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Turesson, C., Liedberg, G. & Björk, M. (2022). Development of a Digital Support Application With Evidence-Based Content for Sustainable Return to Work for Persons With Chronic Pain and Their Employers: User-Centered Agile Design Approach. JMIR Human Factors, 9(1), Article ID e33571.
Open this publication in new window or tab >>Development of a Digital Support Application With Evidence-Based Content for Sustainable Return to Work for Persons With Chronic Pain and Their Employers: User-Centered Agile Design Approach
2022 (English)In: JMIR Human Factors, E-ISSN 2292-9495, Vol. 9, no 1, article id e33571Article in journal (Refereed) Published
Abstract [en]

Background: Persons with chronic pain experience a lack of support after completing rehabilitation and the responsibility for the return-to-work (RTW) process is taken over by the employer. In addition, employers describe not knowing how to support their employees. Smartphone apps have been increasingly used for self-management, but there is a lack of available eHealth apps with evidence-based content providing digital support for persons with chronic pain and their employers when they return to work.

Objective: This study aims to describe the development of a digital support application with evidence-based content that includes a biopsychosocial perspective on chronic pain for sustainable RTW for persons with chronic pain and their employers (SWEPPE [Sustainable Worker Digital Support for Persons With Chronic Pain and Their Employers]).

Methods: A user-centered agile design approach was applied. The multidisciplinary project team consisted of health care researchers, a user representative, and a software team. A total of 2 reference groups of 7 persons with chronic pain and 4 employers participated in the development process and usability testing. Mixed methods were used for data collection. The design was revised using feedback from the reference groups. The content of SWEPPE was developed based on existing evidence and input from the reference groups.

Results: The reference groups identified the following as important characteristics to include in SWEPPE: keeping users motivated, tracking health status and work situation, and following progress. SWEPPE was developed as a smartphone app for the persons with chronic pain and as a web application for their employers. SWEPPE consists of six modules: the action plan, daily self-rating, self-monitoring graphs, the coach, the library, and shared information with the employer. The employers found the following functions in SWEPPE to be the most useful: employees' goals related to RTW, barriers to RTW, support wanted from the employer, and the ability to follow employees' progress. The persons with chronic pain found the following functions in SWEPPE to be the most useful: setting a goal related to RTW, identifying barriers and strategies, and self-monitoring. Usability testing revealed that SWEPPE was safe, useful (ie, provided relevant information), logical, and easy to use with an appealing interface.

Conclusions: This study reports the development of a digital support application for persons with chronic pain and their employers. SWEPPE fulfilled the need of support after an interdisciplinary pain rehabilitation program with useful functions such as setting a goal related to RTW, identification of barriers and strategies for RTW, self-monitoring, and sharing information between the employee and the employer. The user-centered agile design approach contributed to creating SWEPPE as a relevant and easy-to-use eHealth intervention. Further studies are needed to examine the effectiveness of SWEPPE in a clinical setting.

Place, publisher, year, edition, pages
Toronto, ON, Canada: JMIR Publications Inc., 2022
Keywords
agile design process; chronic pain; digital support; eHealth; mobile phone; return to work; self-management; smartphone apps; user-centered design
National Category
Occupational Therapy
Identifiers
urn:nbn:se:liu:diva-184169 (URN)10.2196/33571 (DOI)000787631400019 ()35285814 (PubMedID)
Projects
SWEPPE project
Note

Funding: Swedish Rheumatism Association - Swedish Research Council for Health, Working Life and Welfare [Dnr 2019-01264]

Available from: 2022-04-06 Created: 2022-04-06 Last updated: 2023-05-04Bibliographically approved
Svanholm, F., Liedberg, G., Lofgren, M. & Björk, M. (2022). Factors of importance for return to work, experienced by patients with chronic pain that have completed a multimodal rehabilitation program - a focus group study. Disability and Rehabilitation, 44(5), 736-744
Open this publication in new window or tab >>Factors of importance for return to work, experienced by patients with chronic pain that have completed a multimodal rehabilitation program - a focus group study
2022 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 44, no 5, p. 736-744Article in journal (Refereed) Published
Abstract [en]

