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  • 1.
    Fischl, Caroline
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Englund, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Nygren, Ulla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Lindberg, Margareta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    The occupational therapy programme at umeå university, revised2016In: 1st COTEC-ENOTHE Congress: Connecting: Education, Practice, Research, Policy, Galway, Ireland: COTEC , 2016Conference paper (Other academic)
  • 2.
    Granholm Valmari, Elin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Andersson, Jesper
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Johansson, Anna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Nygren, Ulla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Defining the complexities of an occupational pattern—A concept analysis and theoretical validation2024In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 31, no 1, article id 2362840Article in journal (Refereed)
    Abstract [en]

    Background: The concept of an occupational pattern in occupational therapy and occupational science has evolved with varying definitions, ranging from activity patterns to patterns of daily occupation.AimsThis study aimed to explore the concept of occupational pattern, develop an updated definition of the concept, and theoretically validate the concept’s definition.

    Method: Walker and Avant’s concept analysis method was used, where both theoretical frameworks and peer-reviewed scientific literature were searched and synthesized to clarify and define the concept. Furthermore, seven occupational therapists theoretically validated the concept.

    Findings: The analysis included forty-nine references from various research contexts and theoretical perspectives. The synthesis yielded a conceptualization of the concept of occupational pattern, outlining it into three overarching categories: ‘content in an individual’s occupational pattern’, ‘designing an occupational pattern’, and ‘balancing the occupational pattern’.

    Implications: An updated operational definition of the multifaceted concept of an occupational pattern now exists, with practical implications for enhancing the education of occupational therapy students and guiding the utilization of the concept. Moreover, it holds significance for instrument development and outcome measurement in research; especially in lifestyle intervention studies within the field of occupational therapy.

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  • 3.
    Granholm Valmari, Elin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Ghazinour, Mehdi
    Umeå University, Faculty of Social Sciences, Police Education Unit at Umeå University. Police Education, Umeå University, Umeå, Sweden.
    Nygren, Ulla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Gilenstam, Kajsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.
    A systematic review of lifestyle and health among patrolling police officers2023In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 30, no 5, p. 721-744Article, review/survey (Refereed)
    Abstract [en]

    Background: The police profession is a high-strain and high-risk profession, sometimes resulting in poor physical, mental and social health. This systematic review aims to identify and describe crucial areas for a healthy and sustainable lifestyle among patrolling police officers in Europe, an area not previously studied.

    Methods: The review was conducted according to the PRISMA guidelines. A protocol was published and registered with PROSPERO beforehand. Searches were carried out in eight databases. Two independent authors screened articles and critically appraised the included studies. A narrative synthesis was conducted to analyse the results. The review’s total body of evidence was assessed with GRADE-CERQaul.

    Results: A total of 16 articles were located, representing 13 studies. Barriers and resources for a healthy and sustainable lifestyle were linked to a theoretical framework of life balance. Subsequently, a linkage model was created to explain different aspects of patrolling police officers’ life balance and its relation to health (physical, social and mental).

    Conclusions: Several crucial areas for a healthy and sustainable lifestyle were found and described, indicating that patrolling officers’ working life affects their possibilities of living a balanced lifestyle, which might disturb different aspects of health, depending on which aspect is compromised.

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  • 4.
    Granholm Valmari, Elin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Ghazinour, Mehdi
    Umeå University, Faculty of Social Sciences, Police Education Unit at Umeå University.
    Nygren, Ulla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Gilenstam, Kajsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Exploring the life contexts of patrolling police officers in the European Union – A scoping review2023In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 30, no 5, p. 585-603Article, review/survey (Refereed)
    Abstract [en]

    Background: Patrolling police officers engage in different mentally, socially, and physically challenging life contexts which may affect their life and health. The aim of this scoping review is twofold, to explore life contexts of patrolling officers in the European Union, and to investigate how their lives and health are affected by environmental characteristics within these contexts.

    Methods: The scoping review followed Arksey and O’Malley’s methodology and included a critical appraisal. The environmental model within Kielhofner’s Model of Human Occupation was used in the thematic analysis. The review was reported following PRISMA-ScR.

    Results: In the 16 included studies, two contexts (where environments interact with persons on different levels) were discovered: the global and the immediate context. No local contexts were found. Primarily, research on the social, and occupational environments, including qualities identified in these environments were found. However, some environmental characteristics within patrolling officers’ physical environments were also discovered.

    Discussion: This review contributes to the emerging research area of police officers’ life contexts, by mapping contexts and environments affecting their life and health. However, to get a deeper understanding of how officers are affected by their environments, interviewing them regarding how their different contexts affect their everyday living, would be important.

