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  • 1.
    Andersson, Lena B.
    et al.
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Rehabilitation in Central County.
    Marcusson, Jan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine in Linköping.
    Wressle, Ewa
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine in Linköping.
    Health-related quality of life and activities of daily living in 85-year-olds in sweden2014In: Health and Social Care in the Community, ISSN 0966-0410, Vol. 22, no 4, p. 368-374Article in journal (Refereed)
    Abstract [en]

    Few studies have examined health-related quality of life (HRQoL) with respect to daily living and health factors for relatively healthy elderly individuals. To this end, this study examines 85-year-olds’ reported HRQoL in relation to social support, perceived health, chronic diseases, health care use and instrumental activities of daily living. Data were collected from 360 participants (55% response rate) between March 2007 and March 2008 using a postal questionnaire and a home visit interview.  HRQoL was assessed using the EQ-5D-3L. For the items in the EQ-5D-3L, more problems were related to lower HRQoL. Restricted mobility and occurrence of pain/discomfort was common.  Lower HRQoL was associated with increased risk for depression, increased use of medication, increased number of chronic diseases, and more problems with instrumental activities of daily living (IADL). Health care use and health care costs was correlated to lower HRQoL.  HRQoL is of importance to health care providers and must be considered together with IADL in the elderly population when planning interventions. These should take into account the specific needs and resources of the older individuals.

  • 2.
    Hulting, Karin
    et al.
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Rehabilitation in Central County.
    Holmberg, Tommy
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Mindfulness för patienter med psykisk ohälsa: uppföljning av behandlingseffekter inom primärvården2011Report (Other academic)
    Abstract [sv]

    Mindfulness är en ny inriktning inom kognitiv beteendeterapi. Det är en form av uppmärksamhetsträning för att öva förmågan att vara närvarande i nuet och hitta ett accepterande, icke värderande förhållningssätt gentemot sig själv, sin kropp, sina tankar och känslor. I klinisk tillämpning har programmet mindfulnessbaserad kognitiv terapi utarbetats som en åtta veckor lång behandling med dagliga mindfulnessövningar och gruppträffar varje vecka.

    Syftet med studien var att över tid följa en grupp patienter med psykisk ohälsa som deltog i mindfulnessbehandling med fokus på symtomlindring och förbättrad hälsorelaterad livskvalitet.

    Patientens (n=95) psykiska ohälsa skattades med The Comprehensive Psychopathological Rating Scale-Self Assessment, den hälsorelaterade livskvaliteten med EuroQol 5D och graden av mindfulness med Kentucky Inventory of Mindfulness Skills. En kategorisering genomfördes av svaren på de öppna frågorna i en uppföljningsenkät.

    Inklusionskriterier för deltagande i denna behandling var patienter med depressionstillstånd, ångest-, smärt- eller stressrelaterad problematik och utmattningssyndrom. Patienterna remitterades från kuratorer, läkare och sjukgymnaster i närsjukvården i centrala länsdelen till huvudförfattaren. Bortfall utgjordes av de patienter som inte deltog i gruppträffarna vid minst fyra tillfällen och av patienter som valde att tacka nej till behandlingen i samband med det individuella bedömningstillfället före gruppstart. Den vanligaste behandlingsorsaken var stressrelaterade besvär följt av depression och ångest.

    Andelen patienter som skattade måttlig eller svår depression minskade med 26 procent efter genomgången mindfulnessbehandling. Den hälsorelaterade livskvaliteten skattades som förbättrad och var störst föroro/nedstämdhet. Skattningarna visade att patienterna ökade sin  förmåga att observera, att agera med medvetenhet och att acceptera utan att döma.

    Studien visade att mindfulness som behandling av patienter med stress-, ångest eller depressionsproblematik kan bidra till att patienten får bättre förståelse för sina problem och redskap som hjälper dem att bättre bemästra besvären. Behandlingen bör ses som ett komplement till individuell samtalsbehandling och/eller läkemedelsbehandling. En begränsning som måste beaktas då resultaten värderas är avsaknaden av kontrollgrupp.

