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Thyberg, Mikael
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Publications (10 of 27) Show all publications
Thyberg, I., Dahlström, Ö., Björk, M., Stenström, B. & Adams, J. (2017). Hand pains in women and men in early rheumatoid arthritis, a one year follow-up after diagnosis. The Swedish TIRA project. Disability and Rehabilitation, 39(3), 291-300
Open this publication in new window or tab >>Hand pains in women and men in early rheumatoid arthritis, a one year follow-up after diagnosis. The Swedish TIRA project
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2017 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 39, no 3, p. 291-300Article in journal (Refereed) Published
Abstract [en]

Purpose: This research analysed general pain intensity, hand pain at rest and hand pain during activity in women and men in early rheumatoid arhtritis (RA).

Method: Out of the 454 patients that were recruited into the Swedish early RA project "TIRA" the 373 patients (67% women) that remained at 12 months follow-up are reported here. Disease activity 28 joint score (DAS-28), disability (Health Assessment Questionnaire = HAQ) and pain (VAS) were recorded at inclusion and after 3 (M3), 6 (M6) and 12 (M12) months. General pain, hand pain during rest, hand pain during test of grip force as assessed by Grippit™, prescribed disease-modifying anti-inflammatory drugs (DMARDs) and hand dominance were recorded.

Results: DAS-28 and HAQ scores were high at inclusion and improved thereafter in both women and men. There were no significant differences between sexes at inclusion but women had higher DAS-28 and HAQ at all follow-ups. Women were more often prescribed DMARDs than were men. In both women and men all pain types were significantly lower at follow-up compared to at inclusion and women reported higher pain than men at follow-ups. The pain types differed significantly from each other at inclusion into TIRA, general pain was highest and hand pain during rest was lowest. There were no significant differences in hand pain related to hand dominance or between right and left hands.

Conclusions: Disease activity, disability and pain were high at inclusion and reduced over the first year. Despite more DMARDs prescribed in women than in men, women were more affected than were men. General pain was highest and not surprisingly hand pain during active grip testing was higher than hand pain during rest that was lowest in both sexes. Although our cohort was well controlled, it was evident that hand pain remains a problem. This has implications for rehabilitation and suggests potential ongoing activity limitations that should continue to receive attention from a multi-professional team.

  • Implications for Rehabilitation
  • General pain and hand pain remain a problem in RA despite today's early intervention and effective disease control with new era biologics.
  • The extent of hand pain evidenced in our work gives a more detailed and comprehensive account of pain status.
  • Higher hand pain during active grip testing than that during rest indicates a potential relationship to ongoing activity limitation.
  • Hand pain assessment can help guiding multi-professional interventions directed to reduce hand pain and thereby probably reduce activity limitations.
Place, publisher, year, edition, pages
Taylor & Francis, 2017
Keywords
Disability, grip force, hand function, pain, rehabilitation, sex
National Category
Occupational Therapy
Identifiers
urn:nbn:se:liu:diva-126437 (URN)10.3109/09638288.2016.1140835 (DOI)000392480400009 ()26965161 (PubMedID)
Note

Funding agencies: Swedish Rheumatism Association

Available from: 2016-03-24 Created: 2016-03-24 Last updated: 2018-04-07Bibliographically approved
Björk, M., Thyberg, M., Valtersson, E. & Katz, P. (2016). Validation and internal consistency of the Swedish version of the Valued Life Activities scale.. Clinical Rehabilitation, 30(12), 1211-1219
Open this publication in new window or tab >>Validation and internal consistency of the Swedish version of the Valued Life Activities scale.
2016 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, no 12, p. 1211-1219Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The objective was to create a linguistically and culturally validated Swedish version of the Valued Life Activities scale. The aim was also to describe its content and concurrent validity and its internal consistency in persons with rheumatoid arthritis.

METHODS: The Valued Life Activities scale was translated to Swedish and culturally adapted. In order to describe the content validity, both the Swedish and original Valued Life Activities scale were linked to the International Classification of Functioning, Disability and Health. The concurrent validity and internal consistency were evaluated in 737 patients with rheumatoid arthritis. To establish concurrent validity, the scale was correlated to disease activity, activity limitations, and life satisfaction. Internal consistency was assessed with Cronbach's alpha.

