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  • 1.
    Bergström, Aileen
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institute, Huddinge, Sweden.
    Mondaca, Margarita
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy. Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institute, Huddinge, Sweden.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy. School of Health and Welfare, Halmstad, Sweden.
    Guidetti, Susanne
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institute, Huddinge, Sweden; Medical Unit Occupational Therapy and Physiotherapy, and Theme Women’s Health and Allied Health Professionals, Karolinska University Hospital, Stockholm, Sweden.
    Rosenberg, Lena
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institute, Huddinge, Sweden; Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Phronesis: Recognising a neglected dimension of knowledge within occupational therapy research2024In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 31, no 1, article id 2341782Article in journal (Refereed)
    Abstract [en]

    Background: Phronesis is a way of knowing, implying wisdom, experiences, and reflections that guide our judgements. Phronesis, important for learning, is a neglected form of knowledge when applied to research.

    Aim: To examine how phronesis is conceptualised and practiced in three research projects.

    Method: Data from eight interviews with researchers involved in three research projects was generated. The interview material was analysed. A theoretical matrix of contemporary understanding of phronesis was applied to the material.

    Result: Examples of phronesis from three research projects in occupational therapy are presented according to categories of contemporary phronesis; acknowledging embodiment, embracing humility, using perceptiveness, and practicing reflexivity.

    Significance: This unique approach of analysing research projects contributes to the understanding of phronesis and its implications for research, providing valuable insights into the researchers’ praxis in their respective projects

    Conclusion: There is a need for a greater recognition of phronesis as a dimension of knowledge within all types of research, and within the discipline. By not recognising phronesis as a legitimate form of knowledge, the discipline perpetuates a superiority of knowledge from episteme that dominates our ways of learning about the world around us and where the type of knowledge gleaned from phronesis is consequently marginalised.

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  • 2.
    Bernspång, Birgitta
    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.
    Aktivitetsengagemang under åldrandet2012In: Det goda åldrandet / [ed] Astrid Norberg, Berit Lundman, Regina Santamäki Fischer, Lund: Studentlitteratur AB, 2012, 1, p. 217-236Chapter in book (Other academic)
  • 3.
    Blomstedt, Yulia
    et al.
    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 Nursing.
    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.
    Sundström, Anna
    Umeå University, Faculty of Social Sciences, Department of Psychology. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Brändström, Anders
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Elderly care in Swedish welfare state: implications of the population ageing2013In: Global aging issues and policies: understanding the importance of comprehending and studying the aging process / [ed] Yushi Li, Springfield: Charles C. Thomas Publisher Ltd., 2013, p. 226-244Chapter in book (Refereed)
  • 4.
    Blusi, Madeleine
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindgren, Helena
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Factors to consider when introducing digital social activities to older persons with home care2023In: Caring is sharing: exploiting the value in data for health and innovation / [ed] Maria Hägglund; Madeleine Blusi; Stefano Bonacina; Lina Nilsson; Inge Cort Madsen; Sylvia Pelayo; Anne Moen; Arriel Benis; Lars Lindsköld; Parisis Gallos, IOS Press, 2023, Vol. 302, p. 453-457Conference paper (Refereed)
    Abstract [en]

    Social isolation and loneliness have become everyday concerns forpopulations all over the world as these factors are affecting both physical and mentalhealth in a negative way. Feelings of isolation and loneliness are increasinglyacknowledged as a health risk among older persons. ICTs have been recognized aseffective tools to combat social isolation among older people. The aim of this studywas to explore factors of significance when introducing a tablet-based systemproviding digital social activities for older persons with home care. Participants were17 persons, age 70 and older, who lived alone and had assistance from home care.This exploratory study used cross-sectional qualitative data analyzed throughthematic analysis. Three themes were generated: 1) lacking vocabulary related tothe context, 2) intuitive user interface may replace extensive instructions and 3)unwillingness to commit to a pre-defined measure of performance.

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  • 5.
    Blusi, Madeleine
    et al.
    Umeå University, Faculty of Science and Technology, Department of Computing Science. 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.
    Lindgren, Helena
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Older adults co-creating meaningful individualized social activities online for healthy ageing2018In: Building continents of knowledge in oceans of data: The future of co-created eHealth / [ed] Adrien Ugon, Daniel Karlsson, Gunnar O. Klein, Anne Moen, IOS Press, 2018, Vol. 247, p. 775-779Chapter in book (Refereed)
    Abstract [en]

    Social isolation and loneliness among older people is a growing problem with negative effects on physical and mental health. In co-creation with older adults individualized social activities were designed where older adults through computer mediated communication were able to participate in social activities without leaving their homes. Four types of activities were designed; outdoor activity, music event, visiting a friend and leisure activity. A participatory action research design was applied, where end users together with scientists from two research fields developed, tested and evaluated online participation in the activities. Usability and safety of the systems were major concerns among older adults. The evaluation pointed out that level of simplicity, usability and audio-video quality determined the level of satisfaction with the human interaction during the activity, thereby affecting the meaningfulness of the activity. The research presented in this paper constitutes the first step in a long-term research process aiming at developing a digital coaching system that gives older adults personalized support for increasing participation in meaningful social activities.

