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  • 351.
    Viklund, Caroline
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Koskenniemi, Yvette
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    När energin tar slut: Upplevelser av hjärntrötthet efter stroke2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Personer som drabbas av stroke upplever i efterförloppet ofta så kallad hjärntrötthet, vilket kan innebära stora omställningar i vardagen. Höga krav i dagens samhälle kan göra att hjärntrötthet blir en svår funktionsnedsättning att hantera. Tidigare forskning har visat att det saknas kunskap om individers upplevelse av vad hjärntrötthet innebär. Syftet med studien var att undersöka upplevelsen av hjärntrötthet och dess inverkan på vardagen hos dem som drabbats av stroke. Semistrukturerade intervjuer genomfördes med fem personer i åldrarna 47-58 år som alla hade erfarenhet av hjärntrötthet efter stroke. Intervjuerna bearbetades med hjälp av kvalitativ innehållsanalys. Analysen resulterade i de fem huvudkategorierna; ’Hjärnan får inte plats’, ’Att sakna energi’, ’En förändring som är svår att acceptera och förstå’, ’Att försöka hitta balansen’, ’Intryck är jobbigt’. Viljan att hitta strategier för att hantera tröttheten och energilösheten var centralt hos deltagarna. Deltagarna upplevde att det var svårt att förklara och beskriva hjärntrötthet för andra människor. Information till anhöriga, arbetsplatsen och den närmaste omgivningen angående vad hjärntrötthet innebär skulle öka förståelsen enligt deltagarna. Arbetsterapeutiska interventioner kan stötta personer att hantera hjärntröttheten i vardagen. Arbetsterapeuten har en viktig roll i rehabiliteringen för att stödja personer som drabbats av stroke och deras anhöriga för att lära sig hantera en förändrad livssituation.

  • 352.
    Vikström, Linda-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Aktiviteters effekt på neuropsykiatriska symtom hos personer med demens: - En litteraturstudie2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Abstrakt

    I Sverige finns 148 000 invånare som har en demenssjukdom. De neuropsykiatriska symtom som kan uppstå i samband med sjukdomen kan orsaka en försämrad livskvalitet för personen med demens. Syftet med studien var att studera aktivitetsbaserade interventioners effekt på neuropsykiatriska symtom som apati, agitation och depression hos personer med demens. För att besvara studiens syfte utfördes en litteraturstudie som inkluderade sex studier. Resultatet av den aktuella studien visade att aktiviteter kan ha både positiv och negativ inverkan på neuropsykiatriska symtom hos personer med demens. De interventioner som verkar vara gynnsamma hade ett fokus på klientens intresse. Då antalet studier är begränsat i denna litteraturstudie bör ytterligare studier genomföras för att öka förståelsen kring aktiviteters inverkan på neuropsykiatriska symtom.

     

    Sökord: icke farmakologiska interventioner, demenssjukdom, apati, depression och agitation.

  • 353.
    Vllasalihu, Shyhrete
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Arbetsterapeutiska interventioner i multiprofessionell fallprevention för äldre personer: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Fallolyckor hos den ökande gruppen äldre orsakar mycket lidande, hälsoproblem och stora kostnader för samhället. Syftet med denna studie var att beskriva arbetsterapeutiska interventioner i multiprofessionell fallprevention och effekter av dessa interventioner för personer 60 år eller äldre. Studien genomfördes som en litteraturstudie där systematisk sökning utfördes i olika databaser.  Sex kvantitativa orginalartiklar som publicerarats mellan 2008–2014 har granskats, analyserats och sammanställts i olika kategorier. Sammanfattningsvis visade studien att multiprofessionell fallprevention kan förebygga fall genom att minska fallolyckor, fallskador, fallrädsla och fallrisker i hemmet och underlätta utförandet av dagliga aktiviteter. Arbetsterapeuten beskrevs ha kompetens och kunskap för att i multiprofessionella interventioner kunna identifiera fallrisker i den äldres hemmiljö samt ge förslag på hur miljön och aktivitetsutförandet kan anpassas för att förebygga fallolyckor.