RESULTS: The equivalence of meaning between the Swedish and the original Valued Life Activities scale was ensured by harmonization review. Content validity was high when linked to the International Classification of Functioning, Disability and Health. Concurrent validity showed a strong correlation with the activity limitations (r = 0.87), moderate with life satisfaction (r = -0.61), and weak with disease activity (r = 0.38). Internal consistency was excellent (Cronbach's alpha = 0.97).

CONCLUSIONS: The Swedish Valued Life Activities scale has been tested in a large and well-characterized sample and found to be a linguistically valid and culturally adapted self-reported measure of participation. Content validity of the Valued Life Activities scale was excellent, concurrent validity strong, and the internal consistency excellent. Since both individual preferences and International Classification of Functioning, Disability and Health concepts of disability are taken into account, the Swedish Valued Life Activities scale appears to be a promising new scale addressing important aspects of participation.

Keywords
Activity limitation; Disability and Health; International Classification of Functioning; assessment; participation; patient perspective; validation; valued life activities scale
National Category
Occupational Therapy
Identifiers
urn:nbn:se:liu:diva-126436 (URN)10.1177/0269215515616665 (DOI)000389595500008 ()26603893 (PubMedID)
Note

Funding agencies: Swedish Rheumatism Association [R-309241, R-388161]; Medical Research Council of Southeast [FORSS-307351, FORSS-380281]; County Council of Ostergotland [LIO-356441, LIO-535211]

Available from: 2016-03-24 Created: 2016-03-24 Last updated: 2018-03-23
Sverker, A., Östlund, G., Thyberg, M., Thyberg, I., Valtersson, E. & Björk, M. (2015). Dilemmas of participation in everyday life in early rheumatoid arthritis: a qualitative interview study (The Swedish TIRA Project). Disability and Rehabilitation, 37(14-15), 1251-1259
Open this publication in new window or tab >>Dilemmas of participation in everyday life in early rheumatoid arthritis: a qualitative interview study (The Swedish TIRA Project)
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2015 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 14-15, p. 1251-1259Article in journal (Refereed) Published
Abstract [en]

Abstract Purpose: To explore the experiences of today's patients with early rheumatoid arthritis (RA) with respect to dilemmas of everyday life, especially regarding patterns of participation restrictions in valued life activities. Methods: A total of 48 patients, aged 20-63, three years post-RA diagnosis were interviewed using the Critical Incident Technique. Transcribed interviews were condensed into meaningful units describing actions/situations. These descriptions were linked to ICF participation codes according to the International Classification of Functioning, Disability and Health (ICF) linking rules. Results: Dilemmas in everyday life were experienced in domestic life, interpersonal interactions and relationships, community, social and civic life. Most dilemmas were experienced in domestic life, including participation restrictions in, e.g. gardening, repairing houses, shovelling snow, watering pot plants, sewing or walking the dog. Also many dilemmas were experienced related to recreation and leisure within the domain community, social and civic life. The different dilemmas were often related to each other. For instance, dilemmas related to community life were combined with dilemmas within mobility, such as lifting and carrying objects. Conclusions: Participation restrictions in today's RA patients are complex. Our results underline that the health care needs to be aware of the patients' own preferences and goals to support the early multi-professional interventions in clinical practice. Implications of Rehabilitation Today's rheumatoid arthritis (RA) patients experience participation restrictions in activities not included in International Classification of Functioning, Disability and Health (ICF) core set for RA or in traditionally questionnaires with predefined activities. The health care need to be aware of the patients' own preferences and goals to meet the individual needs and optimize the rehabilitation in early RA in clinical practice.

Place, publisher, year, edition, pages
Informa Healthcare, 2015
National Category
Clinical Medicine Basic Medicine
Identifiers
urn:nbn:se:liu:diva-113134 (URN)10.3109/09638288.2014.961658 (DOI)000357763700006 ()25243767 (PubMedID)
Available from: 2015-01-12 Created: 2015-01-12 Last updated: 2018-01-11
Arvidsson, P., Granlund, M. & Thyberg, M. (2015). How are the activity and participation aspects of the ICF used? Examples from studies of people with intellectual disability. NeuroRehabilitation (Reading, MA), 36(1), 45-49
Open this publication in new window or tab >>How are the activity and participation aspects of the ICF used? Examples from studies of people with intellectual disability
2015 (English)In: NeuroRehabilitation (Reading, MA), ISSN 1053-8135, E-ISSN 1878-6448, Vol. 36, no 1, p. 45-49Article, review/survey (Refereed) Published
Abstract [en]