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  • 6.
    Danielsson, Karin
    et al.
    Umeå University, Faculty of Social Sciences, Department of Informatics.
    Lindgren, Helena
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Mulvenna, Maurice
    Computer Science, Ulster University.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Waterworth, John
    Umeå University, Faculty of Social Sciences, Department of Informatics.
    Digital technology in healthcare and elderly care2017In: ECCE 2017: proceedings of the European conference on cognitive ergonomics 2017, Association for Computing Machinery (ACM), 2017, p. 188-190Conference paper (Other academic)
    Abstract [en]

    The focus of this ECCE 2017 panel is on digital technology in healthcare and elderly care. The discussion concerns the design of technology and the use of technology for health. 

  • 7.
    Fischl, Caroline
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Asaba, Eric
    Karolinska Institutet.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Faculty of Health, Care and Nursing, Norwegian University of Science and Technology, Gjøvik, Norway.
    Exploring potential in participation mediated by digital technology among older adults2017In: Journal of Occupational Science, ISSN 1442-7591, E-ISSN 2158-1576, Vol. 24, no 3, p. 314-326Article in journal (Refereed)
    Abstract [en]

    Facets of participation have changed with the growing pervasiveness of digital technology in daily life. To enable older adults as active participants in an evolving digital society, it is relevant to examine how they engage in and situate digital technology-mediated occupations in daily life. Narrative inquiry was used to elucidate features in older adults’ engagement in occupations involving digital technology situated in everyday life. Analysis was based on data gathered through concurrent think aloud protocol and observations from 10 older adults in Northern Sweden. In line with narrative analysis, findings were presented as three stories about negotiating needs and values while interacting with the technological and social environments, entitled playing by the rules, being on the same wavelength, and calling the shots. Looking at these stories with an occupational lens resulted in an understanding that older adults’ participation involving digital technology likewise deals with negotiating and refining identities, as well as finding and experiencing meaning in daily life. There is potential for older adults to become active participants through digital technology, and new challenges in research and practice emerge.

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  • 8.
    Fischl, Caroline
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy. Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Blusi, Madeleine
    Umeå University, Faculty of Science and Technology, Department of Computing Science. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy. Association of Local Authorities in Västernorrland County, Härnösand, Sweden.
    Lindgren, Helena
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Tailoring to support digital technology-mediated occupational engagement for older adults: a multiple case study2020In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 27, no 8, p. 577-590Article in journal (Refereed)
    Abstract [en]

    Background: With the evolution of contemporary occupations mediated by digital technologies (DTs), there is a need for occupational therapists to develop and structure knowledge on how to support older adults’ engagement in occupations and social participation in a digitalised society.

    Objective: The objective of this study is to explore how tailoring to support older adults’ engagement in DT-mediated occupations could be schematised.

    Material and methods: The study employed a multiple case study methodology. There were nine cases, with each case involving an older adult undergoing a collaborative process to support engagement in DT-mediated occupations. The collaborative process was initiated through questionnaires, observations, and dialogues. Meetings and tailoring strategies were documented in fieldnotes and memos on tailoring, respectively. Semi-structured interviews concluded data collection. Cross-case synthesis was used in data analysis.

    Results: The result is a proposed scheme for tailoring to support older adults’ engagement in digital technology-mediated occupations, wherein strategies undertaken in the collaborative processes were synthesised and described.

    Conclusion and significance: The proposed scheme for tailoring could contribute to occupational therapists’ knowledge on how to support older adults’ engagement in contemporary occupations. Testing the model in various practice settings is recommended in order to enhance occupational therapy practice.

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  • 9.
    Fischl, Caroline
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy. Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Lindelöf, Nina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Lindgren, Helena
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Older adults’ perceptions of contexts surrounding their social participation in a digitalized society: an exploration in rural communities in Northern Sweden2020In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 17, p. 281-290Article in journal (Refereed)
    Abstract [en]

    Social participation and digital engagement can contribute to health and well-being among older adultsBecause of older adults’ decline in abilities, coupled withcomplex technology and its perceived insufficient relevance to daily life, there is a need to create and tailor social opportunities and services that are supported by digital technologies for older adults to continue participating in society. Thus, it becomes relevant to explore older adults’ perceptions about contexts surrounding their social participation in a digital society. This exploration used a qualitative research design with focus group interviews and qualitative content analysis. Eighteen older adults, aged 66-81 years, from rural communities in Northern Sweden, participated in this study. The analysis resulted in three categories: Experiencing conditions for social participation in a state of flux, Perceiving drawbacks of urbanization on social participation, Welcoming digital technology that facilitates daily and community living.These categories were encapsulated in the theme –The juxtaposition of narrowing offline social networks and expanding digital opportunities for social participation. The findings suggested that co-creating usable digitalized services and facilitating satisfactory use of digital technologies could support older adults’ social participation through activities that they find relevant in their lives, and subsequently, might enable them to live longer at home.

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  • 10.
    Fischl, Caroline
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy. Department of Rehabilitation, School of Health and Welfare, Jönköping University, Sweden.
    Malinowsky, Camilla
    Karolinska Institutet.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Measurement of older adults’ performance in digital technology-mediated occupations and management of digital technology2021In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 84, no 6, p. 376-387Article in journal (Refereed)
    Abstract [en]

    Introduction: Supporting older adults’ digital engagement requires an understanding of how occupational performance and technology use are related, as well as having a range of methods that can assist occupational therapists while observing occupational performance and management of technology. The study objectives were to investigate how older adults’ ability to perform digital technology-mediated occupations and ability to manage digital technology could be measured and to examine the association between these two abilities.

