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  • 1.
    Abbott, Allan
    et al.
    Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science, Intervention and Technology, Division of Orthopaedics, Karolinska University Hospital, Karolinska Institute, Stockholm , Sweden.
    Hedlund, Rune
    Department of Orthopaedics, Institute for Clinical Science, University of Gothenburg, Gothenburg, Sweden.
    Tyni-Lenné, Raija
    Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.
    Patient’s experience post-lumbar fusion regarding back problems, recovery and expectations in terms of the international classification of functioning, disability and health.2011Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, nr 15-16, s. 1399-1408Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE:

    To describe within the context of the International Classification of Functioning, Disability and Health (ICF), patient's experiences post-lumber fusion regarding back problems, recovery and expectations of rehabilitation and to contrast with the content of outcome measures and the ICF low back pain (LBP) core sets.

    METHODS:

    The study has a cross-sectional and retrospective design and involves 20 lumbar fusion patients. Using the ICF, qualitative content analysis of semi-structured interviews 3-6 months post-surgery was performed. This was compared with the ICF related content of the Oswestry Disability Index (ODI), Medical Outcome Study Short Form 36 (SF-36), European Quality of Life Questionnaire (EQ5D) and the ICF LBP core sets.

    RESULTS:

    Patient's experiences were most frequently linked to psychological, sensory, neuromusculoskeletal and movement related body function chapters of the ICF. The most frequently linked categories of activity and participation were mobility, domestic activities, family relationships, work, recreation and leisure. Environmental factors frequently linked were the use of analgesics, walking aids, family support, social security systems, health care systems and labour market employment services.

    CONCLUSIONS:

    This study highlights important ICF related aspects of patient's experiences post-lumber fusion. The use of the comprehensive ICF core sets is recommended in conjunction with ODI, SF-36 and the EQ5D for a broader analysis of patient outcomes post-lumbar fusion.

  • 2.
    Ahlstrand, Inger
    et al.
    ADULT, HHJ, Hälsohögskolan, Högskolan i Jönköping.
    Björk, Mathilda
    Avd. för rehabilitering, HHJ, Hälsohögskolan, Högskolan i Jönköping.
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Börsbo, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Landstingets habilitering i centrala Östergötland.
    Pain and daily activities in Rheumatoid Arthritis2012Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, nr 15, s. 1245-1253Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The aim of this study was to describe experiences of pain and its relationship to daily activities in people with rheumatoid arthritis (RA). Method: Seven semi-structured focus group discussions were conducted with 33 men and women of different ages with RA. Data were analysed with content analysis. Results: Pain affected everyday life and may be a barrier to perform valued activities. Regarding the impact of pain on participation and independence, personal factors and the social environment were found to be important. It could be a struggle to find the right activity balance, since it was easy to be overactive, triggering subsequent elevation of pain levels. However, the participants also described activities as a mediator of pain and a distraction from it. Conclusion: The relationship between pain and daily activities in RA was complex. Pain as an impairment was expressed to be related to activity limitations and participation restrictions, as well as to contextual factors. These findings highlight the clinical importance of paying attention to the complexity of pain and its relation to daily activities and participation.

  • 3.
    Aho, Anna Carin
    et al.
    Malmo Univ, Sweden.
    Hultsjö, Sally
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Cty Hosp Ryhov, Sweden.
    Hjelm, Katarina
    Uppsala Univ, Sweden.
    Perceptions of the transition from receiving the diagnosis recessive limb-girdle muscular dystrophy to becoming in need of human support and using a wheelchair: an interview study2019Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, nr 19, s. 2289-2298Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To describe perceptions of the transition from receiving the diagnosis recessive limb-girdle muscular dystrophy to becoming in need of human support to manage daily life and using a wheelchair for ambulation, from the affected young adults and their parents perspectives. Method: A qualitative and descriptive study design was used. Semi-structured interviews were held with 14 young adults diagnosed with recessive limb-girdle muscular dystrophy and 19 parents. Phenomenography was used for data analysis. Results: The diagnosis was described as being a shock and difficult to comprehend but also as a relief and a tool for information. Beginning to use a wheelchair was perceived to be mentally difficult but it also provided freedom. New ways of living involved physical, emotional, practical, and social difficulties as well as experiences of learning to adapt to the disease. The transition was overshadowed by concern about disease progression and influenced by facilitating factors, which were young adult being seen as a person; supportive family and friends; mobilized internal resources; meaningful daily activities; adapted environment; and professional support. Conclusions: The different perceptions expressed in this study highlight the importance of identifying personal perceptions and needs in order to optimize support provided by healthcare professionals.

  • 4.
    Aho, Anna Carin
    et al.
    Linnaeus Univ, Dept Hlth & Caring Sci, Vaxjo, Sweden.
    Hultsjö, Sally
    Cty Hosp, Psychiat Clin, Jonkoping, Sweden.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Young adults' experiences of living with recessive limb-girdle muscular dystrophy from a salutogenic orientation: an interview study.2015Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, nr 22, s. 2083-2091Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    To describe young adults' experiences of living with recessive limb-girdle muscular dystrophy (LGMD2) from a salutogenic orientation. Methods: A qualitative explorative interview study, including 14 participants aged 20-30 years, was performed focusing on comprehensibility, manageability and meaningfulness in daily life. Content analysis was used for data analysis. Result: Living with LGMD2 not only implies learning to live with the disease and the variations between good and bad periods but also means trying to make sense of a progressive disease that brings uncertainty about future health, by striving to make the best of the situation. Disease progression involves practical and mental struggle, trying to maintain control over one's life despite vanished physical functions that require continual adjustments to the body. Restrictions in a double sense were described, not only due to the disease but also due to poor comprehension of the disease in society. Lack of knowledge about LGMD2 among professionals often results in having to fight for the support needed. Conclusion: In order to manage daily life, it is important to be seen and understood as an individual in contacts with professionals and in society in general, to have informal social support and meaningful activities as well as access to personal assistance if necessary. Implications for Rehabilitation Recessive limb-girdle muscular dystrophy (LGMD2) is a group of progressive disorders, which manifest in physical and psychological consequences for the individual. According to the salutogenic orientation, people need to find life comprehensible, manageable and meaningful, i.e. to achieve a sense of coherence (SOC), but living with LGMD2 may recurrently challenge the individual's SOC. Through the holistic view of the individual's situation that the salutogenic orientation provides, professionals may support the individual to strengthen SOC and thereby facilitate the movement towards health.

  • 5.
    Alföldi, Peter
    et al.
    Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin.
    Gerdle, Björn
    Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin.
    Wiklund, Tobias
    Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin.
    Comorbid insomnia in patients with chronic pain: a study based on the Swedish quality registry for pain rehabilitation (SQRP)2014Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, nr 20, s. 1661-1669Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: This study investigates the prevalence of insomnia and its relationship to other symptoms and health aspects in patients with chronic pain. Methods: Patients with chronic pain conditions (n = 845) referred to a multidisciplinary pain centre completed surveys provided by the Swedish quality registry for pain rehabilitation (SQRP). The SQRP collects data on socio-demographics, health status, symptoms of pain, mood and insomnia and life satisfaction. Results: The majority of patients (65.3%) had clinical insomnia according to the insomnia severity index (ISI). Insomnia correlated significantly but weakly with pain, depression, anxiety and coping; the strongest multivariate correlations were found with depression and anxiety followed by pain interference and pain severity. Pain intensity, depression and anxiety correlated stronger than ISI with respect to the two investigated aspects of health. Conclusions: The prevalence of insomnia is high in patients with chronic pain conditions, but the level of importance in relation to other symptoms for health aspects is low, and the associations with other important symptoms are relatively weak. One way to increase the effects of multimodal rehabilitation programs may be to provide interventions directed specifically at insomnia rather than focusing only on interventions that address pain, depression and anxiety. Implications for Rehabilitation The prevalence of insomnia is high in patients with complex chronic pain conditions. Relatively low correlations existed between insomnia and pain intensity, depression, anxiety and other psychological aspects. Pain intensity, anxiety and depression were more important for perceived health aspects than insomnia. One way to increase the effects of multimodal rehabilitation programs may be to also include interventions directed directly to insomnia.

  • 6.
    Alwin, Jenny
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk teknologiutvärdering. Linköpings universitet, Hälsouniversitetet.
    Persson, Jan
    Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk teknologiutvärdering. Linköpings universitet, Hälsouniversitetet.
    Krevers, Barbro
    Linköpings universitet, Institutionen för medicin och hälsa, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Perception and significance of an assistive technology intervention - the perspectives of relatives of persons with dementia2013Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 35, nr 18, s. 1519-1526Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim of this study was to examine relatives' perception of an assistive technology intervention aimed at persons with dementia (PwDs) and their relatives, and to examine whether, and how, experiences of the intervention process differed between relatives valuing the intervention to be of high, and relatives perceiving it to be of low significance. Method: A total of 47 relatives of PwDs within the Swedish Technology and Dementia project were interviewed telephonically using a modified version of the Patient perspective on Care and Rehabilitation process instrument. A total of 46 participants were divided into two groups depending on whether they valued the intervention to be of great significance (GS group; N = 33) or of some/no significance (SNS group; N = 13). Results: Several aspects of the intervention were perceived as highly important, e.g. being shown consideration and respect, and having somewhere to turn. The results indicate that relatives in the GS group perceived certain aspects of the intervention process as highly fulfilled to a larger extent than did relatives in the SNS group. Conclusions: This study illustrates how process evaluations can be used to increase the understanding and to identify improvement aspects of interventions.