INTRODUCTION: Interdisciplinary differences regarding understanding the International Classification of Functioning, Disability and Health (ICF) concepts activity/participation may hinder its unifying purpose. In the ICF model, functioning (and disability) is described as a tripartite concept: 1) Body structures/functions, 2) Activities, and 3) Participation. Activities refer to an individual perspective on disability that does not tally with the basic structure of social models. OBJECTIVE: To review how activity and participation are actually used in studies of intellectual disability (ID). CONCLUSION: Based on 16 papers, four different usages of activity/participation were found. 1) Theoretical reference to tripartite ICF concept with attempts to use it. 2) Theoretical reference to tripartite ICF concept without actual use of activities. 3) "Atheoretical" approach with implicit focus on participation. 4) Theoretical reference to bipartite concept with corresponding use of terms. The highlighted studies have in common a focus on participation. However, the usage of the term "activity" differs both within and between studies. Such terminology will probably confuse interdisciplinary communication rather than facilitating it. Also, the use of an explicit underlying theory differs, from references to a tripartite to references to a bipartite concept of disability. This paper is focused on ID, but the discussed principles regarding the ICF and interdisciplinary disability theory are applicable to other diagnostic groups within rehabilitation practices.

Place, publisher, year, edition, pages
IOS Press, 2015
Keywords
Activity; ICF; intellectual disability; interdisciplinary rehabilitation; participation
National Category
Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-115339 (URN)10.3233/NRE-141190 (DOI)000349326700008 ()25547764 (PubMedID)
Available from: 2015-03-13 Created: 2015-03-13 Last updated: 2017-12-04
Thyberg, M., Arvidsson, P., Thyberg, I. & Nordenfelt, L. (2015). Simplified bipartite concepts of functioning and disability recommended for interdisciplinary use of the ICF.. Disability and Rehabilitation, 37(19), 1783-1792
Open this publication in new window or tab >>Simplified bipartite concepts of functioning and disability recommended for interdisciplinary use of the ICF.
2015 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 19, p. 1783-1792Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To argue for and propose bipartite concepts of functioning and disability, to tally with the structure of the ICF classification list, concepts of social models and clinical needs.

METHOD: The ICF concepts are discussed in relation to the history of ideas regarding disability concepts and the needs for such concepts in interdisciplinary rehabilitation.

RESULTS: Bipartite concepts are presented; they refer to actual functioning, simply body functions/structures and participation, including functioning in standardized environments. Participation refers to actually performed "activities", with "activities" simply denoting things that people may do. Bipartite concepts are congruent with the ICF classification and the structure of social models of disability, suitable for clinical and interdisciplinary use and easy to understand. The issue of standardized environments represents a methodological issue rather than the conceptual issue of defining functioning and disability. An individual perspective on activity and activity limitations, i.e. the middle part of the tripartite ICF concept, is somewhat similar to concepts of traditional language that were regarded as too generalizing already in 1912, when the interactional concept of "disability in a social sense" was introduced in rehabilitation practices.

CONCLUSION: Bipartite concepts of functioning and disability are recommended for interdisciplinary use of the ICF.

IMPLICATIONS FOR REHABILITATION: The ICF classification is useful, but the ICF concept of activities in an individual perspective is confusing. We suggest a use of the term "activities" simply to denote things that people may do and "participation" to denote actually performed activities. Estimations of ability should be explicit about how they are related to environmental factors.