Background and purpose:To reduce the individual, societal, and economic burden of the high sick leave rates due to chronic pain, it is essential to find effective strategies for increasing return to work (RTW). Although multimodal rehabilitation programs (MMRPs) may have positive effects on RTW, the results are inconsistent. This study explores the factors that contribute to decreasing sick leave and increasing RTW in patients with chronic pain who completed a MMRP. Method:Four focus groups and three individual interviews were conducted. In total, 18 patients were interviewed. All patients had chronic pain and had completed a MMRP. They were either employed or unemployed, either working to some degree or fully on sick leave. The data were analysed using qualitative content analysis. Results:Three main categories were identified: Knowledge and understanding-prerequisites for tailored solutions; Individual adaptations-necessary but difficult to implement; and Stakeholder collaboration-needs improvement. Conclusion:The participants described a variety of facilitating and limiting factors that created complex prerequisites for RTW. This finding makes it clear that these patients need tailored interventions and strong collaboration among all stakeholders throughout the rehabilitation process. Tailored interventions and collaborations could improve the effectiveness of MMRPs.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
Chronic pain; return to work; rehabilitation; qualitative method
National Category
Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-168573 (URN)10.1080/09638288.2020.1780479 (DOI)000547985400001 ()32580604 (PubMedID)
Note

Funding Agencies|Swedish Research for Health, Working Life and Welfare [2016-07414]; County council of _Osterg_otland [LiO-582141]

Available from: 2020-08-27 Created: 2020-08-27 Last updated: 2023-04-26
Svanholm, F., Liedberg, G., Löfgren, M. & Björk, M. (2022). Stakeholders experience of collaboration in the context of interdisciplinary rehabilitation for patients with chronic pain aiming at return to work. Disability and Rehabilitation, 44(26), 8388-8399
Open this publication in new window or tab >>Stakeholders experience of collaboration in the context of interdisciplinary rehabilitation for patients with chronic pain aiming at return to work
2022 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 44, no 26, p. 8388-8399Article in journal (Refereed) Published
Abstract [en]

Background and purpose Chronic pain is a major reason for sick leave worldwide. Interdisciplinary pain rehabilitation programs (IPRPs), workplace interventions, and stakeholder collaboration may support patients in their return to work (RTW). Few studies have examined stakeholders experiences of important components in the RTW rehabilitation process for patients with chronic pain, especially in the context of IPRP. This study explores and describes stakeholders experiences with stakeholder collaboration and factors related to RTW for patients with chronic pain who have participated in IPRP. Methods Six focus groups, three pair and four individual interviews were conducted with a total of 28 stakeholder representatives from three societal and three health care stakeholders. Data were analyzed using qualitative content analysis. Results The participants revealed that stakeholder collaboration and a tailored RTW rehabilitation plan were important strategies although they noted that these strategies were not working sufficiently efficient as presently implemented. The different stakeholders paradigms and organizational prerequisites were described as hindrances of such strategies and that the degree of tailoring depended on individual attitudes. Conclusions More knowledge transfer and flexibility, clearer responsibilities, and better coordination throughout the RTW rehabilitation process may increase the efficiency of stakeholder collaboration and support for patients.

Place, publisher, year, edition, pages
Taylor & Francis Ltd, 2022
Keywords
Chronic pain; stakeholder collaboration; return to work; rehabilitation; qualitative method
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-182630 (URN)10.1080/09638288.2021.2018051 (DOI)000745522600001 ()35060831 (PubMedID)
Note

Funding Agencies|Swedish Research for Health, Working Life and Welfare [2016-07414]; County Council of Ostergotland [LiO-582141]

Available from: 2022-02-01 Created: 2022-02-01 Last updated: 2023-04-26Bibliographically approved
Schaller, A., Dragioti, E., Liedberg, G. & Larsson, B. (2019). Are patient education and self-care advantageous for patients with head and neck cancer?: A feasibility study. Nursing Open, 6(4), 1528-1541
Open this publication in new window or tab >>Are patient education and self-care advantageous for patients with head and neck cancer?: A feasibility study
2019 (English)In: Nursing Open, E-ISSN 2054-1058, Nursing open, ISSN 2054-1058, Vol. 6, no 4, p. 1528-1541Article in journal (Refereed) Published
Abstract [en]

Aim: This study evaluates whether patient education and individually self-care reduces pain and improves QoL, mood and sleep during and after radiotherapy treatment for patients with head and neck cancer.

Design: A longitudinal, two-armed feasibility study design was performed.

Methods: Sixty-four participants with curative intent were included in the study. All participants answered questions about pain three times a week and completed a survey questionnaire about pain, QoL, psychological aspects and barriers towards pain management at baseline, at 4 weeks and at 10 weeks. Thirty-four of the participants attended in two education sessions on pain based on their beliefs about pain and received individualized self-care instructions based on their weekly rating of pain.