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  • 5.
    Granholm Valmari, Elin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Ghazinour, Mehdi
    Umeå University, Faculty of Social Sciences, Police Education Unit at Umeå University.
    Nygren, Ulla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Gilenstam, Kajsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Sports Medicine.
    Life contexts among patrolling police officers in the European Union, investigating environmental characteristics and health: a protocol for a scoping review and a systematic review2023In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 30, no 7, p. 1135-1142Article in journal (Refereed)
    Abstract [en]

    Introduction: The police officer occupation is a high-risk profession, with significantly more traumatic and stressful events than other occupations. Key factors for the health of police officers have been found to be related to intra-interpersonal, occupational, and organizational factors. However, the mechanisms underlying why is inconclusive. This protocol therefore intends to explain the approach for conducting both a scoping review, and systematic review. The overall aim of the reviews is to investigate patrolling police officers' life contexts with the intention to identify barriers and resources that affect their lifestyle and health.

    Methods: The protocol is reported according to the PRISMA-P guidelines, with PROSPERO number: CRD42020190583. Searches will be carried out in SCOPUS, Web of Science, PubMed, OpenGrey, and EBSCO (Academic Search Premiere, APA PsychINFO, CINAHL, SocINDEX). Two independent raters will screen articles and conduct the critical appraisal. Analyses include Arksey and O'Malley's methodology for the scoping review, and a narrative synthesis for the systematic review, including critically appraising the total body of evidence in the systematic review.

    Discussion: The purpose of the reviews is to understand patrolling police officers' life contexts, and support future development of an assessment that measures patrolling police officers' life balance from a contextual viewpoint.

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  • 6.
    Granholm Valmari, Elin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Inzunza, Miguel
    Umeå University, Faculty of Social Sciences, Department of applied educational science, Departement of Educational Measurement. Umeå University, Faculty of Social Sciences, Police Education Unit at Umeå University.
    Nygren, Ulla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Ghazinour, Mehdi
    Umeå University, Faculty of Social Sciences, Police Education Unit at Umeå University. Umeå University, Faculty of Social Sciences, Department of Social Work.
    Gilenstam, Kajsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Sports Medicine.
    Designing the Police sustainability and wellness instrumentManuscript (preprint) (Other academic)
    Abstract [en]

    Police officers’ lifestyles, and what they need for a sustainable lifestyle, are rarely addressed within police health research. The reason is partly that no specific tool exists to detect the conditions for living a sustainable and healthy lifestyle within this profession. Thus, the study aims to describe the initial steps and process during the development stage, towards creating an instrument targeting conditions for a sustainable and healthy lifestyle of police officers.Several steps were taken during the initial development stages of the instrument. Firstly, the construct ‘conditions for a sustainable and healthy lifestyle of police officers’ was defined by identifying theoretical dimensionality and operationalizing the construct using two focus groups. One focus group included seven occupational therapists skilled in occupational therapy and -science. The other focus group included four persons with knowledge of police officers’ health or work conditions. Secondly, items were identified, selected, and developed, and a draft of items was tested during cognitive interviews, to assess response processes with 28 police officers. Ultimately, the instrument used a content validity approach with nine occupational therapists. A total of 48 persons were enrolled in the study.In summary, our study provides transparency during the initial developmental stage of an instrument with the working name Police Sustainability and Wellness Instrument (PSWI), including its theoretical model and dimensions. The instrument requires additional validation testing, aiming to establish its suitability as a screening tool for the construct, and feasibility testing for its applicability in facilitating self-reflection.

  • 7.
    Granholm Valmari, Elin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Nygren, Ulla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Ghazinour, Mehdi
    Umeå University, Faculty of Social Sciences, Police Education Unit at Umeå University.
    Gilenstam, Kajsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Sports Medicine.
    Being a top cop in pursuit of a sustainable lifestyle2023In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 18, no 1, article id 2235789Article in journal (Refereed)
    Abstract [en]

    Previous research has widely recognized the challenges uniformed police officers face in their working lives. However, little is known about the overall lifestyles of police officers, including what they do in private life. We interviewed 17 officers and used reflexive thematic analysis to explore their experiences. The study sheds light on how uniformed police officers navigate the intersection between their private and professional lives, as well as how their professional role impacts their day-to-day doings and private life roles. The key findings relate to how the demands of their professional role impact their private life, such as the profession becoming a way of life. Furthermore, they highlight the challenges of avoiding certain environments where they might be recognized as police officers. It also entails balancing energy levels in work and private life, as well as how their profession’s unpredictability affects their daily routines and roles. The findings also show how their personal choices in private life are frequently influenced by their professional role. The study’s findings have theoretical as well as practical implications, contributing to a better understanding of uniformed police officers’ challenges and resources for a sustainable and healthy lifestyle.