    Method: Twenty-five older adults were observed performing digital technology-mediated occupations and managing digital technologies, and were scored on two instruments: the Assessment of Computer-Related Skills and the Management of Everyday Technology Assessment. FACETS was used to generate respective multifaceted Rasch measurement models for scores on the instruments. The Spearman correlation test was used to investigate correlation between person ability measures from respective Rasch models of the instruments.

    Results: The results include item, occupation, and technology difficulty estimates, as well as person ability measures that could illustrate older adults’ ability to perform occupations and to manage technology. There is also a strong positive correlation between these abilities.

    Conclusion: Insight into an older person’s ability to manage technology can provide information about his or her ability to perform digital technology-mediated occupations and vice versa.

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  • 11.
    Fischl, Caroline
    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.
    Asaba, Eric
    Karolinska institutet, Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy.
    Exploring the use of information and communication technology in older persons’ daily activities2016In: 1st COTEC-ENOTHE Congress: Connecting: Education, Practice, Research, Policy, Galway, Ireland: COTEC , 2016Conference paper (Other academic)
  • 12.
    Forsberg, Ellinor
    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.
    Seniorer och Internet. Behov och möjligheter för ett anpassat Internetcafé.2008Report (Other academic)
  • 13. Gantschnig, B. E.
    et al.
    Fisher, Anne G.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Page, J.
    Meichtry, A.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Differences in activities of daily living (ADL) abilities of children across world regions: a validity study of the assessment of motor and process skills2015In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 41, no 2, p. 230-238Article in journal (Refereed)
    Abstract [en]

    Background: One important goal of paediatric occupational therapy services is to improve activities of daily living (ADL) abilities of children. In order to plan and evaluate the effectiveness of targeted interventions, valid assessments are critically needed. The Assessment of Motor and Process Skills (AMPS) is an internationally standardized assessment of ADL performance that has not been validated for use with children in Middle Europe.

    Aim: To evaluate for (i) significant differences in mean ADL motor and mean ADL process ability measures among children from Middle Europe compared with children from North America, UK/Republic of Ireland, Nordic countries, Western Europe, Australia/New Zealand and Asia; and (ii) meaningful differences between the international age-normative means of the AMPS and those for children from Middle Europe.

    Method: We analysed data of children across world regions extracted from the international AMPS database using many-facet Rasch and two-wayanova analyses and by estimating contrasts to evaluate for significant group differences.

    Results: anova analyses of data for 11 189 children ages 2–15 revealed significant effects for mean ADL motor and ADL process ability by region [F ≥ 15.32, d.f. = (6, 11 091), MSE ≥ 0.20, P < 0.001, ή2 ≥ 0.008], and age [F ≥ 253.47, d.f. = (13, 11 091), MSE ≥ 0.20, P < 0.001, ή2 ≥ 0.229], and a significant interaction effect for mean ADL process ability [F = 1.48, d.f. = (78, 11 091), P = 0.004, ή2 = 0.010]. Out of 168 estimated contrasts between Middle Europe and the other world regions for mean ADL motor and ADL process ability, seven were statistically significant (4.17%), but none exceeded ±1SE from the international means.

    Conclusion: The AMPS remains free of relevant differences in mean ADL ability measures between Middle Europe and other world regions, indicating that the international age-normative mean values are likely to be applicable to children from Middle Europe. The AMPS can be used internationally to evaluate ADL performance in children and to determine if the child is eligible for occupational therapy services.

  • 14.
    Gantschnig, Brigitte E
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Institute of Occupational Therapy, School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland.
    Fisher, Anne G
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Department of Occupational Therapy, College of Health and Human Sciences, Colorado State University.
    Page, Julie
    Institute of Occupational Therapy, School of Health Professions, Zurich University of Applied Sciences.
    Meichtry, André
    Institute of Physical Therapy, School of Health Professions, Zurich University of Applied Sciences.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Activities of daily living differences among children across world regions: a validity study of the assessment of motor and process skillsManuscript (preprint) (Other academic)
  • 15. Gantschnig, Brigitte E.
    et al.
    Nilsson, Ingeborg
    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.
    Kunzle, Christoph
    Page, Julie
    Feasibility study of a single-blind randomised controlled trial of an occupational therapy intervention2016In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 23, no 4, p. 260-271Article in journal (Refereed)
    Abstract [en]

    Background: Several factors facilitate or hinder efficacy research in occupational therapy. Strategies are needed, therefore, to support the successful implementation of trials.

    Aim: To assess the feasibility of conducting a randomised controlled trial (RCT). The main feasibility objectives of this study were to assess the process, resources, management, and scientific basis of a trial RCT.

    Material and methods: A total of 10 occupational therapists, between the ages of 30 and 55 (M 43.4; SD 8.3) with seven to 26 years' (M 14.3; SD 6.1) experience, participated in this study. Qualitative data collected included minutes of meetings, reports, and field notes. The data were analysed based on the principles of content analysis, using feasibility objectives as the main categories.