Result: This study did not find any significant group differences for the pain, QoL, mood and sleep.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2019
Keywords
education, head and neck cancer, pain, psychological symptoms, quality of life, self‐care
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-164416 (URN)10.1002/nop2.361 (DOI)000483196000001 ()31660181 (PubMedID)2-s2.0-85071050974 (Scopus ID)
Available from: 2020-03-19 Created: 2020-03-19 Last updated: 2020-04-14Bibliographically approved
Roos, S., Liedberg, G., Hellström, I. & Wilhelmsson, S. (2019). Persistent symptoms in people with celiac disease despite gluten-free diet: A concern?. Gastroenterology Nursing, 42(6), 496-503
Open this publication in new window or tab >>Persistent symptoms in people with celiac disease despite gluten-free diet: A concern?
2019 (English)In: Gastroenterology Nursing, ISSN 1042-895X, E-ISSN 1538-9766, Vol. 42, no 6, p. 496-503Article in journal (Refereed) Published
Abstract [en]

Studies show that people with celiac disease have reduced well-being and have persistent symptoms, mainly related to the gastrointestinal tract. The aim of this study was to analyze how persons in a celiac disease member association report their symptoms, health, and life satisfaction. A questionnaire, with both open and closed questions, was distributed to all members (n = 726) of a celiac association in the southeast of Sweden. The response rate was 74.5%, of which 524 (72%) said they had received a celiac disease diagnosis and were thus included in the study. Almost half of the participants (40.7%-42.2%) stated that they had persistent celiac disease symptoms despite following a gluten-free diet. Diarrhea, abdominal pain, and congestion were persistent symptoms reported and could contribute to a lower health status compared with people without persistent symptoms. The life satisfaction scale (LiSat-9) showed differences in 5 of 9 variables between the groups. Living with celiac disease is far from easy when you have persistent symptoms. People with celiac disease require follow-up by healthcare services, and a new treatment needs to be developed because following the gluten-free diet alone does not seem to alleviate symptoms in everyone.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2019
Keywords
Celiac disease, Comorbidity, Health status, Life satisfaction
National Category
Medical and Health Sciences Gastroenterology and Hepatology
Identifiers
urn:nbn:se:liu:diva-162435 (URN)10.1097/sga.0000000000000377 (DOI)000501331100005 ()31770352 (PubMedID)2-s2.0-85075672187 (Scopus ID)
Note

Funding agencies:  LIONS research fund

Available from: 2019-12-03 Created: 2019-12-03 Last updated: 2021-04-12Bibliographically approved
Holstein, J., Liedberg, G. M., Öhman, A. & Kjellberg, A. (2019). Validity and utility of the Swedish version of the Cultural Competence Assessment Instrument. British Journal of Occupational Therapy, 82(7), 422-432
Open this publication in new window or tab >>Validity and utility of the Swedish version of the Cultural Competence Assessment Instrument
2019 (English)In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 82, no 7, p. 422-432Article in journal (Refereed) Published
Abstract [en]

Introduction: Global migration as well as migration to Sweden has increased during the last few decades. A self-rating instrument that measures cultural competence could support occupational therapists' professional knowledge when they encounterclients from different cultural backgrounds. The purpose of this study was to evaluate the content validity and utility of the Swedish version of the Cultural Competence Assessment Instrument among occupational therapists. Nineteen occupational therapists participated in four focus groups.

Method: Qualitative analysis was used to evaluate content validity and utility.

Results: The results revealed that all 24 items of the Cultural Competence Assessment Instrument were valid, even though six of the items were in need of reformulations and exemplifications. The category Interactions with clients showed that the Cultural Competence Assessment Instrument – Swedish version could be utilised individually to raise awareness on cultural issues inpractice. The category Workplace and its organisational support showed that the Cultural Competence Assessment Instrument – Swedish version had potential for use in different workplaces, and indicated the importance of organisational support in the development of communications and cultural competence.

Conclusion: The evaluation indicated positive content validity for the Cultural Competence Assessment Instrument – Swedish version, and that it had the potential to be utilised in the Swedish context.

Keywords
Instrument development, occupational therapy, qualitative research, ethnicity, cultural competence
National Category
Occupational Therapy
Identifiers
urn:nbn:se:liu:diva-156137 (URN)10.1177/0308022619825813 (DOI)000473502900005 ()
Available from: 2019-04-05 Created: 2019-04-05 Last updated: 2023-01-27
Sernheim, Å.-S., Hemmingsson, H., Witt Engerström, I. & Liedberg, G. (2018). Activities that girls and women with Rett syndrome liked or did ot like to do. Scandinavian Journal of Occupational Therapy, 25(4), 267-277
Open this publication in new window or tab >>Activities that girls and women with Rett syndrome liked or did ot like to do
2018 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 25, no 4, p. 267-277Article in journal (Refereed) Published
Abstract [en]

Objective: Activities occur in all people’s lives. This study investigated over a period of time, 15 years, what activities were enjoyed or not enjoyed and what activities parents and staff liked to do with girls/women with Rett syndrome.

Method: A descriptive study was conducted using secondary data from three earlier questionnaires at the Swedish National Rett Center. The first questionnaire provided data on 123 girls/women with Rett syndrome, the second on 52 and the third questionnaire, on 39. Informants were parents and/or staff, in total 365. Open-ended questions were analysed using a content analysis approach.