  • 354.
    Voxendal, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Bildterapeuters beskrivning av uppgiften ”måla ett träd” i bildterapi med vuxna2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Uppgiften att måla ett träd används ofta inom bildterapi. Studiens syfte var att undersöka hur några bildterapeuter beskrev uppgiften att måla ett träd och sitt användande av uppgiften i bildterapi med vuxna. Hur motiverar bildterapeuterna sitt val av uppgiften? Hur läggs sessionen upp praktiskt? Hur används den färdiga bilden? Sex bildterapeuter intervjuades med semi-strukturerade intervjuer och materialet analyserades enligt Interpretative Phenomenological Analysis (Smith & Osborn, 2003). Resultatet bestod av tre överordnade teman: Trädtemat är enkelt och informationsrikt, Bildterapeuterna skapar förutsättningar för skapande och Bildterapeuterna reflekterar men ger inga svar. Resultatet gav en rik bild av intervjupersonernas perspektiv på sin verksamhet. Många motiv till att använda uppgiften gavs, det praktiska upplägget samt samtalet kring bilden beskrevs.

  • 355.
    Vänglund, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Erfarenheter av stödinsatser i skolmiljö bland gymnasieelever med neuropsykiatriska funktionsnedsättningar.2015Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Abstract:   A successful schooling has proven to be an important factor in regards to students later on not experiencing alienation or mental illnesses. Pupils with neurodevelopmental disorders have in recent years attracted attention, and it has emerged that schools have lacking knowledge of these students’ issues. In 2013-2014, a project was carried out in a medium-sized town in Sweden on structural interventions for high-school students with neurodevelopmental disorders. Aim: The aim of this study was to gain a deeper understanding of how high school students with neurodevelopmental disorders experience their situation in the school and leisure environment, and how structure-related interventions in the school environment affect their ability to perform activities in the school environment and how it affects their general well-being. Method: Nine students in the age of 17 to 20 were recruited through strategic selection. Semi-structured interviews were conducted. A content analysis with an hermeneutic approach was used to analyze the data. The result: The analysis resulted in a main theme, "To be seen and heard", as well as three categories: "To handle demands in school", "Life outside the school" and "Support to deal with difficulties and challenges in school". Conclusion: The results show that all students describe the support from student-coaches as having been significant for their schooling. The study highlights the importance of continuous, structure-related assistance as well as the importance of support from an adult they trust and who has knowledge about their unique difficulties and needs . The total amount of support has given the students the opportunity to complete their secondary education as well as having increased their general well-being.

     

  • 356.
    Vänman, Cecilia
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Wennberg, Johanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    “Mind the GAP”: Aktivitet, delaktighet och hälsorelaterad livskvalitet hos personer som behandlas med Duodopa för avancerad Parkinsons sjukdom2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Personer med Parkinsons sjukdom (PS) som behandlas med Duodopa, har ofta en avancerad form av sjukdomen. Detta kan påverka alla delar av livet med negativ inverkan på personens välmående. Studiens syfte var att undersöka självskattad förmåga, delaktighet och hälsorelaterad livskvalitet i vardagen, hos personer med avancerad Parkinsons sjukdom som behandlas med Duodopa. Data samlades in via postenkäter (inklusive instrumenten Parkinson's Disease Activities of Daily Living Scale (aktivitet), GAP i vardagens aktiviteter (delaktighet) och Parkinson's Disease Quality of Life Questionnaire-39 (hälsorelaterad livskvalitet) från 20 personer med avancerad Parkinsons sjukdom. Resultatet visade begränsningar i aktivitet, delaktighet och hälsorelaterad livskvalitet hos personerna med PS. Det fanns signifikanta samband mellan aktivitet, delaktighet och hälsorelaterad livskvalitet. Ett signifikant samband påvisades även mellan instrumentens respektive ADL-områden. Deltagarna hade mindre aktivitetsbegränsningar än förväntat, troligen till följd av en positiv behandlingseffekt. Vår studie är den första som använder GAP för att mäta delaktighet hos personer med avancerad PS, vilket visade på en otillfredsställande delaktighet hos personerna. Vid en kronisk sjukdom såsom PS påverkas olika områden inom hälsorelaterad livskvalitet i varierande grad. Detta visar att Parkinsons sjukdom är komplex och påverkar varje person individuellt, vilket är en viktig kunskap för arbetsterapeuten i arbetet med klienten.