    Results: Data analysis revealed strengths in relation to retention and inclusion criteria of participants, the study protocol, study organisation, and the competence of researchers. Weaknesses were found related to recruitment, randomisation, data collection, time for training and communication, commitment, and design.

    Conclusion: The findings indicated that there are several factors which had a considerable impact on the implementation of an RCT in practice. However, it was useful to assess methods and procedures of the trial RCT as a basis to refine research plans.

  • 16.
    Gantschnig, Brigitte E
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Zurich University of Applied Sciences, School of Health Professions, Institute of Occupational Therapy.
    Nilsson, Ingeborg
    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. Colorado State University, College of Health and Human Sciences, Department of Occupational Therapy.
    Künzle, Christoph
    Eastern Swiss Children’s Hospital St. Gallen.
    Feasibility of a single-blind randomised controlled trial of an occupational therapy intervention with childrenManuscript (preprint) (Other academic)
  • 17.
    Gantschnig, Brigitte E
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Page, Julie
    Nilsson, Ingeborg
    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.
    Detecting differences in activities of daily living between children with and without mild disabilities2013In: American Journal of Occupational Therapy, ISSN 0272-9490, E-ISSN 1943-7676, Vol. 67, no 3, p. 319-327Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE. We evaluated whether the Assessment of Motor and Process Skills (AMPS) measures are valid for detecting differences in activities of daily living (ADL) ability among children with and without mild disabilities.

    METHOD. Retrospective data from the AMPS database were analyzed using many-facet Rasch analyses and forced regression analyses to evaluate for significant group differences.

    RESULTS. Regression analyses of data for 10,998 children ages 4-15 who met the inclusion criteria revealed significant Age x Group interaction effects (B >= 0.23, T >= 6.20, p <= .001). Post hoc t tests revealed significant group differences in ADL ability at all ages beyond age 4. ADL process ability effect sizes were moderate to large at all ages, and ADL motor ability was mostly moderate to large at ages 6 or older.

    CONCLUSION. These findings support the validity of the AMPS measures when used to identify ADL problems, among children with mild disabilities.

  • 18.
    Gustafsson, Per E
    et al.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Fonseca Rodriguez, Osvaldo
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    San Sebastian, Miguel
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Intersectional inequalities in loneliness among older adults before and during the early phase of the COVID-19 pandemic: A total population survey in the Swedish eldercare setting2022In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, article id 115447Article in journal (Refereed)
    Abstract [en]

    Loneliness among older adults is a public health problem that has received particular attention since the emergence of the COVID-19 pandemic. Studies to date have however found a rather modest psychosocial impact of the pandemic on older adults, and scarce research has analyzed this impact using a comprehensive equity lens. The present study used an intersectional approach to examine social inequalities in loneliness before and during the early phase of the pandemic among older adults receiving eldercare in Sweden. The study population (analytical N = 205,529) came from two waves (2019 and 2020) of a total population survey to all older adult (>65 years of age) home care recipients and nursing home residents in Sweden. Loneliness was self-reported by a single-item measure, and survey data were linked to population register data on age, gender, residential setting, income, and country of birth. Additive binomial regression models were used to estimate prevalence differences and discriminatory accuracy according to an analysis of individual heterogeneity and discriminatory accuracy (AIHDA) approach. Results showed inequalities in loneliness arising particularly in the intersection of country of birth, income, and residential setting. The inequalities widened slightly but ubiquitously following the emergence of the pandemic in 2020, with particularly nursing home residents emerging as a risk group. The discriminatory accuracy of inequalities was consistently low to moderate throughout the analyses but increased marginally during the pandemic in 2020. The study illustrates how social inequalities engenders heterogeneity in the psychosocial risk of older adults before and during the pandemic. These findings should stimulate more nuanced and equity-oriented depictions, research and policies about loneliness among older adults in the peri-pandemic era.

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  • 19.
    Gustafsson, Per E.
    et al.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    San Sebastian, Miguel
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Venerable vulnerability or remarkable resilience?: A prospective study of the impact of the first wave of the COVID-19 pandemic and quarantine measures on loneliness in Swedish older adults with home care2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 5, article id e060209Article in journal (Refereed)
    Abstract [en]

    Objectives: To examine the early impact of the pandemic and of quarantine measures targeting older adults introduced in March 2020 on loneliness among older adults in Sweden.

    Design: Prospective pretest-posttest and controlled interrupted time series designs.

    Setting: The population of older adults receiving home care before and during the emergence of the first COVID-19 pandemic wave in Sweden in Spring 2020.

    Participants: Respondents (n=45 123, mean age 85.6 years, 67.6% women) came from two waves of a total population survey targeting all community-dwelling older adults receiving home care for older adults in Sweden in Spring 2019 and 2020.

    Outcome: Self-reported loneliness.

    Results: Results estimated 14% (95% CI: 10 to 19) higher loneliness in Spring 2020 compared with 2019, taking covariates into account. No impact of the quarantine measure was found (1% increase, 95% CI: -1 to 4).