  • 7.
    Arvidsson, Patrik
    et al.
    Örebro University, Sweden; Uppsala University, Sweden .
    Granlund, Mats
    Örebro University, Sweden; Jönköping University, Sweden .
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Thyberg, Mikael
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum. Örebro University, Sweden.
    Important aspects of participation and participation restrictions in people with a mild intellectual disability2014Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, nr 15, s. 1264-1272Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 8.
    Bertilsson, Monica
    et al.
    University of Gothenburg, Sweden .
    Petersson, Eva-Lisa
    University of Gothenburg, Sweden .
    Östlund, Gunnel
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten.
    Waern, Margda
    University of Gothenburg, Sweden .
    Hensing, Gunnel
    University of Gothenburg, Sweden .
    Capacity to work while depressed and anxious - a phenomenological study2013Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 35, nr 20, s. 1705-1711Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim was to explore experiences of capacity to work in persons working while depressed and anxious in order to identify the essence of the phenomenon capacity to work. Method: Four focus groups were conducted with 17 participants employed within the regular job market. Illness experiences ranged from symptoms to clinical diagnoses. A phenomenological approach was employed. Results: The phenomenon of capacity to work was distinguished by nine constituents related to task, time, context and social interactions. The phenomenon encompassed a lost familiarity with ones ordinary work performance, the use of a working facade and adoption of new time-consuming work practices. Feelings of exposure in interpersonal encounters, disruption of work place order, lost "refueling and a trade-off of between work capacity and leisure-time activities was also identified. The reduced capacity was pointed out as invisible, this invisibility was considered troublesome. Conclusions: A complex and comprehensive concept emerged, not earlier described in work capacity studies. Rehabilitation processes would benefit from deeper knowledge of the individuals capacity to work in order to make efficient adjustments at work. Results can have particular relevance both in clinical and occupational health practice, as well as in the workplaces, in supporting re-entering workers after sickness absence.

  • 9.
    Beukes, Eldre W.
    et al.
    Anglia Ruskin Univ, England.
    Manchaiah, Vinaya
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV). Lamar Univ, TX 77710 USA; Audiol India, India; Manipal Univ, India.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Karolinska Inst, Sweden.
    Allen, Peter M.
    Anglia Ruskin Univ, England; Anglia Ruskin Univ, England.
    Terlizzi, Paige M.
    Lamar Univ, TX 77710 USA.
    Baguley, David M.
    Anglia Ruskin Univ, England; Nottingham Biomed Res Ctr, England; Univ Nottingham, England.
    Situationally influenced tinnitus coping strategies: a mixed methods approach2018Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, nr 24, s. 2884-2894Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The primary aim of this study was to identify coping strategies used to manage problematic tinnitus situations. A secondary aim was to determine whether different approaches were related to the level of tinnitus distress, anxiety, depression, and insomnia experienced. Materials and methods: A cross-sectional survey design was implemented. The study sample was adults interested in undertaking an Internet-based intervention for tinnitus. Self-reported measures assessed the level of tinnitus distress, depression, anxiety, and insomnia. An open-ended question was used to obtain information about how problematic tinnitus situations were dealt with. Responses were investigated using qualitative content analysis to identify problematic situations. Further data analysis comprised of both qualitative and quantitative methods. Results: There were 240 participants (137 males, 103 females), with an average age of 48.16 years (SD: 22.70). Qualitative content analysis identified eight problematic tinnitus situations. Participants had either habituated to their tinnitus (7.9%), used active (63.3%), or passive (28.8%) coping styles to manage these situations. Those who had habituated to tinnitus or used active coping strategies had lower levels of tinnitus distress, anxiety, and depression. Conclusions: The main problematic tinnitus situations for this cohort were identified. Both active and passive coping styles were applied to approach these situations. The coping strategies used most frequently and utilised in the widest range of problematic situations were using sound enrichment and diverting attention.

  • 10.
    Boström, Kristina
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad.
    Ahlstrom, G.
    Ahlström, G., Department of Caring Science, Örebro University, Örebro, Sweden.
    Living with a chronic deteriorating disease: The trajectory with muscular dystrophy over ten years2004Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 26, nr 23, s. 1388-1398Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim of the study was to elucidate experiences of living with muscular dystrophy in terms of consequences for activity over 10 years. Methods: The study population was identified in a prevalence study in a county of Sweden. Forty-six persons of this cohort with MD were interviewed. A qualitative research approach was chosen. The World Health Organization's International Classification of Functioning, Disability and Health (ICF) was used for categorization. Results: Nearly all the subjects experienced a deterioration of physical capacity. Most obvious were the restrictions on mobility and increased fatigue and feebleness. The persons described psychosocial consequences of the muscular dystrophy as well as stigma when the disability had become more obvious. In spite of reported distress several persons experienced better psychological adaptation over time. The image of the future was often dark but several focus on today and avoid thoughts about the future. ICF showed some limitation with regard to temporal aspects, emotions and the subjective perspective. Conclusions: The knowledge of the trajectory with MD is important in order to offer the best possible treatment and support. Repeated assessment by ICF can serve as a valuable source of such knowledge, and a development of the classification would increase its usefulness in future analysis of functioning and disability. © 2004 Taylor & Francis Ltd.

  • 11.
    Börsbo, Björn
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Gerdle, Björn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Peolsson, Michael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Impact of the interaction between selfefficacy, symptoms and catastrophizing on disability, quality of life and health in chronic pain patients2010Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, nr 17, s. 1387-1396Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study investigates the interactions between self-efficacy–including subcomponents–and symptoms (pain, depression, and anxiety), catastrophizing, disability, quality of life, and health in a population of chronic pain patients. The study used 433 chronic pain patients including 47 patients with spinal cord injuryrelated pain, 150 with chronic whiplash-associated disorders, and 236 with fibromyalgia. The participants answered a postal questionnaire that provided background data, pain intensity and duration, and psychological- and health-related items. In the multivariate context, depression, anxiety, catastrophizing, and disability were intercorrelated. Self-efficacy correlated positively with variables of quality of life and general health. These two groups of variables were negatively correlated. The pain variables–duration of pain, pain intensity, and spreading of pain–formed a third group of variables. Self-efficacy function was negatively correlated to these three pain variables. When regressing disability, quality of life, and health, we found that self-efficacy had a positive impact whereas symptoms, catastrophizing, and pain had a negative influence on these aspects. Different patterns of influencing variables were discerned for the three different analyses, and specific patterns of the subscales of self-efficacy corresponded to specific patterns of negative factors for the outcome of disability, quality of life, and health.

    Perspective: This article presents the complex interaction of psychological factors and symptoms and their positive and negative influence on disability, quality of life, and health. The results indicate that it might be important to assess and influence both enhancing and detoriating factors to ensure an effective pain management programme.

  • 12.
    Börsbo, Björn
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Peolsson, Michael
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin.
    Gerdle, Björn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Östergötlands Läns Landsting, Medicincentrum, Smärt- och rehabiliteringscentrum.
    The complex interplay between pain intensity, depression, anxiety and catastrophizing with respect to quality of life and disability2009Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, nr 19, s. 1605-1613Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To identify subgroups of chronic pain patients based on the occurrence of depression, anxiety, and catastrophizing and the duration of pain and pain intensity. In addition to this, to investigate the relationship between the subgroups with respect to background variables, diagnosis, pain-related disability, and perceived quality of life.

    Methods: This study used 433 chronic pain patients including 47 patients with spinal cord injury related pain, 150 with chronic whiplash associated disorders, and 236 with fibromyalgia. The participants answered a postal questionnaire that provided background data, pain intensity and duration and psychological and health related items.

    Results: Based on depression, anxiety, catastrophizing, pain intensity and duration, we identified subgroups of chronic pain patients that differed with respect to perceived quality of life, disability and diagnosis. The psychological factors, especially depression, significantly influenced perceived quality of life and disability. Pain intensity and duration play a minor role with respect to quality of life although pain intensity is associated contributes more to perceived disability.

    Conclusions: The results of this study highlight the importance of not looking at chronic pain patients as a homogenous entity. A detailed assessment, including psychological factors with emphasis on depressive symptoms, might be essential for planning and carrying through treatment and rehabilitation.

  • 13.
    Chee, Derserri Yan Ting
    et al.
    Curtin Univ, Australia.
    Lee, Hoe Chung Yeung
    Curtin Univ, Australia.
    Patomella, Ann-Helen
    Karolinska Inst, Sweden.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Curtin Univ, Australia.
    Investigating the driving performance of drivers with and without autism spectrum disorders under complex driving conditions2019Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, nr 1Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim of this study was to investigate the driving performance of drivers with autism spectrum disorders under complex driving conditions. Method: Seventeen drivers with autism spectrum disorders and 18 typically developed drivers participated in a driving simulator trial. Prior to the assessment, participants completed the Driving Behaviour Questionnaire and measurements of cognitive and visual-motor ability. The driving simulation involved driving in an urban area with dense traffic and unpredictable events. Results: In comparison with the typically developed group, drivers with autism spectrum disorders reported significantly more lapses in driving, committed more mistakes on the driving simulator, and were slower to react in challenging situations, such as driving through intersections with abrupt changes in traffic lights. However, they were also less likely to tailgate other vehicles, as measured by time-to-collision between vehicles, on the driving simulator. Conclusions: The performances of licensed drivers with autism spectrum disorders appeared to be safer in respect to car-following distance but were poorer in their response to challenging traffic situations. Driver education for individuals with autism spectrum disorders should focus on quick identification of hazards, prompt execution of responses, and effective allocation of attention to reduce lapses in driving.