  • 357.
    Waehrens, Eva Ejlersen
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Ergoterapeutiske redskaber: undersøgelse og evaluering2008Book (Other academic)
  • 358.
    Waehrens, Eva Ejlersen
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Measuring quality of occupational performance based on self-report and observation: development and validation of instruments to evaluate ADL task performance2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background People with rheumatic or neurologic conditions are commonly referred for occupational therapy because of decreased ability to perform ADL tasks. Upon referral, occupational therapists use a client-centred, occupationfocused approach when evaluating a person's perceived and observed quality of ADL task performance to clarify the nature and extent of the person’s problems, plan interventions and determine effectiveness of interventions. Evaluation of the extent of problems and change following intervention require the use of linear measures of ADL. The aim of this doctoral thesis was to develop and validate linear measures of perceived and observed quality of ADL task performance for occupational therapy clinical praxis and research.

    Methods To develop linear measures of observed quality of ADL task performance based on Rasch measurement methods, clients with ABI (n=70) were evaluated using a 3-category rating scale and the ADL Taxonomy. Similarly, to develop linear measures of perceived quality of ADL task performance women with rheumatic diseases (n=118) reported their ability on a questionnaire and in an interview based on the ADL Taxonomy and a 4- category rating scale. To further validate the ADL ability measures of the Assessment of Motor and Process Skills (AMPS) data were collected in two samples. In a sample of women with chronic widespread pain (CWP) or fibromyalgia (FM) (n=50) the ADL ability measures were validated with regard to discrimination, stability and sensitivity to changes. Discrimination was examined by comparing AMPS data from women with CWP/FM to those of healthy women. Stability and sensitivity to change were examined based on repeated AMPS observations pre and post intervention. In addition, sensitivity to change was examined in a sample of clients with ABI (n=36) using a pre- and post-test design. Finally, the validity of the AMPS ADL ability measures in relation to perceived ADL ability was examined in women with rheumatic diseases (n=118) and women with CWP/FM (n=50).

    Results Based on the results of the four studies in this thesis, we were able to conclude that it was possible to obtain linear measures of observed quality of ADL task performance based on a revised version of the ADL Taxonomy (ADL-O). It was also possible to obtain linear measures of perceived quality of ADL task performance based on revised versions of the ADL Taxonomy using the formats of questionnaires (ADL-Q) and interviews (ADL-I). Moreover, it was possible to establish further evidence of validity of the ADL ability measures of the AMPS. Thus, the AMPS ADL ability measures could discriminate between women with CWP/FM and healthy women. The ADL ability measures of remained stable when no intervention was provided and the ADL motor ability measures were sensitive to change among women with CWP/FM. Moreover, the ADL ability measures were sensitive to change among clients with low ADL ability following ABI. Finally, only low to moderate correlations were found between measures of perceived and observed ADL ability.

    Conclusions Rasch analyses of revised versions of the ADL Taxonomy suggest that the majority of the ADL tasks and rating scales focused on quality of ADL task performance can be used to obtain linear measures of quality of ADL task performance based on methods of questionnaire, interview or observation. Furthermore, the studies provided evidence of validity of the ADL ability measures of the AMPS in relation to discrimination, stability and sensitivity to change and relation to perceived ADL ability. The results may, therefore, enhance the use of ADL instruments that provide linear measures of perceived and observed quality of ADL task performance in occupational therapy clinical praxis and research.

  • 359.
    Waehrens, Eva Ejlersen
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Amris, K
    Fisher, Anne G
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Observation-based assessment of ADL ability among women with chronic widespread painArticle in journal (Other academic)
  • 360.
    Waehrens, Eva Ejlersen
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. The Parker Institute, Frederiksberg Hospital, Denmark.
    Amris, Kirstine
    Fisher, Anne G.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Performance-based assessment of activities of daily living (ADL) ability among women with chronic widespread pain2010In: Pain, ISSN 0304-3959, E-ISSN 1872-6623, Vol. 150, no 3, p. 535-541Article in journal (Refereed)
    Abstract [en]