    Conclusions: The results illustrate the broader public health consequences of the COVID-19 pandemic for older adults, but also suggest a relative resilience among older adults in home care to quarantine measures, at least during the first months of the pandemic. Future studies should examine the long-term effects of sustained pandemic and social distancing measures on loneliness among older adults.

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  • 20.
    Gustafsson, Per E.
    et al.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Schröders, Julia
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Department of Sociology.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    San Sebastián, Miguel
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Surviving through solitude: A prospective national study of the impact of the early COVID-19 pandemic and a visiting ban on loneliness among nursing home residents in Sweden2022In: The journals of gerontology. Series B, Psychological sciences and social sciences, ISSN 1079-5014, E-ISSN 1758-5368, Vol. 77, no 12, p. 2286-2295Article in journal (Refereed)
    Abstract [en]

    Objectives: Targeted social distancing measures were widely implemented for nursing home residents when the extremely high coronavirus disease 2019 mortality in this setting became apparent. However, there is still scarce rigorous research examining how the pandemic and accompanying social distancing measures affected loneliness in this group. This prospective nationwide Swedish study of nursing home residents aimed to examine the impact on loneliness of the early phase of the pandemic and of a national visiting ban at nursing homes.

    Methods: A panel was selected from a total population survey of all nursing home residents in Sweden March–May 2019 and 2020 (N = 11,782; age range 70–110 years; mean age 88.2 years; 71% women). Prospective pretest–posttest and controlled interrupted time series (ITS) designs were employed, with time trends estimated by date of returned questionnaire. Generalized linear models were used for estimation of effects, adjusting for demographic-, survey-, and health-related covariates.

    Results: Loneliness prevalence increased from 17% to 19% from 2019 to 2020 (risk ratio, RR (95% confidence interval, CI) = 1.104 (1.060; 1.150)), but which was explained by self-reported health (RR (95% CI) = 1.023 (0.982; 1.066)). No additional impact of the visiting ban on loneliness trends was found in the ITS analyses (RR (95% CI) = 0.984 (0.961; 1.008)).

    Discussion: The moderate but health-dependent increased risk of loneliness, and the lack of impact of the nationwide visiting ban at nursing homes, suggests that this ostensibly vulnerable group of nursing home residents also shows signs of resilience, at least during the early phase of the pandemic.

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  • 21.
    Johansson, Erika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Jonsson, Frida
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Rapo, Emil
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of 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).
    Hörnsten, Åsa
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Arctic Research Centre at Umeå University.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Let’s Try Social Prescribing in Sweden (SPiS): an Interventional Project Targeting Loneliness among Older Adults Using a Model for Integrated Care: A Research Protocol2021In: International Journal of Integrated Care, E-ISSN 1568-4156, Vol. 21, no 2, article id 33Article in journal (Refereed)
    Abstract [en]

    Introduction: Loneliness and social isolation among older adults (≥65) are an emerging issue of public concern, associated with increased morbidity and mortality. Today there is no systematic intervention developed, implemented or evaluated in Sweden addressing loneliness. The overall aim for this project is to develop, test and refine a person-centred Swedish model for social prescribing (SPiS), and to assess whether and how it reduces loneliness, promotes health and improves well-being among older adults.

    Description: The focus will be to develop, culturally adapt, evaluate and refine the SPiS model. Following the sequential structure of realist evaluation in three consecutive phases qualitative and quantitative data along with subsequent analysis methods will be collected and utilized. The project will provide knowledge of what works with the social prescribing model, for whom, in what conditions and why, in relation to loneliness, health and well-being among older adults.

    Discussion: SPiS has the unique position of providing initial knowledge regarding how to reduce loneliness in the Swedish context. However, evaluation is complex as this research goes beyond the unidimensional question “Is it working?”.

    Conclusion: Developing, implementing and evaluating such a complex program needs systematic and close evaluation.

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  • 22.
    Johansson, Erika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Rapo, Emil
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Can an ecological-transactional systems model in occupational therapy contribute to a social prescribing programme?2021In: Irish Journal of Occupational Therapy, ISSN 0791-8437, Vol. 49, no 2, p. 115-118Article in journal (Refereed)
    Abstract [en]

    Purpose: The spread and level of loneliness is today considered a public health issue. Attempts to promote or reduce the level of loneliness have been made, one of which is social prescribing (SP), developed and extensively used. Complex interventions such as SP are advised to be connected to theory.

    Design/methodology/approach: For this purpose, the Person-Environment-Occupation-Participation model (PEOP) will be reviewed and used as an example, both as a way of organize occupational knowledge and as a model for practice.

    Findings: Occupational therapy underpinned by transactional system theory such as the PEOP model seems to give comprehensive and relevant support in the SP process. Particularly, this model can guide practitioners through crucial phases when assessing needs, matching interests and goals with relevant occupations, as well as understanding of important components embedded in the program.

    Originality/value: This opinion piece offers insights in why and how specific components connected to SP needs to be understood by theory and applied by personnel to facilitate a meaningful and sustainable occupational performance for the individuals.