  • 14.
    Ehrenfors, R
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Borell, L
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Hemmingsson, Helena
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Assessments used in school-aged children with acquired brain injury - Linking to the international classification of functioning, disability and health2009Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, nr 17, s. 1392-1401Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: The aim was to examine widely used assessments within the rehabilitation of school-aged children with acquired brain injury (ABI) with the International Classification of Functioning, Disability and Health (ICF) as a framework.

    METHOD: A survey identified the assessments most widely used in the rehabilitation of school-aged children with ABI in Sweden. The aims of these assessments were linked to the ICF according to previously published linking rules for clinical assessments.

    RESULTS: Thirty out of 43 widely used assessments were linked to body functions. The remaining assessments were linked to activities and participation, with no assessments being linked to environmental factors. Many categories within activities and participation were missing, whereas some categories within body functions were covered by numerous assessments.

    CONCLUSIONS: The widely used assessments within paediatric brain injury rehabilitation do not cover essential aspects of functioning and disability. Specifically, assessments focussing on many crucial categories of activities and participation, and all categories within environmental factors were missing. A better understanding of school-aged children's health and disability might be achieved by using the ICF to identify a set of assessments, illuminating body functions, activities and participation and environmental factors.

  • 15.
    Eklund, K.
    et al.
    Institute of Occupational Therapy and Physiotherapy, Sahlgrenska Academy, Göteborg University, Box 455, SE-405 30 Göteborg, Sweden.
    Sonn, U.
    Institute of Occupational Therapy and Physiotherapy, Sahlgrenska Academy, Göteborg University, Box 455, SE-405 30 Göteborg, Sweden, Department of Geriatric Medicine, Sahlgrenska Academy, Göteborg University, Box 455, SE-405 30 Göteborg, Sweden.
    Nystedt, Paul
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Nationalekonomi.
    Dahlin-Ivanoff, S.
    Institute of Occupational Therapy and Physiotherapy, Sahlgrenska Academy, Göteborg University, Box 455, SE-405 30 Göteborg, Sweden, The Vardal Institute, Sahlgrenska Academy, Göteborg University, Box 455, SE-405 30 Göteborg, Sweden.
    A cost-effectiveness analysis of a health education programme for elderly persons with age-related macular degeneration: A longitudinal study2005Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 27, nr 20, s. 1203-1212Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To analyse the cost-effectiveness of the activity-based Health Education Programme 'Discovering New Ways' versus a standard Individual Programme. Method: Two-hundred and twenty-nine persons were randomized to either the Health Education Programme or an Individual Programme. The present study is based on 131 persons who participated in the 28-month follow-up. Costs for the low vision clinic were documented prospectively along with external costs. A cost-effectiveness analysis was done using cases with an improved level of perceived security in daily activities as the effectiveness measure. Results: The Health Education Programme led to significantly more cases with an improved level of perceived security (45 vs. 10%, CI 95%: 21-49, p value < 0.001) and the total social cost per treatment was lower (28 004 vs. 36 341 SEK). Taken separately the low vision clinic costs were slightly higher due to a higher prescription of assistive devices, but external costs were lower for the Health Education Programme compared to the Individual Programme, though neither of these differences was statistically significant. Conclusion: The results suggest that replacing the standard Individual Programme with the Health Education Programme 'Discovering New Ways' is cost-effective as more persons experience increased security to a lesser total cost. © 2005 Taylor & Francis.

  • 16.
    Engstrand, Christina
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Hand- och plastikkirurgiska kliniken US.
    Kvist, Joanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Krevers, Barbro
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Medicinska fakulteten.
    Patients'€™ perspective on surgical intervention for Dupuytren'€™s disease€: experiences, expectations and appraisal of results2016Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, nr 24-26, s. 2538-2549Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose To explore patients’ perspectives on surgical intervention for Dupuytren’s disease (DD), focusing on patients’ appraisal of results, involving previous experiences, expectations and patient characters.

    Method The participants were 21 men, mean age 66 years, scheduled for DD surgery. Qualitative interviews were conducted 2–4 weeks before surgery and 6–8 months after surgery. The model of the Patient Evaluation Process was used as theoretical framework. Data were analyzed using problem-driven content analysis.

    Results Five categories are described: previous experiences, expectations before surgery, appraisal of results, expectations of the future and patient character. Previous experiences influenced participants’ expectations, and these were used along with other aspects as references for appraisal of results. Participants’ appraisal of results concerned perceived changes in hand function, care process, competency and organization, and could vary in relation to patient character. The appraisal of results influenced participants’ expectations of future hand function, health and care.

    Conclusions Patients’ appraisal of results involved multidimensional reasoning reflecting on hand function, interaction with staff and organizational matters. Thus, it is not enough to evaluate results after DD surgery only by health outcomes as this provides only a limited perspective. Rather, evaluation of results should also cover process and structure aspects of care.

    Implications for Rehabilitation

    • To improve health care services, it is important to be aware of the role played by patient’s previous experiences, expectations as well as staff and organizational aspects of care.
    • Knowledge about patients’ experience and view of the results from surgery and rehabilitation should be established by assessment of care effects on health as well as structure and process aspects of care.
    • Evaluation of structure and process aspects of care can be done by using questions about if the patient felt listened to, received clear information and explanations, was included in decision-making, and their view of waiting time or continuity of care.
    • Improving health care services means not only providing the best treatment method available but also developing individualized care by ensuring good interaction with the patient, providing accurate information, and working to improve the structure of the care process.
    • Before treatment, health care providers should have a dialogue with the patient and consider previous experiences and expectations in order to ensure the patient has balanced expectations of the outcome.
  • 17.
    Grahn, B
    et al.
    Kronoberg Occupat Rehabil Serv, Vaxjo, Sweden Univ Lund, Dept Phys Therapy, Lund, Sweden Linkoping Univ, Dept Family Med, Linkoping, Sweden Linkoping Univ, Dept Hlth & Soc, Linkoping, Sweden.
    Ekdahl, C
    Borgquist, Lars
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Motivation as a predictor of changes in quality of life and working ability in multidisciplinary rehabilitation - A two-year follow-up of a prospective controlled study in patients with prolonged musculoskeletal disorders2000Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 22, nr 15, s. 639-654Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose : To evaluate the two year outcome of multidisciplinary rehabilitation for patients with prolonged musculoskeletal disorders (MSDs), in terms of health-related quality of life (HRQL) and working ability. In addition, predictors of outcome were examined. Methods : The rehabilitation group and the matched control group comprised 122 and 114 patients respectively. Baseline data were compared with two year follow-up data within and between the groups. The variables that were measured were : HRQL (Nottingham Health Profile), motivation, body awareness, pain, pain-related medicine consumption, psychosomatic symptoms, working environment and working ability. Results : Variables which improved significantly for the rehabilitation group compared with the control group were : HRQL (p=0.049), emotional reactions (p=0.043), pain related to movements (p=0.028) and need for pain-related medicines (p=0.009). Multivariate regression analysis including all patients revealed that motivation was a predictor of change in HRQL (p=0.001) and working ability (p<0.001). Conclusion : The rehabilitation programme appeared to improve HRQL to a greater extent than ordinary treatment available within primary care. The patient's level of motivation could be an important predictor of outcome.

  • 18.
    Grahn, Birgitta
    et al.
    Medicinska fakulteten Lunds universitet.
    Ekdahl, C
    Medicinska fakulteten Lunds universitet.
    Borgquist, Lars
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Allmänmedicin. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Effects of a multidisciplinary rehabilitation programme on health-related quality of life in patientswith prolonged musculoskeletal disorders. A 6-months follow-up of a prospective controlled study1998Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 20, nr 8, s. 285-297Artikkel i tidsskrift (Fagfellevurdert)
  • 19.
    Gunnarsson, Stina
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken.
    Alehagen, Siw
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Lemming, Dag
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Ertzgaard, Per
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken.
    Berntsson, Shala Ghaderi
    Department of Neuroscience, Uppsala University, Uppsala, Sweden.
    Samuelsson, Kersti
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken.
    Experiences from intrathecal baclofen treatment based on medical records and patient- and proxy-reported outcome: a multicentre study2019Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, nr 9, s. 1037-1043Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To investigate patient satisfaction with intrathecal baclofen treatment, complications from the treatment, and the impact of general expectations on treatment outcome in relation to satisfaction.

    Methods: A multicentre study with cross-sectional design. Data were collected through questionnaires and patient records. Patients were recruited from six outpatient intrathecal baclofen clinics in Sweden. Eighty-three patients who had been treated with intrathecal baclofen for 1–4 years were included. For patients unable to communicate, data were collected through a proxy. The Patient Global Impression of Change was used to measure patients’ general satisfaction with change from intrathecal baclofen treatment. The Life Orientation Test – revised, was used to measure general expectations/optimism.