    Functional ability, including the ability to perform activities of daily living (ADL), is considered a core outcome domain in chronic pain clinical trials and is usually assessed through generic or disease-specific self-report questionnaires. Research, however, indicates that self-report and performance-based assessment of ADL offer distinct but complementary information about ability. The present study, therefore, investigated the applicability of a performance-based measure of ADL ability, the Assessment of Motor and Process Skills (AMPS), among 50 women with chronic widespread pain. The investigated psychometric properties of the AMPS included discrimination between a sample of healthy women and those with chronic widespread pain, as well as stability when no intervention was provided and sensitivity to change following intervention. Data were obtained based on a repeated measures design performing AMPS evaluations twice pre- and twice post-rehabilitation. Results indicated that the ADL motor ability measures of the participants were significantly lower than those of healthy women of same age, the ADL motor and ADL process ability measures remained stable when no intervention was provided and the ADL motor ability measures were sensitive to change following a 2-week interdisciplinary rehabilitation program. A weak correlation (r(s) = -0.35) was found between self-reported ADL ability as measured by the physical function subscale of the Functional Impact Questionnaire (FIQ) and performance-based ADL motor measures, and no correlation (r(s) = -0.02) was found between FIQ ADL measures and ADL process ability, supporting the need for both performance-based and self-reported assessment of ADL. (C) 2010 International Association for the Study of Pain.

  • 361.
    Waehrens, Eva Ejlersen
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Bliddal, H
    Danneskiold-Samsöe, B
    Lund, H
    Fisher, Anne G
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Differences between questionnaire- and interview-based measures of ADL ability and their association to observed ADL ability in women with rheumatiod arthritis, knee osteoarthritis and fibromyalgiaArticle in journal (Other academic)
  • 362.
    Waehrens, Eva Ejlersen
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Fischer, Anne G
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Developing linear ADL ability measures based on the ADL taxonomy: a Rasch analysis2009In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 16, no 3, p. 159-171Article in journal (Refereed)
    Abstract [en]

    Purpose. The aim of this pilot study was to explore the possibility of developing linear measures of ADL ability based on the ADL Taxonomy and a three-category rating scale.

    Method. Data were obtained from medical records of adults with moderate to severe brain injury. The participants were rated on the ADL taxonomy, and recorded on the ADL Taxonomy Circle, based on direct observations. By applying the Rasch rating scale model, we examined the possibility of converting the raw ordinal scores into equal-interval estimates of the participants’ ADL ability.

    Results. The data analysis indicated that the rating scale used in this study displays sound psychometric properties. Items from the ADL taxonomy defined one construct after 10 actions were removed, but retention of all items did not disrupt the measurement system. Except for one item in each of five different activity domains, the item difficulty hierarchy was the same as in the hierarchy originally published, supporting reliability of the item difficulty estimates. The ADL taxonomy discriminated well between different levels of ability in this sample of persons with brain injury.

    Conclusion. This preliminary study indicates that the ADL taxonomy has potential to become a linear measure of a person's ability to perform ADL tasks.

  • 363.
    Waehrens, Eva Ejlersen
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Fisher, Anne
    Improving quality of ADL performance after rehabilitation among people with acquired brain injury2007In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 14, no 4, p. 250-257Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate whether people with brain injury show improvements in quality of performance of activities of daily living (ADL) after rehabilitation. A retrospective pre- and post-test design with no control group was used. Subjects received interdisciplinary rehabilitation consisting of restorative and compensatory strategies. Thirty-six adults with moderate to severe disability following acquired brain injury were evaluated using the Assessment of Motor and Process Skills (AMPS), an observational evaluation of the quality of ADL task performance. Paired t-tests revealed significant increase in ADL ability after intervention; effect sizes were medium. Improvements occurred across ages, within all diagnostic groups, and with no relation to time post-injury. It was concluded that people with moderate to severe disability following acquired brain injury improved in ADL ability after participating in an intensive, interdisciplinary rehabilitation programme. Although lack of a control group prevented a conclusively conclusion that the changes were due to the intervention provided, the fact that the subjects had shown slow spontaneous recovery and minimal improvements before the study was implemented supports the likelihood that their gains were largely the result of the intervention.