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  • 23.
    Lampinen, Josefine
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Conradsson, Mia
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nyqvist, Fredrica
    Faculty of Education and Welfare Studies, Social Policy, Åbo Akademi University, Vaasa, Finland.
    Olofsson, Birgitta
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Littbrand, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Loneliness among very old people with and without dementia: prevalence and associated factors in a representative sample2022In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 19, p. 1441-1453Article in journal (Refereed)
    Abstract [en]

    Loneliness and dementia are common among very old (aged ≥ 80 years) people, but whether the prevalence of loneliness differs between very old people with and without dementia is unknown and few studies have investigated associated factors. The aims of the present study were to compare the prevalence of loneliness between people with and without dementia in a representative sample of very old people, and to investigate factors associated with loneliness in the two groups separately. This population-based study was conducted with data on 1176 people aged 85, 90, and ≥ 95 years (mean age 89.0 ± 4.47 years) from the Umeå 85 + /Gerontological Regional Database study conducted in northern Sweden, during year 2000–2017. Structured interviews and assessments were conducted during home visits. Loneliness was assessed using the question “Do you ever feel lonely?.” Multivariable logistic regression analysis was conducted to identify factors associated with loneliness in participants with and without dementia. The prevalence of loneliness did not differ between people with and without dementia (50.9% and 46.0%, respectively; p = 0.13). Seven and 24 of 35 variables were univariately associated with the experience of loneliness in participants with and without dementia, respectively. In the final models, living alone and having depressive symptoms were associated with the experience of loneliness in both study groups. In participants without dementia, living in a nursing home was associated with the experience of less loneliness. These findings contribute with important knowledge when developing strategies to reduce loneliness in this growing age group.

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  • 24.
    Larsson, Ellinor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Larsson Lund, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Department of Health Science, Lulea˚ University of Technology, Lulea˚ , Sweden.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Ageing and Living Conditions Program (ALC), Umeå University, Umeå, Sweden.
    Internet Based Activities (IBAs): Seniors' experiences of the conditions required for the performance of and the influence of these conditions on their own participation in society2013In: Educational gerontology, ISSN 0360-1277, E-ISSN 1521-0472, Vol. 39, no 3, p. 155-167Article in journal (Refereed)
    Abstract [en]

    The digital gap is a threat to the participation of senior citizens in society, as a large proportion of seniors are not involved in Internet based activities (IBAs). To be able to overcome this disadvantage for seniors, there is a need to both learn more about the conditions that make seniors start performing IBAs and to be able to provide them with the most beneficial professional interventions. The aim of this study was to explore and describe seniors' experiences with IBAs. Qualitative interviews were conducted with 10 seniors (aged: 66-82 years) with a variety of experiences with IBAs, and the interviews were analyzed with the constant comparative method. The results reveal three categories that describe the experiences of the established performers, the new performers of IBAs in the process of starting out, and the nonperformers. The variations in performance were influenced by the meaning that the performance of IBAs had for the seniors. In addition, the seniors were affected by several other conditionssuch as the support available in their environment, including access to knowledgeas this could encourage them to develop their performance. Basic aspects, such as having access to a computer and to the Internet had been arranged for the performers of IBAs. The different ways of performing IBAs, revealed in the three categories, influenced how the seniors viewed their opportunities to participate in society. The conclusion highlights the finding that professionals should consider a multitude of conditions when introducing seniors to the performance of meaningful IBAs.

  • 25.
    Larsson, Ellinor
    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.
    Att vara en socialt aktiv person som äldre: hur kan modern teknik bidra?2015In: Vardagsteknik och äldre personer / [ed] Åsa Larsson Ranada, Studentlitteratur AB, 2015, p. 119-141Chapter in book (Other academic)
  • 26.
    Larsson, Ellinor
    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. Ageing and Living Conditions Program (ALC).
    Larsson Lund, Maria
    Department of Health Science, Luleå University of Technology, Luleå, Sweden.
    Participation in social internet-based activities: five seniors' intervention processes2013In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, no 6, p. 471-480Article in journal (Refereed)
    Abstract [en]

    Objective: To explore how client-centred occupational therapy intervention processes for participation in meaningful Social Internet-Based Activities (SIBAs) can be designed, and to explore the influences of participation in SIBAs on seniors' social activities and social contacts. Method: A qualitative, descriptive, multiple-case study was conducted, and an intervention was provided to the five participants, who were aged 65-85. Data were collected through assessment tools, field notes, and interviews. Results: The participants' needs and challenges related to SIBAs varied during the intervention processes. Individual-adapted support was provided for the seniors (by the occupational therapist) to managing the introduction to different SIBAs, their appearance on the internet, and the lack of privacy. The association between the seniors' participation in SIBAs and their satisfaction with these activities, as well as their social contacts, requires further exploration. Conclusions: Client-centred occupational therapy interventions can support seniors' participation in SIBAs and their self-reliance when performing these activities.

  • 27.
    Larsson, Ellinor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Padyab, Mojgan
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Umeå University, Faculty of Social Sciences, Department of Social Work.
    Larsson Lund, Maria
    Luleå Tekniska Universitet/Enheten för Arbetsterapi.
    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).
    Effects of a social Internet-based intervention programme for older adults: An explorative randomized crossover study2016In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 79, no 10, p. 629-636Article in journal (Refereed)
    Abstract [en]

    Introduction: Restraints and changes in social activities might contribute to loneliness and health decline for older adults. To reduce loneliness and support activities, social internet-based interventions are indicated to be effective. The aim of this study was to evaluate the effects of a social internet-based intervention for older adults who are vulnerable to loneliness.