    Results: General satisfaction with intrathecal baclofen treatment was high; 51/77 patients reported “much improved” or “very much improved.” There was no relationship between the two main outcomes (general satisfaction and general expectations/optimism) (rs = 0.12, p = 0.382). The two groups; those who could and those who could not communicate, did differ regarding personal characteristics and should be evaluated as such.

    Conclusions: Most patients/proxies reported a high level of satisfaction with intrathecal baclofen treatment. The reported satisfaction with intrathecal baclofen treatment was not dependent on general expectations.

    • Implications for Rehabilitation
    • Patients with intrathecal baclofen treatment report low levels of health and quality of life at the same time as they are highly satisfied with their treatment.

    • Intrathecal baclofen should be equally offered to both optimistic and less optimistic patients.

    • Patients who are able to/not able to communicate, differs in characteristics and should be informed and followed up in different ways in daily clinical practice.

  • 20.
    Gunnarsson, Stina
    et al.
    Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Samuelsson, Kersti
    Östergötlands Läns Landsting, Sinnescentrum, Rehabiliteringsmedicinska kliniken. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Patient experiences with intrathecal baclofen as a treatment for spatsticity - a pilot study2015Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, nr 10, s. 834-841Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: This study describes how patients experience intrathecal baclofen (ITB) treatment. Methods: Data were collected from interviews with 14 patients (19–76 years old) who were diagnosed with spinal cord injury (SCI), multiple sclerosis (MS), or cerebral palsy (CP). Data were analyzed using conventional content analysis. Result: The analysis resulted in 16 subcategories arranged into five main categories: procedures before treatment, the effect of ITB on daily life and activities, continuous follow-up, expected and unexpected consequences of ITB, and overall level of satisfaction with ITB. Together these categories described the patients' experiences with ITB treatment. When the patients were asked whether they would undergo ITB again, they all stated that they would. Conclusion: Patients stated that they were highly satisfied with the ITB treatment. However, the patients identified several areas that could be improved. Specifically, the patients wanted more information about the different steps in the treatment process and what to expect from ITB treatment.Implications for Rehabilitation

    • An overall satisfaction with the effect from ITB treatment was shown, but some areas still need to be improved.

    • Complications following ITB treatment still remain a major concern for the patient group.

    • Future clinical practice, should address how to take into account patients' expectations and define relevant goals with respect to ITB treatment as well as how to supply professional information.

  • 21.
    Gutefeldt, Kerstin
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Infektionskliniken i Östergötland.
    Hedman, Christina A
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Endokrinmedicinska kliniken.
    Thyberg, Ingrid S M
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Bachrach-Lindström, Margareta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Arnqvist, Hans
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Endokrinmedicinska kliniken.
    Spångeus, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Endokrinmedicinska kliniken.
    Upper extremity impairments in type 1 diabetes with long duration: common problems with great impact on daily life2019Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, nr 6, s. 633-640Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: To investigate the prevalence, activity limitations and potential risk factors of upper extremity impairments in type 1 diabetes in comparison to controls.

    METHODS: In a cross-sectional population-based study in the southeast of Sweden, patients with type 1 diabetes <35 years at onset, duration ≥20 years, <67 years old and matched controls were invited to answer a questionnaire on upper extremity impairments and activity limitations and to take blood samples.

    RESULTS: Seven hundred and seventy-three patients (ages 50 ± 10 years, diabetes duration 35 ± 10 years) and 708 controls (ages 54 ± 9 years) were included. Shoulder pain and stiffness, hand paraesthesia and finger impairments were common in patients with a prevalence of 28-48%, which was 2-4-folds higher than in controls. Compared to controls, the patients had more bilateral impairments, often had coexistence of several upper extremity impairments, and in the presence of impairments, reported more pronounced activity limitations. Female gender (1.72 (1.066-2.272), p = 0.014), longer duration (1.046 (1.015-1.077), p = 0.003), higher body mass index (1.08 (1.017-1.147), p = 0.013) and HbA1c (1.029 (1.008-1.05), p = 0.007) were associated with upper extremity impairments.

    CONCLUSIONS: Compared to controls, patients with type 1 diabetes have a high prevalence of upper extremity impairments, often bilateral, which are strongly associated with activity limitations. Recognising these in clinical practise is crucial, and improved preventative, therapeutic and rehabilitative interventions are needed. Implications for rehabilitation Upper extremity impairments affecting the shoulder, hand and fingers are common in patients with type 1 diabetes, the prevalence being 2-4-fold higher compared to non-diabetic persons. Patients with diabetes type 1 with upper extremity impairments have more pronounced limitations in daily activities compared to controls with similar impairments. Recognising upper extremity impairments and activity limitations are important and improved preventive, therapeutic and rehabilitation methods are needed.

  • 22.
    Gutke, Annelie
    et al.
    Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
    Bullington, Jennifer
    Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden.
    Lund, Madeleine
    Home Care and Rehabilitation, The City of Gothenburg, Gothenburg, Sweden.
    Lundberg, Mari
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; ; Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Adaptation to a changed body. Experiences of living with long-term pelvic girdle pain after childbirth2018Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, nr 25, s. 3054-3060Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To explore how women experience living with long-term pregnancy-related pelvic girdle pain.

    Materials and methods: Nine women with persistent pregnancy-related pelvic girdle pain of 2–13 years were recruited by means of purposive sampling from long-term follow-up studies. The women were 28–42 years of age and had given birth to 2–3 children. Audio-taped in-depth interview with open-ended questions were used with the guiding question 'How do you experience living with pregnancy-related pelvic girdle pain?'. The Empirical Phenomenological Psychological method was chosen for analysis.

    Results: The pregnancy-related pelvic girdle pain syndrome has a profound impact on everyday life for many years after pregnancy. Three constituents were identified as central to the experience of living with pregnancy-related pelvic girdle pain: (1) the importance of the body for identity, (2) the understanding of pain, and (3) stages of change. The manner in which the women experienced their pain was interpreted in terms of two typologies: the ongoing struggle against the pain, and adaptation and acceptance.

    Conclusion: The participants’ narratives highlighted that the pain led to severe functional limitations that threatened their capability to perform meaningful daily activities, and interfered with their sense of identity. It appears essential to meet with each patient individually and to manage long-term pregnancy-related pelvic girdle pain as a pain syndrome.

    IMPLICATIONS FOR REHABILITATION

    Chronic pregnancy-related pelvic girdle pain

    • Pregnancy-related pelvic girdle pain impairs women’s capacity to perform meaningful activities of daily life for many years after pregnancy.

    • The participants’ narratives highlighted that the pain interfered with their sense of identity.

    • It appears essential to meet with each patient individually and to manage long-term pregnancy-related pelvic girdle pain as a pain syndrome.

  • 23.
    Hemmingsson, Helena
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för arbetsterapi. Linköpings universitet, Medicinska fakulteten.
    Björk Olafsdottir, Linda
    University of Iceland, Iceland.
    Thora Egilson, Snaefridur
    University of Iceland, Iceland.
    Agreements and disagreements between children and their parents in health-related assessments2017Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 39, nr 11, s. 1059-1072Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Purpose: To systematically review research concerning parent-child agreement in health-related assessments to reveal overall agreement, directions of agreement, and the factors that affect agreement in ratings. Method: The Uni-Search and five additional databases were searched. Childrens health issues were grouped into psychosocial issues including autism and ADHD, and physical and performance issues including pain. Measures used for comparison were those addressing (a) psychosocial functioning, (b) physical and performance functioning, and (c) health-related quality of life. Results: Totally, 39 studies met the inclusion criteria, comprising 44 analyses in all since four studies contained more than one analyses. Moderate child-parent agreement was demonstrated in 23 analyses and poor agreement in 20 analyses. Several analyses found more agreement on observable/external than on non-observable/internal domains. Overall, parents considered their children had more difficulties than did the children themselves, although there were indications that for children with physical performance issues, parents may underreport their childrens difficulties in emotional functioning and pain. There were no consistencies in differences between childrens and parents ratings on levels of agreement with respect to the childrens health issue, age or gender. Conclusions: Discrepancies between child and parent reports seem to reflect their different perspectives and not merely inaccuracy or bias. IMPLICATIONS FOR REHABILITATION In general, parents consider their children to have more difficulties - or more extensive difficulties than the children themselves think they have. The perspectives of the child and his or her parents should be sought whenever possible since both constitute important information concerning the childs health and well-being. Children with physical and performance issues reported more difficulties than their parents concerning the childrens emotional functioning and pain. Clinicians should prioritize obtaining childrens views on subjective aspects such as emotional issues as well as on pain.