Keywords
Activity limitation; ICF; interaction; interdisciplinary; participation; social model
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:liu:diva-124397 (URN)10.3109/09638288.2014.978506 (DOI)25365700 (PubMedID)
Available from: 2016-01-28 Created: 2016-01-28 Last updated: 2017-11-30
Sverker, A., Björk, M., Thyberg, I., Thyberg, M., Valtersson, E. & Östlund, G. (2014). AB1154-HPR Men's Strategies of Handling Participation Restrictions Related to Rheumatoid Arthritis (The Swedish Tira Study). In: : . Paper presented at Ann Rheum Dis 2014 (pp. 141-142). , 73
Open this publication in new window or tab >>AB1154-HPR Men's Strategies of Handling Participation Restrictions Related to Rheumatoid Arthritis (The Swedish Tira Study)
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2014 (Swedish)Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Background: In spite of early interventions and advancements in medication disability and restricted work capacity is closely related to rheumatoid arthritis (RA). Around 1/3 of diagnosed patients are men, however few studies describe men's need and experiences of living with RA [1].Objectives: To explore male strategies of handling participating restriction in everyday life.Methods: In this study 25 men with early RA from the TIRA2 cohort [2], age 20 – 63, were interviewed about participation restrictions with Critical Incident Technique [3]. Transcribed interviews were synthesized into dilemmas and linked to ICF participation [4] codes and the strategies in handling these dilemmas were analyzed and categorized using content analysis [5].Results: The men described four types of strategies of handling participating restriction in everyday life. Resilience strategies; to find enjoyments, develop self-trust, and a new body-knowledge. Daily routine strategies; use more time on each task and rest in between activities, adjust medication to activity, adjust movements finding new ways to conduct work tasks and physical training. Avoidance strategies; avoid alcohol, social contacts after work, inform of RA and sometimes medicine. Action strategies; continue activities, attend activities as a spectator instead of being an active participant, go home if needed, say no, ask for help, and talk about RA. Acceptance strategies; accept pain, accept less work pace, accept less endurance and fewer activities.Conclusions: Men described dilemmas in everyday life due to RA, but not all experienced being restricted in life they rather expressed reorganizing their everyday lives.References:Shuttleworth RP (2004). Disabled masculinity; Expanding the masculine repertoire. In Smith BG, Hutchinson B (Eds). Gendering disability, New Brunswick, NJ; Rutgers University Press.Björk M, Thyberg I, Rikner K, Balogh I, Gerdle B. Sick leave before and after diagnosis of rheumatoid arthritis: a report from the Swedish TIRA project. J Rheumatol 2009;36:1170-1179.Flanagan, C (1954). The critical incident technique. Psychological Bulletin, 51: p. 327-358.Cieza A, Geyh S, Chatterji S, Kostanjsek N, Ustun B, Stucki G ICF linking rules: an update based on lessons learned. J Rehabil Med. 2005;37:212-8.Sverker A, Thyberg I, Östlund G, Valtersson E, Thyberg M. (2013). Participation in work in early rheumatoid arthritis: A qualitative interview study interpreted in terms of the ICF. Disability & Rehabilitation May (3); ISSN1464-5165

National Category
Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-114604 (URN)10.1136/annrheumdis-2014-eular.3717 (DOI)
Conference
Ann Rheum Dis 2014
Available from: 2015-02-26 Created: 2015-02-26 Last updated: 2015-06-11
Sverker, A., Waltersson, E., Thyberg, I., Thyberg, M. & Östlund, G. (2014). Deltagande i arbete vid tidig reumatoid artrit – en kvalitativ intervjustudie tolkad i termer av ICF. Reumatologi (18)
Open this publication in new window or tab >>Deltagande i arbete vid tidig reumatoid artrit – en kvalitativ intervjustudie tolkad i termer av ICF
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2014 (Swedish)In: Reumatologi, no 18Article in journal (Other academic) Published
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-114372 (URN)
Available from: 2015-02-19 Created: 2015-02-19 Last updated: 2015-03-02
Östlund, G., Björk, M., Thyberg, I., Thyberg, M., Valtersson, E., Stenström, B. & Sverker, A. (2014). Emotions related to participation restrictions as experienced by patients with early rheumatoid arthritis: a qualitative interview study (the Swedish TIRA project). Clinical Rheumatology, 33(10), 1403-1413
Open this publication in new window or tab >>Emotions related to participation restrictions as experienced by patients with early rheumatoid arthritis: a qualitative interview study (the Swedish TIRA project)
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2014 (English)In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 33, no 10, p. 1403-1413Article in journal (Refereed) Published
Abstract [en]