    Method: An explorative, randomised, crossover study with an AB/BA sequence was completed. The intervention was conducted over a period of three months. Thirty participants were included (24 women and six men, 61-89 years old) and allocated to two groups. Data were collected at three time points. The primary outcome was the UCLA loneliness scale, and the secondary outcomes were satisfaction with social contacts and social interaction skills. Statistical analyses were conducted with the paired t-test, Wilcoxon's signed-rank test and repeated-measures analysis of variance.

    Results: Loneliness was significantly decreased in both groups post intervention, and satisfaction with social contacts online significantly increased in one group. Significant treatment effects were detected for all outcomes.

    Conclusion: The results of the social internet-based intervention programme are promising, but further evaluations are needed

  • 28.
    Lindelöf, Nina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy. School of Health and Welfare, Halmstad University, Halmstad, Sweden.
    Littbrand, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Olofsson, Birgitta
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    A focus groups study of staff team experiences of providing interdisciplinary rehabilitation for people with dementia and their caregivers: a co-creative journey2023In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 23, no 1, article id 572Article in journal (Refereed)
    Abstract [en]

    Background: The World Health Organization claims that rehabilitation is important to meet the needs of persons with dementia. Rehabilitation programmes, however, are not routinely available. Person-centred, multidimensional, and interdisciplinary rehabilitation can increase the opportunities for older adults with dementia and their informal primary caregivers to continue to live an active life and participate in society. To our knowledge, staff team experiences of such rehabilitation programmes, involving older adults with dementia and their informal caregivers has not been previously explored.

    Methods: The aim of this qualitative focus group study was to explore the experiences of a comprehensive staff team providing person-centred multidimensional, interdisciplinary rehabilitation to community-dwelling older adults with dementia, including education and support for informal primary caregivers. The 13 staff team members comprised 10 professions who, during a 16-week intervention period, provided individualised interventions while involving the rehabilitation participants. After the rehabilitation period the staff team members were divided in two focus groups who met on three occasions each (in total six focus groups) and discussed their experiences. The Grounded Theory method was used for data collection and analysis.

    Results: The analysis resulted in four categories: Achieving involvement in rehabilitation is challenging, Considering various realities by acting as a link, Offering time and continuity create added value, and Creating a holistic view through knowledge exchange, and the core category: Refining a co-creative process towards making a difference. The core category resembles the collaboration that the staff had within their teams, which included participants with dementia and caregivers, and with the goal that the intervention should make a difference for the participants. This was conducted with flexibility in a collaborative and creative process.

    Conclusions: The staff team perceived that by working in comprehensive teams they could provide individualised rehabilitation in creative collaboration with the participants through interaction, knowledge exchange, time and continuity, coordination and flexibility, and a holistic view. Challenges to overcome were the involvement of the person with dementia in goal setting and the mediating role of the staff team members. The staff pointed out that by refinement they could achieve well-functioning, competence-enhancing and timesaving teamwork.

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  • 29.
    Lindgren, Helena
    et al.
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Baskar, Jayalakshmi
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Guerrero, Esteban
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Nieves, Juan Carlos
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Yan, Chunli
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Computer-Supported Assessment for Tailoring Assistive Technology2016In: DH'16: PROCEEDINGS OF THE 2016 DIGITAL HEALTH CONFERENCE, New York: Association for Computing Machinery (ACM), 2016, p. 1-10Conference paper (Refereed)
    Abstract [en]

    The main purpose of assistive technology is to support an individual's daily activities, in order to increase ability, autonomy, relatedness and quality of life. The aim for the work presented in this article is to develop automated methods to tailor the behavior of the assistive technology for the purpose to provide just-in-time, adaptive interventions targeting multiple domains. This requires methods for representing and updating the user model, including goals, preferences, abilities, activity and its situation. We focus the assessment and intervention tasks typically performed by therapists and provide knowledge-based technology for supporting the process. A formative evaluation study was conducted as a part of a participatory action research process, involving two rehabilitation experts, two young individuals and one senior individual as end-user participants, in addition to knowledge engineers. The main contribution of this work is a theory-based method for assessing the individual's goals, preferences, abilities and motives, which is used for building a holistic user model. The user model is continuously updated and functions as the base for tailoring the system's assistive behavior during intervention and follow-up.

  • 30.
    Lindgren, Helena
    et al.
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Designing systems for health promotion and autonomy in older adults2009In: Interact´09, Springer , 2009, p. 700-703Conference paper (Refereed)
    Abstract [en]

    The inclusion and autonomy of older people in the society where large parts of the life is organized with computer and Internet use as means is addressed in an ongoing project in the rehabilitation and health domains. Part from investigating the potentials of using ICT for rehabilitation of older people with limited or no computer skills, the aim for the project is to develop methods and tools for the purpose, and also for the interaction design domain where systems are developed for older people. The resulting methods are used for informing the design of the system in an iterative process.