  • 24.
    Henriksson, Chris
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Arbetsterapi.
    Liedberg, Gunilla
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Arbetsterapi.
    Gerdle, Björn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin. Östergötlands Läns Landsting, Medicincentrum, Smärt- och rehabiliteringscentrum.
    Women with fibromyalgia: Work and rehabilitation2005Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 27, nr 12, s. 685-695Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose. To explore disability in women with fibromyalgia with a focus on their work situation. Method. Review of literature on work status of women with fibromyalgia. Results. Major differences exist between studies in reported disability and in the percentages of women working. Limitations caused by pain, fatigue, decreased muscle strength, and endurance influence work capacity. However, 34-77% of the women work. Individual adjustments in the work situation are reported. When the women find a level that matches their ability, they continue to work and find satisfaction in their work role. Many factors besides degree of impairment or disability influence whether clients with longstanding pain can remain in their work role or return to work after sickness leave. Conclusion. The total life situation, other commitments, type of work tasks, the ability to influence the work situation, and the physical and psychosocial work environment are important factors in determining whether a person can remain in a work role. More knowledge is needed about how to adjust work conditions for people with partial work ability to the benefit of society and the individual.

  • 25.
    Johansson, Inga-Lena
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Logopedi, Audiologi och Otorhinolaryngologi. Linköpings universitet, Medicinska fakulteten.
    Samuelsson, Christina
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Logopedi, Audiologi och Otorhinolaryngologi. Linköpings universitet, Medicinska fakulteten.
    Müller, Nicole
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Logopedi, Audiologi och Otorhinolaryngologi. Linköpings universitet, Medicinska fakulteten.
    Patients’ and communication partners’ experiences of communicative changes in Parkinson’s disease2019Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim of the present study was to investigate the experiences of people with Parkinson’s disease and their close communication partners regarding disease-related communicative changes and participation in everyday conversations.

    Materials and methods: Semi-structured qualitative interviews were conducted with six dyads consisting of a person with Parkinson’s disease and a close communication partner. The interview material was analysed through thematic analysis.

    Results: The main theme was the experiences of barriers and facilitators for participation in conversations. Subthemes were experiences related to changes in voice and articulation, language and cognition, body language and facial expressions, fatigue, self-image, communicative initiative, and familiarity with conversation partner. The results show individual variation. A change observed in almost all dyads was the person with Parkinson’s disease participating less in conversations.

    Conclusions: Assessment and interventions should be based on a broad perspective on communication, and individuals’ priorities should be foregrounded in intervention planning. Both the person with Parkinson’s disease and communication partners need to make adjustments for communication to work. Therefore, close communication partners should be included in assessment and intervention of communicationin Parkinson’s disease from an early stage.

  • 26.
    Karlsson, Elin
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Liedberg, Gunilla
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för arbetsterapi. Linköpings universitet, Medicinska fakulteten.
    Sandqvist, Jan
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för arbetsterapi. Linköpings universitet, Medicinska fakulteten.
    Initial evaluation of psychometric properties of a structured work task application for the Assessment of Work Performance in a constructed environment2018Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, nr 21, s. 2585-2591Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 27.
    Karlsson, Elin
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Seing, Ida
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Pedagogik och sociologi. Linköpings universitet, Filosofiska fakulteten.
    Sandqvist, Jan
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för arbetsterapi. Linköpings universitet, Medicinska fakulteten.
    Ståhl, Christian
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Communication characteristics between clients and stakeholders within the Swedish sickness insurance system: a document analysis of granted and withdrawn sickness benefit claims2019Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The purpose of this study was to investigate how communication within the Swedish sickness insurance system differs between cases of sick leave and how this may affect clients’ cases.

    Materials and methods: This was a document study using 30 client files from the Swedish Social Insurance Agency (SIA). The clients included had been on a work ability evaluation during their sick leave spell and were aged 32–64 years. The material was analyzed using qualitative document analysis.

    Results: The results show different approaches to communication, characterized by emotional argumentation, matter-of-fact driven argumentation and information exchange, which have diverse success in affecting official decisions. Arguments characterized by emotions such as frustration or desperation are to a larger extent neglected by the authorities compared to those characterized by a matter-of-fact driven approach and referring to regulations and medical certificates.

    Conclusion: There are differences regarding how clients and stakeholders communicate the clients’ needs and pre-requisites, and how this affects official decisions. Further research must be carried out in order to establish social insurance literacy, initially for individuals on sick leave within the sickness insurance system, and whether there are differences between diverse groups that could lead to injustices.

    • Implications for rehabilitation
    • Within a social insurance context, professionals need to provide clients with adequate and individually adapted information in order for procedures to be perceived as comprehensible and manageable by the clients.

    • The support from stakeholders such as the treating physician and/or employer can affect clients’ sick-leave process.

    • Clients’ treating medical professionals can contribute to ensuring that clients rights are met by communicating the clients’ needs to other stakeholders in a formal way.

  • 28.
    Karlsson, Kristina
    Linköpings universitet, Institutionen för tema, Tema Kommunikation. Linköpings universitet, Filosofiska fakulteten.
    Handling dilemmas of self-determination in ‘user-centred’ rehabilitation2007Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 29, nr 3, s. 245-253Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To describe discursive strategies used by different professionals and parents to handle dilemmas of self-determination versus paternalism during six 'user-centred' team meetings in the Swedish rehabilitation sector. The dilemmas arise when the users' responses do not fully meet the demands of the liberal ideal of self-determination.

    Method: Three cases are used to illustrate three discursive strategies that have been found by means of discourse analysis of transcriptions of the audio-recorded meetings. Four teams consisting of one user each participate in the study. The users have been ascribed physical and/or cognitive disabilities and their ages vary between 14 and 30.

    Results: The dilemmas were never made explicit. Parents and professionals performed a kind of paternalistic steering termed 'challenging the user's response', 'substituting for the user', or 'dropping the user's response'.

    Conclusions: The least paternalistic steering includes making the dilemma explicit and offering the user the opportunity of sharing the responsibility for the handling of the situation. However, due to the complexity of the interactions no strategy can be found to either completely prevent the occurrence of dilemmatic situations, or definitely maintain the user's self-determination during dilemmatic situations. Paternalism may occasionally be a just way of enhancing future autonomy.

  • 29.
    Kjellberg, Anette
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV).
    More or less independent2002Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 24, nr 16, s. 828-840Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim of this study was to describe how persons with learning disabilities conceived their opportunities to participate in decisions in different environmental settings. Further, the study focused on factors that persons with learning disabilities conceived what facilitated or hindered their participation in decisions in everyday life. Method: Qualitative interviews were performed with 23 persons with mild to moderate learning disabilities. The youngest was 22 years and the oldest 63. Data were categorized in three levels of decision making, described as independent, interdependent and dependent. Results: The participants were presented in five profiles depending on level of decision and in relation to the environmental arenas work and leisure. Most conceptions were categorized as dependent or interdependent regardless of arena. Few examples of independence were given. Factors that facilitated or hindered participation in decisions varied: national legislation, attitudes, and forms of daily routines and activities. Conclusions: This study showed a gap between official ideologies of every citizen's rights and the studied participants' conceptions of how they participate in decisions in everyday life. As a consequence of this, professionals have to develop methods promoting decision-making as conceived by the clients.

  • 30.
    Kjellman, Görel
    et al.
    Linköpings universitet, Institutionen för hälsa och samhälle, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Skargren, Elisabeth
    Linköpings universitet, Institutionen för hälsa och samhälle, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för hälsa och samhälle, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Prognostic factors for perceived pain and function at one-year follow-up in primary care patients with neck pain2002Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 24, nr 7, s. 364-370Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To identify prognostic factors for perceived pain and function with focus at one-year follow-up in primary care patients treated for non-specific neck pain.

    Methods: A prospective study was performed including 193 neck pain patients. Before and after treatment period, and 12 months after the start date for treatment, patients completed a questionnaire including background data and aspects of pain, function and general health. Linear multiple regression analysis was used to identify prognostic factors with the dependent variables Oswestry score and pain intensity at 12-month follow-up. Response rate 81%.

    Results: At 12-month follow-up, Oswestry score identified four prognostic factors: pain intensity; well-being; expectations of treatment; and duration of current episode. Adjusted R2 for the model was 0.32, and 20% of the patients had three of the four prognostic factors at entry, indicating risk of poor outcome. The dependent variable pain intensity revealed three prognostic factors: Oswestry score; duration of current episode; and similar problem during the previous five years. Adjusted R2 was 0.24, and 60% of the patients had two of the three prognostic factors at entry, indicating risk of poor outcome.

    Conclusions: Different prognostic factors (with the exception of duration of current episode) were identified by the two outcome variables. Thus the results suggest that it should be taken into account whether an impairment or disability outcome is used.

  • 31.
    Krevers, Barbro
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Sjukgymnastik.
    Närvänen, Anna Liisa
    ITUF Norrköping.
    Öberg, Birgitta
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Sjukgymnastik. Östergötlands Läns Landsting, Folkhälsovetenskapligt centrum, Folkhälsovetenskapligt centrum.
    Patient evaluation of the care and rehabilitation process in geriatric hospital care2002Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 24, nr 9, s. 482-491Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To gain a deeper understanding of how elderly persons experience and evaluate the care and rehabilitation process. Method: Qualitative interview data from elderly patients were analysed using a grounded theory approach. The patients were interviewed twice, at the beginning of geriatric hospital care and some weeks after discharge. Results: The patient-perceived outcome of the care and rehabilitation process reflected two dimensions, the effect on their health and the quality of the process, i.e. how their needs were met. The analysis revealed that the patients' needs differed during the care and rehabilitation process. It also indicated that patients perceived their needs and the care differently based on their previous experience of the care unit, their perceived trajectory of illness and their 'patient character' which represented the patient's definition of himself/herself and the situation. A hypothetical model of the patients' evaluation process has been derived. Conclusion: The results indicate the importance of using a process perspective in the assessment and the interpretation of patient-perceived outcome of care and rehabilitation, and that patient expectations, trajectories of illness and the patient character must be taken into consideration.