Results: Three categories appeared: Being in motion, receiving impressions and having contact. Bathing/swimming, listening to music and being outdoors/walking were the most enjoyed activities over the years. Of the few activities that were reported as being unenjoyable, most were daily care activities. The activities that the parents/staff enjoyed doing with the girls/women were similar to those the girls/women themselves liked to do.

Conclusion: A preliminary overview for both liked and disliked activities of girls/women with Rett syndrome was presented. This knowledge could facilitate the choice and use of activities.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Activities of daily living, human activities, human development, neurodevelopmental disorders, qualitative research
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-136247 (URN)10.1080/11038128.2016.1250812 (DOI)000436878200005 ()27817243 (PubMedID)2-s2.0-84994304785 (Scopus ID)
Available from: 2017-04-03 Created: 2017-04-03 Last updated: 2020-08-13Bibliographically approved
Karlsson, E., Liedberg, G. & Sandqvist, J. (2018). Initial evaluation of psychometric properties of a structured work task application for the Assessment of Work Performance in a constructed environment. Disability and Rehabilitation, 40(21), 2585-2591
Open this publication in new window or tab >>Initial evaluation of psychometric properties of a structured work task application for the Assessment of Work Performance in a constructed environment
2018 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, no 21, p. 2585-2591Article in journal (Refereed) Published
Abstract [en]

Purpose: The Swedish Social Insurance Administration has developed a new assessment tool for sickness insurance. This study is a part of the initial evaluation of the application, called the Assessment of Work Performance, Structured Activities, and focuses on evaluation of the psychometric properties of social validity, content validity, and utility.

Materials and methods: This was a qualitative study using semi-structured telephone interviews with occupational therapists. A convenience sample was used and participants who fulfilled inclusion criteria (n = 15) were interviewed. Data were analyzed using content analysis with a directed approach.

Results: The results indicate that the application provides valuable information and that it is socially valid. Assessors found work tasks suitable for a diverse group of clients and reported that clients accepted the assessments. Improvements were suggested, for example, expanding the application with more work tasks.

Conclusion: The instrument has benefits; however, further development is desired. The use of a constructed environment in assessments may be a necessary option to supplement a real environment. But depending on organizational factors such as time and other resources, the participants had different opportunities to do so. Further evaluations regarding ecological validity are essential to ensure that assessments are fair and realistic when using constructed environments.

  • Implications for rehabilitation
  • This study indicates that assessment in a constructed environment can provide a secure and protected context for clients being assessed.

  • Psychometric evaluations are a never-ending process and this assessment instrument needs further development. However, this initial evaluation provides guidance in development of the instrument but also what studies to give priority to.

  • It is important to evaluate social validity in order to ensure that clients and assessors perceive assessment methods fair and meaningful. In this study, participants found the work tasks appropriate and usable when assessing their clients but client’s perspective must also be included in following studies.

  • This assessment instrument is the only activity-based assessment instrument within the Swedish Social Security Insurance. Psychometric evaluations are important since it affects so many individuals in Sweden.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Occupational therapy, vocational rehabilitation, Return to Work, Model of Human Occupation, instrument development
National Category
Occupational Therapy
Identifiers
urn:nbn:se:liu:diva-141984 (URN)10.1080/09638288.2017.1342279 (DOI)000446621800014 ()2-s2.0-85021222024 (Scopus ID)
Available from: 2017-10-16 Created: 2017-10-16 Last updated: 2018-10-30Bibliographically approved
Liedberg, G. M. (2017). Occupational life trajectories in the context of chronic pain and immigration. In: : . Paper presented at 7th Association of South-East Asian Pain Societies Congress, Yangon, Myanmar.
Open this publication in new window or tab >>Occupational life trajectories in the context of chronic pain and immigration
2017 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-135793 (URN)
Conference
7th Association of South-East Asian Pain Societies Congress, Yangon, Myanmar
Available from: 2017-03-22 Created: 2017-03-22 Last updated: 2017-03-22
Liedberg, G. & Björk, M. (2017). Pain, self-efficacy, anxiety, and quality of life are central for a bad or good night's sleep in persons with fibromyalgia. In: : . Paper presented at 7th Association of South-East Asian Pain Societies Congress February 16-19, Yangon, Myanmar.
Open this publication in new window or tab >>Pain, self-efficacy, anxiety, and quality of life are central for a bad or good night's sleep in persons with fibromyalgia
2017 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-135791 (URN)
Conference
7th Association of South-East Asian Pain Societies Congress February 16-19, Yangon, Myanmar
Available from: 2017-03-22 Created: 2017-03-22 Last updated: 2017-03-27
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-2980-2835

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