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  • 8.
    Granholm Valmari, Elin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Nygren, Ulla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Ghazinour, Mehdi
    Umeå University, Faculty of Social Sciences, Police Education Unit at Umeå University.
    Gilenstam, Kajsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    How police officers juggle work, a life partner, and kids2023In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 14, article id 1178314Article in journal (Refereed)
    Abstract [en]

    Police officers frequently encounter stressful social situations during their working days. Furthermore, previous research on policing and families show that police officers’ families are impacted in different ways when at least one member of the family has the role of a police officer. Despite work spilling over to family life there is currently little research on police officers’ role-balancing. Thus, the purpose of this study was to explore and describe the challenges that arise at the intersection between police officers’ professional roles and their private life roles as parents and life partners, as well as how police officers balance these roles in between. We used qualitative content analysis after interviewing 13 uniformed police officers. The findings show how the police officers’ professional roles affect their private life roles within three different sub-themes and are summarized under the theme of "Balancing conflicting roles: Coping with professional and private life commitments". The theme revolves around the various challenges of working as a uniformed police officer, such as hypervigilance and risks, as well as the enrichments and conflicts of working shifts while also juggling private life roles. The results also touch on gender and equality in life-partner relationships. The study raises an important question about how these challenges can be mitigated within Police authorities to enable uniformed police officers to balance their professional and personal lives in a healthy and sustainable manner.

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  • 9.
    Markström, Urban
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Nygren, Ulla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Sandlund, Mikael
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Arbete för alla?:  Införande och resultat av supported employment i en svensk kommun2011Report (Other academic)
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  • 10.
    Nygren, Ulla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Att luckra upp invanda strukturer och påbörja en vandring i okänd terräng: ett pedagogiskt utvecklingsarbete2015In: Universitetspedagogiska konferensen 2015: gränslös kunskap / [ed] Katarina Winka, Umeå: Universitetspedagogik och lärandestöd (UPL), Umeå universitet , 2015, p. 54-55Conference paper (Other academic)
  • 11.
    Nygren, Ulla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. Umeå University, Faculty of Social Sciences, Department of Social Work.
    Individual placement and support (IPS) i en socialpsykiatrisk kontext: en väg till arbete för personer med psykiskt funktionshinder?2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [sv]

    Introduktion

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

    Metod

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

    Resultat

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

    Diskussion

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

    Slutsats

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

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  • 12.
    Nygren, Ulla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Markström, Urban
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Processes towards employment among persons with psychiatric disabilities: a study of two individual placement and support programmes in Sweden2016In: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 18, no 1, p. 32-51Article in journal (Refereed)
    Abstract [en]

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

  • 13.
    Nygren, Ulla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Markström, Urban
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Unique processes towards employment within an IPS-programme: illustrated by five casesManuscript (preprint) (Other academic)
    Abstract [en]

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

  • 14.
    Nygren, Ulla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Markström, Urban
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Svensson, Bengt
    Institutionen för hälsovetenskap.
    Hansson, Lars
    Institutionen för hälsovetenskap.
    Sandlund, Mikael
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Predictors of vocational outcomes using individual placement and support for people with mental illnessManuscript (preprint) (Other academic)
    Abstract [en]

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

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

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

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

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

  • 15.
    Nygren, Ulla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Markström, Urban
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Svensson, Bengt
    Lund Univ, Dept Hlth Sci, Lund, Sweden.
    Hansson, Lars
    Lund Univ, Dept Hlth Sci, Lund, Sweden.
    Sandlund, Mikael
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Predictors of vocational outcomes using Individual Placement and Support for people with mental illness2013In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 45, no 1, p. 31-39Article in journal (Refereed)
    Abstract [en]

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

  • 16.
    Nygren, Ulla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Markström, Urban
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Svensson, Bengt
    Hansson, Lars
    Sandlund, Mikael
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Individual placement and support - a model to get employed for people with mental illness: the first Swedish report of outcomes2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 3, p. 591-598Article in journal (Refereed)
    Abstract [en]

    Lack of participation in the open labour market is highly prevalent for people with a mental illness across countries, and the proportion of people who get some kind of sickness benefit because of mental illness is steadily growing in Europe. Vocational rehabilitation through individual placement and support (IPS) has been shown to be effective and is evidence-based for people with severe mental illness. In Sweden, the method is used but not scientifically evaluated. The aim was to investigate vocational and nonvocational outcomes at a 1-year follow-up and the relationships between these outcomes, at two different sites in the north of Sweden. The participants were 65 men and women, mostly younger than 30 years of age and with a mental illness. Occupational situation, psychiatric symptoms, self-esteem, quality of life and psychosocial functioning were assessed. The vocational outcome during 1 year was that 25% of the participants were employed, and 14% were in education. Most of the participants moved from unemployment to work practice for a prolonged time. Participants in employment, education or work practice at follow-up showed higher satisfaction with their occupational situation than those without regular activities outside home. Among the participants in work practice, improvements in psychiatric symptoms and global functioning were identified. This attempt is the first to evaluate supported employment according to the IPS model for persons with mental illness applied in the Swedish welfare system. There is a need for a longer follow-up period to evaluate whether interventions such as further education and work practice actually will lead to real work.