  • 32.
    Larsson, Britt
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Gard, Gunvor
    Lund University, Sweden.
    Karlsson, Linn
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin.
    Persson, Ann L.
    DIGNITY Danish Institute Torture, Denmark.
    Patient expectations for a multimodal pain rehabilitation programme: active participation and coping skills. A qualitative study2016Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, nr 20-21, s. 2135-2143Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To describe what patients with chronic pain expect from a multimodal pain rehabilitation programme. Material and method: Qualitative interviews were used to uncover expectations about a multimodal rehabilitation programme offered at the Pain and Rehabilitations Centre, The University Hospital; Linkoping, Sweden. Sixteen women and two men (mean age 37 years; standard deviation 10 years) with chronic benign pain participated. The interviews were analysed using qualitative content analyses. Results: To participate actively in the multimodal pain rehabilitation programme and to learn adequate coping strategies to improve daily life emerged as a main category. It was based on the following four categories comprising expectations about: participating actively in the programme, interacting with the professionals and fellow patients, cognitive effects of the programme and tools for coping, and explicit effects from the programme. Conclusions: Many patients expressed expectations which may reflect that the information before the programme had started rehabilitation process at the time point for this study. The results could be applied in rehabilitation programmes by acknowledging expectations to interact with professional team members and fellow patients, by early addressing of positive and negative expectations about the future pain and by incorporating and strengthen expectations of learning to cope with pain.

  • 33.
    Liedberg, Gunilla M.
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Burckhardt, Carol S.
    Division of Arthritis and Rheumatic Diseases, Department of Medicine, School of Medicine, Oregon Health Sciences University, Portland, OR, USA.
    Henriksson, Chris M.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier. Linköpings universitet, Hälsouniversitetet.
    Young women with fibromyalgia in the United States and Sweden: Perceived difficulties during the first year after diagnosis2006Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 28, nr 19, s. 1177-1185Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose. The major symptoms of fibromyalgia (FM) - pain, tiredness, disrupted sleep, and muscle weakness - severely impact everyday activities, including the paid work role of women who have had FM for a long time. There are no prospective studies on young and newly diagnosed women with FM. The aim of the present study was to describe and compare difficulties young and newly diagnosed women in Sweden and the United States experienced during their first year after diagnosis.

    Method. Three interviews, 6 months apart, were conducted, with 49 Swedish and 45 US women between the ages of 18 and 39. Five open-ended questions were asked concerning physical, psychological and social difficulties and limitations, and factors that increased or decreased their difficulties and limitations. At interviews 2 and 3 the women were also asked about ways of preventing their difficulties. The answers were written down and analysed by a content analysis approach.

    Results. Consistent categories of difficulties were reported: symptoms, movements, activities, moods, social network, external factors and coping strategies. More US women were working outside their homes than were their Swedish counterparts and they expressed more difficulties compared with the Swedish women.

    Conclusions. In general, difficulties decreased and coping strategies increased over the 1-year period in both groups of newly diagnosed, young women.

  • 34.
    Liedberg, Gunilla Margareta
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Vrethem, Magnus
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Polyneuropathy, with and without neurogenic pain, and its impact on daily life activities - a descriptive study2009Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, nr 17, s. 1402-1408Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose. Few studies on disabilities relate to neurogenic chronic pain conditions and how pain influences the patient's ability to maintain life roles. Polyneuropathy is a condition with muscle weakness, sensory impairment and sometimes additional pain of neurogenic origin. The aim was to investigate disability reported in daily activities and quality of life in patients with polyneuropathy, with and without neurogenic pain. Method. A mail questionnaire designed to collect data on the state of health and impact on daily activities, including the Quality of Life-scale, Swedish version (QOLS-S), were sent to 60 patients with polyneuropathy. Forty-two (72.4%) responded. Results. Twenty-three patients were old-age pensioners (>65 years), ten had disability pension and nine were employed. Twenty-seven patients reported pain in addition to polyneuropathy. The neuropathy symptoms influenced occupational performance at work and leisure and in housework for 72% of the patients. Patients with additional neurogenic pain reported significantly greater performance problems in 55% of the daily activities compared with patients without pain. Quality of life was significantly lower for patients with pain concerning health and participation in active recreation. Conclusions. Symptoms in polyneuropathy, especially when accompanied by pain, give rise to disability that affects daily activities and ought to be considered in planning a successful intervention programme.

  • 35.
    Lundberg, Gunnar
    et al.
    Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    The relationships between pain, disability, and health-related quality of life: an 8-year follow-up study of female home care personnel2016Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, nr 3, s. 235-244Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To investigate the development of pain conditions, disability, and health-related quality of life over an 8-year period in home care personnel. Method: In earlier studies of 607 women, we reported baseline data concerning home care personnel. This study reports the results from an 8-year follow-up using a postal questionnaire. Results: The questionnaire was completed by 87%. Prevalences of pain in upper back, lower back, and knees as well as pain intensity of the low back had decreased. Participants with the highest pain intensities of the low back at baseline had relatively lower pain intensities at follow-up. Anatomical spreading of pain was associated with higher average pain intensity. Disability had increased significantly during the time period. In the regression of disability at follow-up, average pain intensity together with disability rating index at baseline were the most important regressors; a similar pattern was found for quality of life. Conclusions: The development of disability differed from that of low-back pain intensity. Spreading of pain and pain intensity across the anatomical regions influenced disability and quality of life over 8 years. When assessing pain, it seems important to determine the spread of pain rather than just focusing on the area with intense pain.Implications for RehabilitationSpreading of pain and the average intensity of pain across the involved anatomical regions have importance for future pain and disability and quality of life.The clinical assessment of subjects with chronic pain prior to rehabilitation interventions has to determine the spreading of pain rather than just focusing on the area with the most intense pain.The different developments over time for pain intensity and disability indicate the need for applying a bio-psycho-social view of pain both when assessing the patient with pain and when discussing the prognosis and course of the actual pain condition with the patient.

  • 36.
    Löfgren, Håkan
    et al.
    Department Neuro-Orthopedic Surgery, Ryhov Hospital, Jönköping, Sweden.
    Johansen, F.
    National Social Insurance Hospital (Research and Rehabilitation Centre), Tranås, Sweden .
    Skogar, O.
    Department Rehabilitation Medicine, Ryhov Hospital, Jönköping, Sweden .
    Levander, Bo
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Reduced pain after surgery for cervical disc protrusion/stenosis: A 2 year clinical follow-up2003Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 25, nr 18, s. 1033-1043Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To follow the clinical outcome after surgery for cervical radiculopathy caused by degenerative cervical disc disease and to compare it with the outcome after conservative treatment.

    Method: Forty-three patients all awaiting surgery were studied prospectively. A control group of 39 conservatively treated patients were chosen, matched for gender and age. All patients rated their Sickness Impact Profile (SIP) and pain (VAS) and were clinically examined by unbiased observers initially and after 3, 9 and 24 months.

    Results: Long-lasting pain reduction was noted both in the neck and in the arm for the operated patients, as well as improved sensory function and reduction of reflex disturbances. Their SIP showed a temporary improvement in the overall index, in the psychosocial dimension, in sleep/rest and home management, but only mobility remained improved. Among the operated patients referred directly to us, there was an improvement in SIP at the final follow-up. The control group's SIP indicated only a temporary improvement in sleep/rest.

    Conclusions: Surgically treated patients experienced pain reduction which was partially maintained for at least 24 months. A sustained improvement in the health status measured by SIP was observed only among operated patients that were not referred via the social insurance offices.

  • 37.
    Medin, Jennie
    et al.
    Linköpings universitet, Institutionen för hälsa och samhälle, Rikscentrum arbetslivsinriktad rehabilitering IHS. Linköpings universitet, Hälsouniversitetet.
    Barajas, Josefin
    Linköpings universitet, Institutionen för hälsa och samhälle, Rikscentrum arbetslivsinriktad rehabilitering IHS. Linköpings universitet, Hälsouniversitetet.
    Ekberg, Kerstin
    Linköpings universitet, Institutionen för hälsa och samhälle, Rikscentrum arbetslivsinriktad rehabilitering IHS. Linköpings universitet, Hälsouniversitetet.
    Stroke patients' experiences of return to work2006Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 28, nr 17, s. 1051-1060Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose. The aim of this study was to describe the experience of return to work (RTW) after stroke from the patient's perspective.

    Method. Six patients who had their first ever stroke in 2001, were <65 years of age and were working at the time of their stroke were included. Information was obtained via an open-ended interview. The material was transcribed verbatim and analysed using Giorgi's empirical phenomenology.

    Results. Rehabilitation was perceived as primarily aimed at restoring bodily functions and a return to everyday activities, rather than at promoting a return to work. It was not experienced as adapted to the participants' needs or their age. The workplace was experienced as very important in the rehabilitation process. When the informants experienced that the rehabilitation professionals were not taking action, they took control of the situation themselves. The informants expressed pride in their own capacity to take the initiative and in their ability to take action. Both self-employed and employed informants said they had possibilities and opportunities to take action since their work situation was flexible. The informants' adaptation to a new role at work was perceived as facilitated by the understanding and positive attitude of co-workers.