Psychological distress is a well-known complication in rheumatoid arthritis (RA), but knowledge regarding emotions and their relationship to participation restrictions is scarce. The objective of the study was to explore emotions related to participation restrictions by patients with early RA. In this study, 48 patients with early RA, aged 20-63 years, were interviewed about participation restrictions using the critical incident technique. Information from transcribed interviews was converted into dilemmas and linked to International Classification of Functioning, Disability, and Health (ICF) participation codes. The emotions described were condensed and categorized. Hopelessness and sadness were described when trying to perform daily activities such as getting up in the mornings and getting dressed, or not being able to perform duties at work. Sadness was experienced in relation to not being able to continue leisure activities or care for children. Examples of fear descriptions were found in relation to deteriorating health and fumble fear, which made the individual withdraw from activities as a result of mistrusting the body. Anger and irritation were described in relation to domestic and employed work but also in social relations where the individual felt unable to continue valued activities. Shame or embarrassment was described when participation restrictions became visible in public. Feelings of grief, aggressiveness, fear, and shame are emotions closely related to participation restrictions in everyday life in early RA. Emotions related to disability need to be addressed both in clinical settings in order to optimize rehabilitative multi-professional interventions and in research to achieve further knowledge.

Place, publisher, year, edition, pages
Springer, 2014
Keywords
Critical incidents; Emotions; Lived experiences; Participation; Patients perspectives
National Category
Clinical Medicine Basic Medicine Sociology
Identifiers
urn:nbn:se:liu:diva-111444 (URN)10.1007/s10067-014-2667-2 (DOI)000342197400007 ()24838364 (PubMedID)
Note

Funding Agencies|County Council of Ostergotland Research Foundations; Medical Research Council of South-East Sweden (FORSS); Norrbacka-Eugenia Foundation; Swedish Rheumatism Association

Available from: 2014-10-21 Created: 2014-10-17 Last updated: 2018-01-11Bibliographically approved
Arvidsson, P., Granlund, M., Thyberg, I. & Thyberg, M. (2014). Important aspects of participation and participation restrictions in people with a mild intellectual disability. Disability and Rehabilitation, 36(15), 1264-1272
Open this publication in new window or tab >>Important aspects of participation and participation restrictions in people with a mild intellectual disability
2014 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, no 15, p. 1264-1272Article in journal (Refereed) Published
Abstract [en]

Purpose: This study explored a possibility to assess the concepts of participation and participation restrictions in the International Classification of Functioning, Disability and Health (ICF) by combining self-ratings of the perceived importance with the actual performance of different everyday activities in people with a mild intellectual disability. Method: Structured interviews regarding 68 items from the ICF activity/participation domain were conducted (n = 69). The items were ranked by perceived importance, performance and by combined measures. Furthermore, the measures were related to a single question about subjective general well-being. Results: Rankings of performance highlighted about the same items as "important participation", while rankings of low performance addressed quite different items compared with "important participation restriction". Significant correlations were found between subjective general well-being and high performance (r = 0.56), high performance/high importance (important participation) (r = 0.56), low performance (r = -0.56) and low performance/high importance (important participation restriction; r -0.55). Conclusions: The results support the clinical relevance of the ICF and the studied selection of 68 items. Although performance only may sometimes be a relevant aspect, knowledge about the relationship between the perceived importance and the actual performance is essential for clinical interventions and for research aiming to understand specific needs regarding participation.

Place, publisher, year, edition, pages
Informa Healthcare, 2014
Keywords
Assessment; ICF; intellectual disability; participation; self-ratings
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-110499 (URN)10.3109/09638288.2013.845252 (DOI)000340450300005 ()24160858 (PubMedID)
Note

Funding Agencies|County Council of Gavleborg, Sweden; FAS (Swedish Research Council on Work and Social Life)

Available from: 2014-09-12 Created: 2014-09-12 Last updated: 2017-12-05Bibliographically approved
Östlund, G., Sverker, A., Björk, M., Thyberg, I., Thyberg, M., Valtersson, E. & Stenström, B. (2014). Känslor relaterade till delaktighet begränsningar – erfarenheter från patienter med reumatoid artrit,en kvalitativ intervjustudie. Reumatologi (18)
Open this publication in new window or tab >>Känslor relaterade till delaktighet begränsningar – erfarenheter från patienter med reumatoid artrit,en kvalitativ intervjustudie
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2014 (Swedish)In: Reumatologi, no 18Article in journal (Other academic) Published
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-114369 (URN)
Available from: 2015-02-19 Created: 2015-02-19 Last updated: 2015-03-02
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