  • 364.
    Wallin, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Aho, Amanda
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Arbetsterapeuters uppfattning om instrumentet ’Frågor om aktivitetsmässigt välbefinnande’: En kvalitativ studie2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Abstrakt

    Två huvudantaganden inom arbetsterapi är att människors individuella upplevelser av meningsfull aktivitet bidrar till hälsa och välbefinnande samt att människans självupplevda hälsa och välmående kan påverkas av nedsatt aktivitetsförmåga. Dessa antaganden understöds i den arbetsterapeutiska litteraturen, vad som däremot ännu saknar god evidens är relationen mellan aktivitet och hälsa. På grund av denna bristfälliga kunskap uppkom syftet med föreliggande studie; att undersöka arbetsterapeuters uppfattning om påståendena och dess innebörd i instrumentet ‘Frågor om aktivitetsmässigt välbefinnande’. I studien inkluderades sex legitimerade arbetsterapeuter i varierande åldrar, av båda könen och med erfarenheter från olika verksamhetsområden. Sex kvalitativa intervjuer genomfördes och en kvalitativ innehållsanalys användes. Denna resulterade i fyra huvudkategorier som beskriver hur frågorna omfattar olika varianter av varande, aspekter av görande, den egna viljan och motivationen och att känna samhörighet med andra, dessa utgjordes vidare av elva underkategorier. Resultatet visar att påståendena bland annat uppfattas handla om att aktiviteter bör möta individens behov, att upplevelsen av aktivitet är subjektiv och att möjligheten till meningsfull aktivitet kan variera mellan personer. Slutsatsen är att denna studie bidrar till processen av att utveckla och validera instrumentet. Det framkom att de antaganden som instrumentet bygger på i flera fall motsvarar de områden som föreliggande studie beskriver även om andra, av instrumentet icke nämnda områden, också kan identifieras.

  • 365.
    Wanhatalo, Kerstin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Bildarbete med våldsutsatta kvinnor i nära relation: En kartläggning2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of the study is to describe if and how Art Therapy is used in treatment with survivors of interpersonal violence in municipal center as well as to describe the outcomes of Art Therapy for the service recipients. The method used is short interviews and survey. Forty-one (n=41) centers participated in the study. The result shows that eight centers uses Art Therapy, mainly in individual contacts. One outcome is increasing self-esteem. Women take space, show themselves through art. Art Therapy makes it easier to verbalize and makes it easier to remember. Women can respond to their feelings and Art Therapy give women acknowledgement that violence is not normal. One of the centers has evaluated their work and another center is planning one. One-third of the centers who are not using Art Therapy are expressing an interest in the method.

  • 366.
    Westin, Mikaela
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Jönsson, Emmie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Betydelsen av arbetsterapeutiska interventioner och rehabilitering för mental hälsa och livskvalitet hos patienter med stroke: En allmän litterturstudie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Stroke är en sjukdom som påverkar den mentala hälsan och livskvaliteten hos den drabbade. Författarna vill belysa vikten av arbetsterapeutiska interventioner och rehabilitering för patienter med stroke. Syftet med litteraturstudien var att belysa betydelsen av arbetsterapeutiska interventioner och rehabilitering för mental hälsa och livskvalitet hos patienter med stroke. Materialet till den kvantitativa litteraturstudien samlades in från databaserna CINAHL, PubMed, Psycinfo samt OT seeker. Alla artiklar kvalitetsgranskades med ett protokoll och analyserades utifrån likheter och skillnader. Studierna visade på att patientens livskvalitet påverkades negativt av depressiva symtom. De skadliga konsekvenserna av stroke reduceras om rehabilitering skedde i tidigt stadie efter insjuknandet, till exempel Post stroke depression (PSD) som var starkt associerad till låg livskvalitet. Konventionell arbetsterapeutisk behandling gav lika eller bättre effekt än teknologiska behandlingar. Arbetsterapi visade sig ha en positiv inverkan på patienternas mentala hälsa och livskvalitet. Författarna ser dock ett behov av ytterligare forskning i hur professionen kan förbättra bemötandet av den mentala hälsan hos patienter med stroke.  

  • 367.
    Westman, Lisa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    En kartläggning av tillgänglighet i gruppbostäder för rullstolsburna2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Många som bor i gruppbostäder och är rullstolsburna har behov av att den fysiska miljön är anpassad för att kunna vara delaktiga i sin egen dagliga livsföring. Syftet var att kartlägga tillgängligheten i boendemiljön för rullstolsburna personer som bor i gruppbostäder. Som metod för kartläggningen användes bedörnningsinstrumentet             Housing Enabler. Bedömningar gjordes i fyra gruppbostäder i centrala Härnösand, både i de gemensamma utrymmena och i en av lägenheterna i varje gruppbostad. Resultatet visar att det finns miljöhinder på samtliga gruppbostäder.  De flesta miljöhindren  som påträffades i de gemensamma utrymmena var vid entreer och i köket. I de egna lägenheterna påträffades de flesta  miljöhindren  i  köket och i hygienutrymmen. Slutsatser är att det inte var många miljöhinder som påträffades i gruppbostäderna trots att det var många komponenter som bedömdes. Det finns dock behov för mer forskning kring tillgänglighet och delaktighet för studiens persongrupp.