    Conclusion. Among this group of stroke patients, the individual patient's capacity and ability to return to work was enhanced by motivation or “will” and self-efficacy in combination with external support. Self-efficacy was not only a personal trait or internal factor; it was enhanced and encouraged in interaction with contextual conditions. There are similarities between the RTW process and processes of health promotion.

  • 38.
    Medin, Jennie
    et al.
    Linköpings universitet, Institutionen för hälsa och samhälle, Rikscentrum arbetslivsinriktad rehabilitering IHS. Linköpings universitet, Hälsouniversitetet.
    Bendtsen, Preben
    Linköpings universitet, Institutionen för hälsa och samhälle, Socialmedicin och folkhälsovetenskap. Linköpings universitet, Hälsouniversitetet.
    Ekberg, Kerstin
    Linköpings universitet, Institutionen för hälsa och samhälle, Rikscentrum arbetslivsinriktad rehabilitering IHS. Linköpings universitet, Hälsouniversitetet.
    Health promotion and rehabilitation: a case study2003Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 25, nr 16, s. 908-915Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Since the number of people in Sweden on long-term sick leave has rapidly increased since 1996, new non-biomedical models of occupational rehabilitation are at stake. A group of seven women who had finished medical treatment and rehabilitation but were still on sick leave or temporary disability pension for several years, worked in a problem-based rehabilitation group for 6 months. Focus for the group was on a process of change towards health and work ability.

    Purpose: The aim of this case study was to improve understanding of effects of a problem-based rehabilitation model (PBR) on health promoting processes amongst a group of women on long-term sick leave. Method: Data source was a focus group interview. The analysis follows the guidelines of qualitative analysis that emerges from grounded theory.

    Results: The pedagogical model of PBR enhanced the participant's internal resources such as self-confidence and ability to act in a social setting. External resources such as social support were improved. An individual follow-up was conducted 2 years after the rehabilitation process and four out of seven women had returned to work.

    Conclusion: Among this group of women PBR launched health-promoting processes. When the more medically oriented treatment is finished or is not able to contribute further to the individual's recovery, other aspects of the individuals abilities and health resources will be focused upon.

  • 39.
    Mäki-Torkko, Elina
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken US.
    Vestergren, Sara
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Harder, Henrik
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken US.
    Lyxell, Björn
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken US. Linköpings universitet, Institutet för handikappvetenskap (IHV).
    From isolation and dependence to autonomy - expectations before and experiences after cochlear implantation in adult cochlear implant users and their significant others2015Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, nr 6, s. 541-547Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim of the study was to examine pre-operative expectations and the postoperative experiences related to cochlear implants (CI) in CI-users and their significant others. Methods: A questionnaire was used and the responses were analysed by means of The Qualitative Content Analysis. All adults implanted between 1992 and 2010, who had had their implants for a minimum of 12 months (n = 120) were contacted. Response rate was high (90.8%), and all-inclusive answers were received from 101 CI-users (84.2%). Results: The overall sense of increased well-being and life satisfaction was described as having lived in two different worlds, one with the auditory stimulation and one without. In the overall sense of increased well-being and satisfaction three interwoven subcategories, alienation - normality, fear - autonomy, and living a social life emerged. When CI-users and their significant others recalled the time prior to receiving the CI, a sense of fear was present with origins in the concern for the respondents (CI-users) ability to cope and care independently in society. Conversely, after the implantation both parties emphasized the notion of a distinct transformation within the CI-user towards autonomy. Communication was highlighted as a large part of living social life. Conclusion: The CI increases well-being and satisfaction for both CI-users and their significant others, which is especially evident regarding enhanced autonomy, normality and living social life.

  • 40.
    Natterlund, B
    et al.
    Univ Orebro, Dept Caring Sci, S-70182 Orebro, Sweden Uppsala Univ, Sect Caring Sci, Dept Publ Hlth & Caring Sci, Uppsala, Sweden Orebro Med Ctr Hosp, Dept Neurol & Neurophysiol, S-70185 Orebro, Sweden Linkoping Univ, Dept Med & Caring Sci, S-58183 Linkoping, Sweden.
    Gunnarsson, LG
    Univ Orebro, Dept Caring Sci, S-70182 Orebro, Sweden Uppsala Univ, Sect Caring Sci, Dept Publ Hlth & Caring Sci, Uppsala, Sweden Orebro Med Ctr Hosp, Dept Neurol & Neurophysiol, S-70185 Orebro, Sweden Linkoping Univ, Dept Med & Caring Sci, S-58183 Linkoping, Sweden.
    Ahlström, Gerd
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad.
    Disability, coping and quality of life in individuals with muscular dystrophy: a prospective study over five years2000Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 22, nr 17, s. 776-785Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose : The present study investigates progressive muscular dystrophy over a five year period. The purpose is twofold: to describe changes over time and to investigate relations between disability, coping and quality of life. Method: The study group comprised 45 adults (16 men and 29 women), with an average age of 44 years. All were assessed in 1991 and 1996, with the following instruments: the ADL staircase, the Self-report ADL, the Mental Adjustment to Cancer scale, the Sickness Impact Profile and the Psychosocial well-being questionnaire (Kaasa). Results : Increasing disability was accompanied by an increase in dependence on others and a significant deterioration of health-related quality of life and with regard to 'Satisfaction'. The predominant type of coping was 'Fighting spirit', whilst 'Fatalism' showed the greatest decline over time. 'Ambulation' and the ADL staircase correlated with 'Physical index' on the SIP. Correlations between disability, coping and quality of life were moderate. The results can serve as a basis for planning and evaluation of recurring rehabilitation for persons with MD.

  • 41.
    Nilsing Strid, Emma
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Söderberg, Elsy
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Sickness certificates: what information do they provide about rehabilitation?2014Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, nr 15, s. 1299-1304Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To investigate whether patients are prescribed rehabilitation early in a new sick leave period, and whether this prescription is associated with age, sex, diagnosis, description of functioning, and affiliation of certifying physician.

    Methods: A cross-sectional study using data from sickness certificates issued during a total sick leave period, collected consecutively during 2 weeks in 2007 in Östergötland County, Sweden. Rehabilitation prescribed in the first certificate or within 28 days after the start of sick leave was defined as early rehabilitation.

    Results: Musculoskeletal diseases (MSD) were the largest diagnostic group, followed by mental disorders (MD). The mean certified duration of sick leave was 94 days (SD 139), longest for MD patients. Early rehabilitation was prescribed in 27% of all certificates and in 45% of certificates for MSD and MD diagnoses. Logistic regression analysis indicated that prescription of early rehabilitation was associated with certificates issued for MSD and MD, youngest patients, and certificates issued by primary health care physicians. The final model explained 29% of variation in the prescription of early rehabilitation.

    Conclusion: There is a modest prescription of early rehabilitation in sickness certificates, based on younger age and MSD or MD diagnosis. This indicates that patients’ rehabilitation needs may not have been identified.

  • 42.
    Nordenfelt, Lennart
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för hälsa och samhälle, Tema hälsa och samhälle.
    Action Theory, Disability and the ICF2003Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 25, nr 18, s. 1075-1079Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The purpose of this paper is to make a critical analysis of the conceptual platform of the recently introduced International Classification of Functioning, Disability and Health (ICF). Special attention is paid to the suggested definitions of the concepts of activity and participation. My argument intends to show that these definitions are not coherent.Method: The theoretical platform of this paper is philosophical action theory. My argument makes particular use of the distinction between capacity and opportunity and shows that both concepts are applicable to all actions. Capacity and opportunity are distinguished from the actual performance of actions. The latter presupposes the existence of a will. On this conceptual basis follows an analysis of the distinction between activity and participation as conceived by the WHO in ICF.Conclusions: The main conclusion of my reasoning is that the notions of activity and participation in ICF partly rest on confusion between capacity for action and the actual performance of an action. If my conclusion is sound this has far-reaching consequences for the application of the ICF in the practice of rehabilitation. My diagnosis therefore is that the conceptual framework of ICF is in great need of a strict action - theoretic reconstruction.

  • 43.
    Nordenfelt, Lennart
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för hälsa och samhälle, Tema hälsa och samhälle.
    On health, ability and activity: Comments on some basic notions in the ICF2006Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 28, nr 23, s. 1461-1465Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose. The purpose of this article is to highlight and at the same time criticize the holistic view of health expressed in the "International Classification of Functioning, Disability and Health (ICF)". Particular attention will be paid to the idea suggested in the ICF that not only the ability to perform a specified action but also its actual performance is included in the person's health. My argument intends to show that this is an untenable position. Method. The theoretical platform of this paper is philosophical action theory. My argument makes particular use of the distinctions between ability, opportunity, activity and will. My analysis also uses some insights from the contemporary philosophical discussion of health concepts. Conclusions. Ability (or capacity) and its opposite disability (or incapacity) are essential ingredients in the implicit philosophy of health of the ICF. However, the ICF also puts an emphasis on the actual performance of actions. This is entailed by the performance qualifier that is included in the ICF. I give some arguments for questioning the relevance of this qualifier if it is intended to have a place in the concept of health or have a general function for decisions in health care or rehabilitation. Instead I suggest the introduction of an opportunity qualifier, which could fulfill some of the purposes intended for the performance qualifier.

