Background The need to support a healthy lifestyle among the population has become increasingly apparent in recent years. The National Board of Health and Welfare in Sweden has published national guidelines regarding unhealthy lifestyle habits since 2011. An instrument based on the practical and theoretical foundations of occupational therapy was developed to support the professions unique contribution to implementing these guidelines. Aims The aim was to examine the utility of the instrument by investigating its implementation potential and clinical relevance. Material and Method Sixteen occupational therapists used the instrument in practice together with 60 clients. Afterwards, they completed a questionnaire covering questions of utility. Result The instrument demonstrated mostly positive dimensions of utility. The results show that the instrument seems to have a high implementation potential and is clinically relevant. It seems, for example, to support implementation of the national guidelines and to capture how a persons lifestyle habits are expressed in everyday occupations. The instrument further seems to promote peoples participation in treatment. Conclusion The instrument Diary-based survey of lifestyle habits in everyday activities and support for the process of change seems promising in terms of utility. However, the scientific merit of the instrument will need to be further established.

Background: Fatigue is common among people with multiple sclerosis (MS), and significantly influences engagement in occupations. The Managing Fatigue (MF) programme is an evidence-based occupational therapy group-based intervention, utilising self-management science that provides people with tools to manage fatigue. Although the national MS-guidelines in Sweden cite this as best practice, a Swedish version is not available. Aim: To translate and investigate the feasibility of a Swedish MF programme delivered by occupational therapists working with MS clients in Sweden. Material and methods: We used a mixed-methods design. Eight recruited occupational therapists, participated in a workshop prior to delivering the MF programme. Following programme delivery, they completed a questionnaire and participated in focus group interviews. Results: Each therapist conducted one programme with 5-9 MS clients. Overall, therapists were satisfied with programme content, and delivery was followed. Minor improvements were suggested, specifically in relation to how cognitive fatigue can be managed. Therapists acknowledged challenges moving from "expert" to supporting self-management. Conclusion: The MF programme is feasible in Sweden, and its client-centred and occupation focus is consistent with therapists scope of practice. In the future, acceptability and satisfaction from the perspectives of MS participants should be examined. Larger, more robust intervention studies evaluating effectiveness are also warranted.

Occupational therapists in Sweden are expected to use evidence-based practice. To meet this expectation, a helpful tool could be the Model of Human Occupational Screening Tool (MOHOST). The aim of this study was to examine the utility of the Swedish version of MOHOST. Thirty-seven occupational therapists were invited to take part in the examination. A questionnaire covering transferability, feasibility and clinical relevance was developed. The results show that MOHOST-S seems to have suitable utility. The study supports its implementation potential and clinical relevance. It gives a broad picture of the clients occupational participation and it supports the treatment planning process.

Fatigue är vanligt förekommande hos personer med Multipel skleros (MS) och MS-fatigue har ofta en negativ inverkan på personernas möjligheter att utföra och vara delaktig i vardagens olika aktiviteter. Fatigue Management (FM) programmet är en arbetsterapeutisk intervention som syftar till att deltagarna lär sig strategier för att kunna hantera MS-fatigue i vardagen. Programmet använder sig av self-management metodik under genomförandet och rekommenderas av Socialstyrelsen i de nationella riktlinjerna för MS. Syftet var att undersöka svenska arbetsterapeuters uppfattning av användbarheten av den svenska översättningen av programmet med klienter med MS.

Metod/Tillvägagångssätt* En mixad metod användes tillsammans med åtta arbetsterapeuter som initialt deltog i en workshop och sedan genomförde FM programmet med MS-klienter. Därefter fyllde de i en enkät innan de deltog i fokusgrupps intervjuer där fokus var på användbarheten av programmet.

Resultat/Preliminärt resultat* Varje arbetsterapeut genomförde programmet i sin helhet en gång med 5-9 MS-klienter. Överlag var arbetsterapeuterna nöjda med innehållet i programmet och de följde programmets struktur under genomförandet. Mindre förändringar föreslogs särskilt i relation till hur kognitiv fatigue kan hanteras. De diskuterade även utmaningar gällande att använda self-management metodik där arbetsterapeuten har en annan roll än den traditionella som expert.

Slutsats/Praktisk tillämpning* FM programmet visade sig vara användbart i Sverige men arbetsterapeuter som vill erbjuda programmet bör först delta i en kortare workshop där programmets innehåll och struktur diskuteras såväl som dess underliggande teorier. Framtida studier bör fokusera på större interventionsstudier som utvärderar effekterna av programmet.

Intressechecklistan är ett självskattningsinstrument med syfte att identifiera vilka intressen en person har haft, vilka hen har för närvarande samt vilka hen vill ha i framtiden.

Bakgrund/Syfte*

Inom WHO pågår ett utvecklingsarbete av en ny klassifikation av åtgärder ”International Classification of Health Interventions” (ICHI), som kompletterar ICF och ICD. WHO har pågående tester av ICHI. Socialstyrelsen och nordiska klassifikationscentret har genomfört ett antal tester bland annat omfattande arbetsterapiåtgärder inom psykiatrin. Åtgärder dokumenteras med Klassifikation av vårdåtgärder (KVÅ) inom hälso- och sjukvård i Sverige.

