations, circumstances and events perceived as of importance for the IPS intervention. A collective instrumental case-study was used and five cases were included, three women and two men enrolled in one of two IPS programmes. Data from three different sources were collected, both quantitative and qualitative. For analysing the qualitative data, an approach of directed content analysis was used. The findings illustrate how a relation marked by curiosity, interest and engagement in the individual client, positive risk-taking and time for reflected experiences resulted in unique processes of change. It was concluded that doing IPS is a kind of pronounced relation based work which includes advanced problem solving.

  • 349.
    Nygren, Ulla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Markström, Urban
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Svensson, Bengt
    Institutionen för hälsovetenskap.
    Hansson, Lars
    Institutionen för hälsovetenskap.
    Sandlund, Mikael
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Predictors of vocational outcomes using individual placement and support for people with mental illnessManuscript (preprint) (Other academic)
    Abstract [en]

    Objective: People with disabilities find it harder to enter the labour market than people without disabilities and those with a mental illness are, in relation to people with other disabilities, employed at an essentially lower extent. Many are effectively helped by the vocational rehabilitation model Individual Placement and Support (IPS), but there are still many individuals left in undesired unemployment. This study investigates potential predictors of the vocational outcomes of a one-year follow up of IPS in the north of Sweden.

    Participants: The participants were 65 men and women, mostly younger than 30 years of age predominantly with a diagnosis of anxiety and/or depression.

    Methods: Baseline data related to sociodemographic and clinical characteristics of the client, the client’ own perceptions of every day living and participation, self-esteem and quality of life, as well as  the quantity of employment support, were investigated using analyses of  logistic regression.

    Results: Of three identified potential predictors, only psychiatric symptoms remained significant in the multivariate logistic regression analyses. A lower level of symptoms increased the odds with 5.5 for gaining employment during one year.

    Conclusions: Careful investigation of how psychiatric symptoms influence clients’ occupational performance is of importance. By understanding essential aspects of the relationships between the clients´ individual characteristics, the rehabilitation context and the vocational outcomes, more appropriate and effective interventions may be offered to the individual client.

  • 350.
    Nygren, Ulla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Markström, Urban
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Svensson, Bengt
    Lund Univ, Dept Hlth Sci, Lund, Sweden.
    Hansson, Lars
    Lund Univ, Dept Hlth Sci, Lund, Sweden.
    Sandlund, Mikael
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Predictors of vocational outcomes using Individual Placement and Support for people with mental illness2013In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 45, no 1, p. 31-39Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: People with disabilities find it harder to enter the labour market than people without disabilities and those with a mental illness are, in relation to people with other disabilities, employed at an essentially lower extent. Many are effectively helped by the vocational rehabilitation model Individual Placement and Support (IPS), but there are still many individuals left in undesired unemployment. This study investigates potential predictors of the vocational outcomes of a one-year follow up of IPS in the north of Sweden. PARTICIPANTS: The participants were 65 men and women, mostly younger than 30 years of age diagnosed with a mental illness (predominantly with a diagnosis of anxiety and/or depression). METHODS: Baseline data related to sociodemographic and clinical characteristics of the client, the client's own perceptions of every day living and participation, self-esteem and quality of life, as well as the quantity of employment support, were investigated using analyses of logistic regression. RESULTS: Of three identified potential predictors, only psychiatric symptoms remained significant in the multivariate logistic regression analyses. A lower level of symptoms increased the odds with 5.5 for gaining employment during one year. CONCLUSIONS: Careful investigation of how psychiatric symptoms influence clients' occupational performance is of importance. By understanding essential aspects of the relationships between the clients' individual characteristics, the rehabilitation context and the vocational outcomes, more appropriate and effective interventions may be offered to the individual client.

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