  • 44.
    Nordenfelt, Lennart
    Linköpings universitet, Institutionen för hälsa och samhälle, Tema hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Reply to Commentaries: in Disability and rehabilitation(ISSN 1464-5165), vol 28, issue 23, pp 1487-14892006Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 28, nr 23, s. 1487-1489Artikkel i tidsskrift (Fagfellevurdert)
  • 45.
    Nätterlund, Birgitta
    et al.
    Uppsala, Örebro.
    Sjödén, Per-Olow
    Uppsala.
    Ahlström, Gerd
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Omvårdnad.
    The illness experience of adult persons with muscular dystrophy.2001Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 23, s. 788-798Artikkel i tidsskrift (Fagfellevurdert)
  • 46.
    Peolsson, Anneli
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Vavruch, Ludek
    Department of Neuro-Orthopedic Surgery, Ryhov Hospital, Jönköping, Sweden.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för medicin och hälsa, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Can the results 6 months after anterior cervical decompression and fusion identify patients who will have remaining deficit at long-term?2006Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 28, nr 2, s. 117-124Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose. There is no knowledge if short-term outcome in patients after anterior cervical decompression and fusion (ACDF) can be used to identify which patients have remaining deficit in long term. This study investigates if 6-month outcome with a broad assessment after ACDF with a cervical intervertebral fusion cage can be a guide for the 3-years outcome.

    Method. A prospective study. Questions about background data, pain, numbness, neck specific disability, distress, sick leave, health, symptom satisfaction and effect of and satisfaction with surgery were asked 28 patients 3 years after ACDF. Measurements have earlier been obtained before and 6 and 12 months after ACDF.

    Results. Compared with the results before surgery patients had improved in pain intensity (p = 0.001), neck pain (0.001), numbness (p = 0.02) and were more ‘satisfied’ with having their neck problems (p = 0.01). Except for a worsening in expectations of surgery fulfilled (p = 0.04) there were no significant differences between 6-month and 3-year outcome. Three years after ACDF about two-thirds of the patients had remaining deficit with regard to pain intensity, Neck Disability Index, Distress and Risk Assessment Method and general health. According to the parameters studied 50 – 78% of those who at the 6-month follow-up were without deficit were still healthy at the 3-year follow-up. For patients with deficit at 6-month follow-up, still 83 – 100% had deficit 3 years after surgery.

    Conclusions. Despite a rather small study obtained the stability of 6-month and 3-year results indicates that short-term results might be sufficient for evaluating effects of the treatment. Since the patients in this study clearly demonstrate broad problems array of development of more structured multi-professional rehabilitation models including exercises which improve neck muscle strength, endurance and proprioception need to be introduced.

  • 47.
    Persson, Jan
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Hälsouniversitetet.
    Bernfort, Lars
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Hjärt- och Medicincentrum, Allergicentrum US.
    Wåhlin, Charlotte
    Region Östergötland, Hjärt- och Medicincentrum, Arbets- och miljömedicin. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Karolinska Institutet, Sweden.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Hälsouniversitetet.
    Ekberg, Kerstin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet.
    Costs of production loss and primary health care interventions for return-to-work of sick-listed workers in Sweden2015Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, nr 9, s. 771-776Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim of this study was to investigate, from the perspective of society, the costs of sick leave and rehabilitation of recently sick-listed workers with musculoskeletal disorders (MSD) or mental disorders (MD). Methods: In a prospective cohort study, 812 sick-listed workers with MSD (518) or MD (294) were included. Data on consumption of health care and production loss were collected over six months from an administrative casebook system of the health care provider. Production loss was estimated based on the number of sick-leave days. Societal costs were based on the human capital approach. Results: The mean costs of production loss per person were EUR 5978 (MSD) and EUR 6381 (MD). Health care interventions accounted for 9.3% (MSD) and 8.2% (MD) of the costs of production loss. Corresponding figures for rehabilitation activities were 3.7% (MSD) and 3.1% (MD). Health care interventions were received by about 95% in both diagnostic groups. For nearly half of the cohort, no rehabilitation intervention at all was provided. Conclusions: Costs associated with sick leave were dominated by production loss. Resources invested in rehabilitation were small. By increasing investment in early rehabilitation, costs to society and the individual might be reduced. Implications for Rehabilitation Resources invested in rehabilitation for sick-listed with musculoskeletal and mental disorders in Sweden are very small in comparison with the costs of production loss. For policy makers, there may be much to gain through investments into improved rehabilitation processes for return to work. Health care professionals need to develop rehabilitative activities aiming for return to work, rather than symptoms treatment only.

  • 48.
    Pohl, Petra
    et al.
    Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken. Umeå University, Sweden .
    Dizdar (Dizdar Segrell), Nil
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Hallert, Eva
    Linköpings universitet, Institutionen för medicin och hälsa, Utvärdering och hälsoekonomi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    The Ronnie Gardiner Rhythm and Music Method – a feasibility study in Parkinson’s disease2013Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 35, nr 26, s. 2197-2204Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To assess the feasibility of the novel intervention, Ronnie Gardiner Rhythm and Music (RGRM™) Method compared to a control group for patients with Parkinson’s disease (PD).

    Method: Eighteen patients, mean age 68, participating in a disability study within a neurological rehabilitation centre, were randomly allocated to intervention group (n = 12) or control group (n = 6). Feasibility was assessed by comparing effects of the intervention on clinical outcome measures (primary outcome: mobility as assessed by two-dimensional motion analysis, secondary outcomes: mobility, cognition, quality of life, adherence, adverse events and eligibility).

    Results: Univariable analyses showed no significant differences between groups following intervention. However, analyses suggested that patients in the intervention group improved more on mobility (p = 0.006), cognition and quality of life than patients in the control group. There were no adverse events and a high level of adherence to therapy was observed.

    Conclusions: In this disability study, the use of the RGRM™ Method showed promising results in the intervention group and the adherence level was high. Our results suggest that most assessments chosen are eligible to use in a larger randomized controlled study for patients with PD.

    Implications for Rehabilitation

    • The RGRM™ Method appeared to be a useful and safe method that showed promising results in both motor and cognitive functions as well as quality of life in patients with moderate PD.

    • The RGRM™ Method can be used by physiotherapists, occupational, speech and music therapists in neurological rehabilitation.

    • Most measurements were feasible except for Timed-Up-and-Go.

     

     

  • 49.
    Samuelsson, Kersti
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Östergötlands Läns Landsting, Rekonstruktionscentrum, Rehabiliteringsmedicinska kliniken US.
    Wressle, Ewa
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Geriatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Geriatriska kliniken.
    User satisfaction with mobility assistive devices: An important element in the rehabilitation process2008Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 30, nr 7, s. 551-558Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background. An assistive device often means an evident change in a person's ability, more easy to notice than the effects of most of other types of physiotherapy or occupational therapy intervention. In spite of this, there is very little evidence in this area. Purpose. The objective was to follow-up user satisfaction with and the use and usefulness of rollators and manual wheelchairs. The objective was also to determine any difference in satisfaction between users of the two different types of mobility assistive products. Methods. A random sample of 262 users participated in the study, 175 rollator users and 87 wheelchair users. The Quebec User Evaluation of Satisfaction with Assistive Technology - QUEST 2.0 and an additional questionnaire were used for data collection. Results. Overall satisfaction with both types of device was high and most clients reported use of their device on a daily basis. There was a difference in how the users estimated the usefulness and other characteristics as well as some service aspects related to prescription and use of the two types of device. Most users reported not having had any follow-up, however, most users had not experienced any need for one. Conclusions. A standardized follow-up will give rehabilitation professionals continuous and valuable information about the effect of and satisfaction with assistive devices.

  • 50.
    Sandström, Karin
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Sjukgymnastik. Östergötlands Läns Landsting, Rekonstruktionscentrum, Rehabiliteringsmedicinska kliniken US.
    Alinder, John
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Rehabiliteringsmedicinska kliniken US.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för medicin och hälsa, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Descriptions of functioning and health and relations to a gross motor classification in adults with cerebral palsy2004Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 26, nr 17, s. 1023-1031Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim of this study was to describe functioning and health, and explore the use of the Gross Motor Function Classification System (GMFCS) in an adult population with cerebral palsy (CP).

    Methods: From a cohort of 199 persons, 48 persons were selected for structured interviews and functional assessments regarding activities of daily living, motor function, range of motion, pain and general health.

    Results: A third of the population had deteriorated in function from adolescence to adulthood according to the GMFCS. The majority were independent in personal ADL, but many of those were dependent in instrumental ADL. Motor function scores reflected problems in walking ability, and limited ROM and pain were common in all functional levels. General health was lower than in a general population. GMFCS seems valid for classifying adults with CP since it is correlated with instruments measuring motor function and ADL in terms of dependence.

    Conclusion: Decreased functional ability and secondary musculoskeletal problems are common in adults with CP and general health can be associated with those problems. It is important to further explore health aspects and relations between health status and self-perceived health. The GMFCS is a useful tool, especially for comparisons throughout the life span, but in order to use in an adult population further development is needed.

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