Syfte var att mappa ett antal KVÅ-åtgärder som tillämpas inom psykiatrisk arbetsterapi till ICHI.

Metod/Tillvägagångssätt*

En lista med åtgärder inom psykiatri, som används av arbetsterapeuter från sex olika sjukhus i Sverige mappades till ICHI 2018. Mappningsregler för ICHI användes där grad av samstämmighet värderas. Även kardinalitet dvs. hur många ICHI-interventioner användes för att beskriva KVÅ-åtgärden. Resultatet bearbetades med deskriptiv statistik.

Resultat/Preliminärt resultat*

Totalt mappades 136 KVÅ-åtgärder (27 undersökande, 98 behandlande och 11 administrativa). Kardinaliteten mellan KVÅ och ICHI varierade från 1:0 till 1:28. Nio procent av KVÅ-åtgärderna kunde inte mappas till ICHI (1:0). I 37 procent var förhållandet 1:1, dvs en KVÅ-åtgärd mappades till en ICHI-intervention. I 34 procent var förhållandet 1:2 eller 1:3 och i 17 procent mellan 1:4-1:9. Fyra KVÅ-åtgärder hade förhållandet 1:14, 1:25 och 1:28. Grad av samstämmighet mellan KVÅ-åtgärd och ICHI-intervention visade att 14 procent överensstämde exakt. 67 procent av KVÅ-åtgärderna var bredare dvs. mindre specifika än ICHI-interventionerna och 18 procent av KVÅ-åtgärderna var mer specifika än ICHI-intervention.

Slutsats/Praktisk tillämpning*

ICHI har fler specifika interventioner för att dokumentera arbetsterapeuters åtgärder inom psykiatrisk verksamhet än KVÅ. Att börja tillämpa ICHI inom svenska psykiatrisk arbetsterapiverksamhet skulle öka kvalitén på dokumentationen.

Min mening om olika aktiviteter (OSA-S) är ett självskattningsinstrument som syftar till att ge personen möjlighet att uttrycka sin egen uppfattning om sitt aktivitetsutförande och sin delaktighet i saker och ting i vardagen. Personens känsla av kompetens (problem och styrkor) inför utförandet av dagliga aktiviteter tydliggörs, liksom värderingar av olika aktiviteter. Genom självskattningen och uppföljande samtal med arbetsterapeuten påbörjas en process som gör det möjligt för personen att få större kontroll över sin situation och behandlingsmålen.

Manualen beskriver instrumentets teoretiska grund, utveckling och uppdaterad forskning, syfte, genomförande och uppföljning av självskattningen, samt en mappning av instrumentets påståenden till ICF. Alldeles nytt i den nya manualen (tidigare manual är ifrån 2012) är en fallbeskrivning samt en alldeles nyframtagen kortversion med enbart 12 påstående som kan användas i vård- och omsorgsituationer där tiden att samla information är relativt kort.

The Interest Checklist was translated into Swedish already in 1987 but it has never been adapted to Swedish context. And, since MOHO has been updated severely times since 1983 it was advisable to initially make asurvey in Sweden examining interests’ people do today.

In total 76 people participated by filling in a questionnaire investigated to what extent the interests on the list were carried out today by adults. The responder could add new interests and they could make comments to the list. Based on the feedback and national surveys on how leisure time in Sweden is spend an updated list was designed. The different interests were categorized into sex areas; Outdoor interests, Exercise, Productivity - at home, Art and creative, Social, and Others. All, 68, interests are stated extensively in verbform and arranged in alphabetical order within each group. New interests have been added, others have been updated, clarified or removed. Example of new interests is "Networks and be active on social media (eg Facebook, Instagram, Blogs)". Example of updated interest is "Clothes", which now is called "Follow fashion (eg clothes, makeup)". Some interests have been removed either because they are part of one of the new interests or because they are not a leisure interest, for example "Housecleaning”. The new Swedish version, completed in 2019, has also been related to the latest MOHO (2017) and ICF. An assessment manual has been developed with an introduction, theoretical ground, instructions to self-report and additionally a case has been added.

The presented MOHO intervention methods; strategies and interventions, for facilitating change has not been investigated in practice in Sweden. MOHO is often seen as an assessment model. Many assessments have been translated and tested for scientific standard in Sweden but the intervention part has not been noticed in the same way. The aim of the presented survey was to investigate the use of the methods for facilitating change with MOHO in a Swedish context. Ten OT in the area of mental health were invited to partaken in the survey. In their daily work they reported on a questionnaire which methods they used if they were applying MOHO in the treatment sessions together with the client. Regarding therapeutic strategies in total 78 treatment sessions were reported. After following a treatment planning process including different MOHO assessments depending on the client ́s needs, it was stated that the main areas of concern for the clients were volition or habit or performance capacity to almost the same extent for all three elements. The result show that two of the strategies; “Validation” and “Identifying” was use most frequently. “Providing Physical Support” and “Negotiating” was used very sparingly. The most surprising result was that ”Structuring” was rated as number 6of the 9 strategies. When OT describe what they are doing, structuring daily occupations very often is mention as a regular intervention. The interventions are currently being tested, the results will be presented in September.