  • 31.
    Lindgren, Helena
    et al.
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Towards User-Authored Agent Dialogues for Assessment in Personalised Ambient Assisted Living2013In: International Journal of Web Engineering and Technology, ISSN 1741-9212, Vol. 8, no 2, p. 154-176Article in journal (Refereed)
    Abstract [en]

    Existing approaches to ambient assisted living (AAL) often fail to consider a human agent's needs from a holistic perspective. In particular, the regular assessment of their changing abilities, skills and limitations are often treated as a separate matter in healthcare, thereby affecting the possibilities to provide support tailored to their current condition. Therefore, the objective of this work is to integrate assessment done by the healthcare professional into the framework of AAL. We use a case scenario as base for domain experts in their development of the interaction between software agents and with the older adult in assessment and adaptation for supporting him/her in a home environment. The potentials in allowing professionals author and design the dialogue systems as part of a meta-design process is evaluated and discussed.

  • 32.
    Lindgren, Helena
    et al.
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Surie, Dipak
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Agent-supported assessment for adaptive and personalized ambient assisted living2011In: Trends in practical applications of agents and multiagent systems / [ed] Juan M. Corchado, Bajo Pérez, Kasper Hallenborg, Paulina Golinska and Rafael Corchuelo, Berlin/Heidelberg: Springer Berlin/Heidelberg, 2011, Vol. 90, p. 25-32Conference paper (Refereed)
    Abstract [en]

    Existing approaches to ambient assisted living (AAL) often fail to consider a human agent's needs from a holistic perspective. In particular the regular assessment of their changing abilities, skills and limitations are often treated as a separate matter in healthcare, thereby affecting the possibilities to provide support tailored to their current condition. Therefore, the objective of this work is to integrate assessment done by the healthcare professional into the framework of AAL. We propose a framework based on a model for activity-centered modeling of knowledge and interaction tailored to users (ACKTUS) and an egocentric interaction model. We exemplify the interaction between system modules as agent dialogues in assessment and adaptation for supporting an older adult in a home environment.

  • 33.
    Lundgren, Anna Sofia
    et al.
    Umeå University, Faculty of Arts, Department of culture and media studies. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Atler, Karen
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Negotiating occupation: How older people make sense around of the concept of "occupation"2020In: Journal of Occupational Science, ISSN 1442-7591, E-ISSN 2158-1576, Vol. 27, no 2, p. 236-250Article in journal (Refereed)
    Abstract [en]

    Background: The concept of occupation has been widely discussed and developed theoretically in occupational science and occupational therapy.

    Objectives: To explore how older community living adults themselves describe and negotiate the meaning and definition of “occupation”.

    Methods: Twenty-seven persons in northern Sweden (67-95 years old) participated in workshops with audio-recorded discussions. The transcribed discussions were analyzed using discourse theory.

    Findings: Discussions started with efforts to establish a initial definition of occupation focusing on what kinds of practices could be seen as occupations. Second, there were significant efforts to value and grade different occupations, described as evaluative definitions. Last, participants resonated around the disadvantages of stable definitions of occupations, and put forth reflexive arguments for more relativizing definitions.

    Conclusion: While physical occupations were tellable, social and mental occupations seemed to require a language that was less familiar. Therefore, interventions that suggest participants to engage in social or mental occupations need to provide a language that makes non-physical occupations comprehensible as occupations.

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  • 34.
    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)
  • 35.
    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.

  • 36.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Strategier för att motverka ofrivillig ensamhet2023In: Bra bostäder för seniorer: en antologi / [ed] Petter Ahlström; Börje Bjelke; Jan Paulsson; Sören Runsteen; Petra Sandberg, Stockholm: Svensk Byggtjänst , 2023, 1, p. 61-66Chapter in book (Other academic)
  • 37.
    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)
  • 38.
    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.

  • 39.
    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)
  • 40.
    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.

  • 41.
    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.

  • 42.
    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.

  • 43.
    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.

  • 44.
    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.))
  • 45.
    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.

  • 46.
    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, 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.

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  • 47.
    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.

  • 48.
    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.

  • 49.
    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.

  • 50.
    Nilsson, Ingeborg
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Nygård, Louise
    Karolinska Institutet.
    Geriatric rehabilitation: elderly client's experiences of a pre-discharge occupational therapy group programme2003In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 10, no 3, p. 107-117Article in journal (Refereed)
    Abstract [en]

    This study describes how elderly people, temporarily living in a pre-discharge community rehabilitation centre, may experience participation in an in-patient occupational therapy programme built around group activities. The group activity programme was comprised of five sessions, each focusing on a theme chosen to encourage reflection and mutual sharing of experiences and support. Data were collected through interviews with each of the three participants immediately after each of the five group sessions. The resultant 15 interviews were analysed by adopting a Grounded Theory approach. The results show that the ways in which the participants experienced participating in the group activity programme can be described from two distinct core categories: experiences of activation and experiences of transformation . The category of activation emerged from their experiences of a creative force whilst engaged in performing the activities and from their discovery that the group was a good place for learning . Engagement in the group activities also seemed to bring about a transformation in the participants in that their experiences triggered reflection and adaptation , which contributed to a change in attitude and a personal synthesis where their new discoveries were internalized. The study shows the potential a group activity programme in occupational therapy has in triggering an adaptational and reflective process within elderly people facing discharge from hospital. Hence, group activity interventions in occupational therapy are suggested as one possible way to support the elderly person in the discharge process from hospital to the home.

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