  • 368.
    Wicksell, Alexander
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Paulsson, Andreas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Förebyggande insatser för äldre som lever i ofrivillig ensamhet: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Var sjunde äldre upplever idag ensamhet och två av dessa upplever det som vanligt förekommande. En åldrande befolkning leder till en ökad risk för att fler äldre kommer uppleva ofrivillig ensamhet med psykisk ohälsa som följd. Genom aktivitet och delaktighet kan äldre förstärka det sociala nätverket, sociala stödet och uppnå högre välmående. Syftet med denna studie var att kartlägga aktivitetfokuserade interventioner som syftar till att minska ensamhet hos äldre som lever i ofrivillig ensamhet. I litteraturstudien utfördes sökningar med databaserna CINAHL, PubMed och PsycINFO. Åtta vetenskapliga artiklar valdes ut och granskades. I resultatet framkom tre olika teman; aktivitet och gemenskap, utbildning för ökad delaktighet i samhället och social interaktion genom informationsteknik. Fyra interventioner minskade ensamhet och alla inkluderade interventioner hade positiv inverkan på äldres välmående. Ensamhet kan förebyggas hos äldre med hjälp av interventioner riktade mot att stärka det sociala nätverket, sociala stödet och genom att utbilda äldre inom befintliga resurser. Studien lyfter fram aktivitetfokuserade interventioner som kan tillämpas för att förebygga upplevelsen av ensamhet. Det krävs mer omfattande forskning inom området för att kunna bekräfta studiens resultat.

  • 369.
    Wolpher, Nicole
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Att erbjuda skapande för att ersätta skadande: - en beskrivning av bildterapeuters erfarenheter av att behandla personer med självskadebeteende2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

  • 370.
    Wågberg, Caroline
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Jakobsson, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Upplevelser av att leva med Multipel Sklerosrelaterad fatigue: En litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

  • 371.
    Zingmark, Magnus
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Occupation-focused and occupation-based interventions for community-dwelling older people: Intervention effects in relation to facets of occupational engagement and cost effectiveness2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background

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

    Aim

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

    Method

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

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

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

    Results

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

    Conclusion

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

  • 372.
    Zingmark, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Community Care Administration, Municipality of Östersund, Östersund.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Meeting the needs of elderly with bathing disability2011In: Australian Occupational Therapy Journal, ISSN 0045-0766, E-ISSN 1440-1630, Vol. 58, no 3, p. 164-71Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 373.
    Zingmark, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Health and Social Care Administration, Municipality of Östersund, Sweden.
    Evertsson, Bodil
    Haak, Maria
    The content of reablement: Exploring occupational and physiotherapy interventions2019In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 82, no 2, p. 122-126Article in journal (Refereed)
    Abstract [en]

    Statement of context: Occupational therapists and physiotherapists in a Swedish municipality answered a web-based survey about their reablement interventions.

    Critical reflection on practice: There were overlapping areas as well as differences regarding the focus of occupational and physiotherapy interventions. Regarding the duration of interventions, occupational therapy was implemented over a short time span in contrast to physiotherapy, which had a longer duration. Both professions used valid and reliable instruments to a very limited extent.

    Implications for practice: If other areas than self-care and mobility are to be addressed within reablement there is a need to critically reflect on the focus, content and duration of reablement interventions. Valid and reliable assessments can be utilised to a greater extent to guide goal-setting, the focus of interventions and to evaluate effects.mited extent.