  • 17.
    Nygren, Ulla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Markstöm, Urban
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Sandlund, Mikael
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Rehabilitering till arbete för personer med psykiskt funktionshinder: Ettårsuppföljning av en verksamhet enligt Supported Employment-metodik i Umeå2009Report (Other academic)
    Abstract [sv]

    En majoritet av de människor som har ett psykiskt funktionshinder vill arbeta. Trots detta står de flesta idag utanför den öppna arbetsmarknaden. Orsakerna kan spåras till bl.a. negativa attityder till personerna i målgruppen, en arbetsmarknad som är dåligt anpassad till gruppens behov, och ett bristfälligt stöd från samhällets sida när det gäller rehabilitering till arbete. Supported Employment enligt den s.k. IPS-modellen är en metodik särskilt utformad för att stödja personer med konsekvenser av psykisk sjukdom att skaffa och behålla ett lönearbete. Arbetssättet har med goda resultat de senaste decennierna utprövats i många olika länder. I Sverige är dock metoden ännu inte en etablerad del av utbudet av arbetsrehabiliteringsinsatser till personer med psykiskt funktionshinder. Föreliggande rapport är en ettårsuppföljning av en verksamhet som arbetar enligt Supported employment-metoden (SE). Syftena med studien är att undersöka hur klienternas situation har utvecklats under ett år efter att de börjat i SE, och hur klienterna har upplevt sitt deltagande. Rapporten redovisar även personalens bild av hinder och möjligheter i rehabiliteringsarbetet. Ettårsuppföljningen är initierad av Samordningsförbundet i Umeå och är en del i ett forskningsprojekt som drivs av Socialpsykiatriskt Kunskapscentrum i Västerbotten och Centrum för Evidensbaserade Psykosociala Insatser (CEPI).

  • 18.
    Nygren, Ulla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Sandlund, Mikael
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    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.
    Exploring perceptions of occupational competence among participants in Individual Placement and Support (IPS)2013In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, no 6, p. 429-437Article in journal (Refereed)
    Abstract [en]

    Objective: The purpose of this study was to explore perceptions of occupational competence and occupational value among a group of clients engaged in Individual Placement and Support (IPS). Methods: The Occupational Self-Assessment (OSA), based on the Model of Human Occupation, was used with 65 men and women with mental illness, and 45 of these completed the study. Results: Rasch analyses showed that the participants perceived "Managing my finances", "Managing my basic needs", and "Doing activities I like" as the most valued occupations. Most competence was perceived in "Taking care of myself". Among the occupations where the participants perceived least competence, "Getting done what I need to do" and "Accomplishing what I set out to do" were the occupations that most stand out. Significant differences were also found between perceived competence and value in most of the occupations. Conclusions: Beyond those occupations valued as most important among the participants, it is essential also to pay attention to those in which they perceived least competence, as they are important for being able to achieve a desired occupation. Support related to perceptions of occupational competence can contribute to enabling clients in IPS to master a desired working life.

  • 19.
    Nygren, Ulla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Sandlund, Mikael
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    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.
    Occupational competence among individuals with psychiatric disabilities in rehabilitation to workManuscript (preprint) (Other academic)
    Abstract [en]

    Introduction: Several qualitative studies have described the struggles persons with mental illness face in mastering their occupational challenges when participating in rehabilitation to work. The purpose of this study was to explore the pattern of perceived occupational competence and occupational values among a group of persons with psychiatric disabilities engaged in Individual Placement and Support for rehabilitation to work.

    Method: The instrument Occupational Self Assessment (OSA), based on the Model of Human Occupation, was used with 65 men and women, mostly younger than 30 years of age and with a mental illness. The ordinal raw scores from three evaluations (baseline, 12 months, 24 months) were analysed using Rasch measurement.  

    Findings: In general, it was easier for the participants to value occupational behaviours as important than to perceive them as being well performed. Among the most valued occupational behaviours, Managing my finances, Managing my basic needs and Doing activities I like, we found clinically meaningful significant gaps between competence and value.

    Conclusion: Beyond those occupational behaviours valued as most important among the participants, it is also essential to pay attention to the behaviours they perceived as most difficult to perform well, as they can be important competencies for being able to achieve desired occupation.

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