  • 374.
    Zingmark, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Fisher, Anne G.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Rocklöv, Joacim
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Occupation-focused interventions for well older people: an exploratory randomized controlled trial2014In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, no 6, p. 447-457Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 375.
    Zingmark, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Nilsson, Ingeborg
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Fisher, Anne G.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Department of Occupational Therapy, College of Health and Human Sciences, Colorado State University, Fort Collins, USA.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Occupation-focused health promotion for well older people: a cost-effectiveness analysis2016In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 79, no 3, p. 153-162Article in journal (Refereed)
    Abstract [en]

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

  • 376.
    Zingmark, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Fisher, Anne
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Occupation-focused health promotion for well older people - a cost-effectiveness analysisIn: Article in journal (Other academic)
  • 377.
    Zingmark, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Community Care Administration, Municipality of Östersund, 83182 Östersund, Sweden.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Norström, Fredrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Sahlén, Klas-Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Medicine, Department of Nursing.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Cost effectiveness of an intervention focused on reducing bathing disability2017In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 14, no 3, p. 233-241Article in journal (Refereed)
    Abstract [en]

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

  • 378.
    Zingmark, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Health and Social Care Administration, Municipality of Östersund, 83182 Östersund, Sweden.
    Norström, Fredrik
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Dahlin-Ivanoff, Synneve
    Göteborgs universitet.
    Gustafsson, Susanne
    Göteborgs universitet.
    Modelling long-term cost-effectiveness of health promotion for community-dwelling older people2019In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380Article in journal (Refereed)
    Abstract [en]

    The effectiveness of health promotion for community-dwelling older people is well documented; however, there is a general lack of health economic evaluations. The aim of the present study was to evaluate long-term cost-effectiveness over 4 years of two health promoting interventions: senior meetings and a preventive home visit, for community-dwelling older people in relation to no intervention. We applied a Markov model including five states defined in relation to level of dependency of home help and place of residency. The model included transitions between dependency states, scores for quality of life and societal costs for each state, intervention costs and intervention effects for two formats of health promoting interventions. For each intervention and a no-intervention control group, we calculated the accumulated quality-adjusted life years (QALYs) and societal costs over 4 years. Sensitivity analyses included higher intervention costs, lower intervention effects and additional intervention costs and effects related to booster sessions. The results of all analyses indicated that health promotion implemented for community-dwelling older people in the format of senior meetings or a preventive home visit was cost-effective. Both interventions lead to QALY gains and reduce societal costs at any follow-up over 4 years, and thus, resources can be used to implement other interventions. The most important factor for the magnitude of QALY gains and cost savings was the intervention effect. Yearly booster sessions implemented for those persons who maintained their level of functioning extended the intervention effects adding additional QALYs and further reducing societal costs.

  • 379.
    Árnadóttir, Guðrún
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Measuring the impact of body functions on occupational performance: validation of the ADL-focused occupation-based neurobehavioral evaluation (A-ONE)2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

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

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

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

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

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

  • 380.
    Árnadóttir, Guðrún
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. 1Occupational Therapy Unit, Grensás, Landspítali University Hospital, Reykjavík; 2Division of Occupational Therapy, Faculty of Health, University of Akureyri, Akureyri, Iceland.
    Löfgren, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Fisher, Anne G
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Difference in impact of neurobehavioural dysfunction on Activities of Daily Living performance between right and left hemispheric stroke2010In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 42, no 10, p. 903-907Article in journal (Refereed)
    Abstract [en]

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

  • 381.
    Önnhall, Sandra
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Sundberg, Cecilia
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Upplevd autonomi hos äldre personer med hemtjänst2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Andelen äldre i Sverige som får vård och omsorg i hemmet ökar. Det kan komma att påverka de äldres autonomi då de blir beroende av andra. Autonomi är ett begrepp som innebär möjligheten att själv bestämma i de frågor som rör den egna individen. Syftet med studien var att beskriva äldre personers upplevelse av autonomi, i samband med hjälp och stöd av hemtjänsten, i aktiviteter i det dagliga livet (ADL). Studien genomfördes i form av intervjuer med sex äldre personer, både män och kvinnor, i åldern 72 till 91 år. Därefter transkriberades intervjuerna och en innehållsanalys utfördes. Resultatet visade att alla deltagarna anser att det är viktigt att få vara med och bestämma om det som rör deras dagliga liv och att de har möjlighet att kunna ändra på överenskomna tider samt att avboka hemtjänstbesök. Det framkom även att de har begränsat självbestämmande inom olika områden och att de ibland undviker att uttrycka sina åsikter för att inte besvära hemtjänstpersonalen.  Det förekom att deltagare får lägga sig och stiga upp tidigare än de själva önskat. Det kan tyda på att deltagarna har en känsla av att inte ha fullständig kontroll över alla sina aktiviteter, vilket kan påverka deras upplevda självständighet.

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