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    Mindfulness för patienter med psykisk ohälsa: uppföljning av behandlingseffekter inom primärvården
  • 3.
    Sverker, Annette
    et al.
    Linköping University, Department of Social and Welfare Studies, Social Work. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Activity and Health.
    Björk, Mathilda
    Östergötlands Läns Landsting, Heart and Medicine Center, Department of Rheumatology. Linköping University, Department of Clinical and Experimental Medicine, Rheumatology. Linköping University, Faculty of Health Sciences.
    Thyberg, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine, Division of Inflammation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Rheumatology.
    Thyberg, Mikael
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Valtersson, Eva
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Rehabilitation in Central County.
    Östlund, Gunnel
    Mälardalen University, Eskilstuna, Sweden.
    AB1154-HPR Men's Strategies of Handling Participation Restrictions Related to Rheumatoid Arthritis (The Swedish Tira Study)2014Conference paper (Other academic)
    Abstract [en]

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

  • 4.
    Sverker, Annette
    et al.
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Rehabilitation in Central County. Linköping University, Department of Social and Welfare Studies, Social Work. Linköping University, Faculty of Arts and Sciences.
    Thyberg, Ingela
    Linköping University, Department of Clinical and Experimental Medicine, Division of Inflammation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Rheumatology.
    Östlund, Gunnel
    Linköping University, Department of Social and Welfare Studies, Social Work. Linköping University, Faculty of Arts and Sciences.
    Waltersson, Eva
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Rehabilitation in Central County.
    Thyberg, Mikael
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Participation in work in early rheumatoid arthritis: a qualitative interview study interpreted in terms of the ICF2014In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, no 3, p. 242-249Article in journal (Refereed)
    Abstract [en]

    Purpose: To explore what work-related dilemmas are experienced by patients with early rheumatoid arthritis (RA), according to their own descriptions, and to interpret this in terms of participation categories of the International Classification of Functioning, Disability and Health (ICF). Method: In 48 patients with early RA, qualitative interviews were analyzed, followed by linking of concepts to the activity/participation component of the ICF and interpretation of general themes. Results: Work-related dilemmas represented different societal perspectives on work related to acquiring, keeping and terminating a job, self-employment, part-time, full-time and non-remunerative employment. Dilemmas also represented participation priorities in economic self-sufficiency, self-care such as health care, and avoiding social relationships and recreation in favor of work. Leisure time was influenced because efforts of working took energy and time of day-to-day procedures. Embedded actions in work-related dilemmas were carrying out daily routine, mobility including using transportation, self-care, domestic life and social interaction. Conclusion: The general themes societal perspectives, participation priorities and embedded actions, with the included ICF categories that are described in detail according to the experiences of the patients, can support clinical reasoning and research on quantitative relations to disease activity, body functions, ability and contextual factors. Implications for Rehabilitation In early rheumatoid arthritis, keeping a job is complex; patients and practitioners need to know and handle the perspectives of, e.g. employers and social insurance agents. Participation in work is an issue of prioritizing against, e.g. maintaining one's health and social relationships. Rehabilitation practitioners need to analyze what actions are embedded in a work situation.

     

     

     

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  • 5.
    Sverker, Annette
    et al.
    Linköping University, Department of Social and Welfare Studies, Social Work. Linköping University, Faculty of Arts and Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Rehabilitation in Central County.
    Östlund, Gunnel
    Mälardalens högskola, Hälsa och välfärd, Sweden.
    Thyberg, Mikael
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine.
    Valtersson, Eva
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Rehabilitation in Central County.
    Björk, Mathilda
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine.
    Thyberg, Ingrid
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology. Linköping University, Department of Clinical and Experimental Medicine, Division of Inflammation Medicine. Linköpings universitet.
    Dilemmas of participation in everyday life in early rheumatoid arthritis (RA),: a qualitative interview study (The Swedish TIRA study)2014Conference paper (Other academic)
  • 6.
    Östlund, Gunnel
    et al.
    Mälardalen University, Eskilstuna, Sweden .
    Björk, Mathilda
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Rehabilitation Center. Jönköping University, Sweden.
    Thyberg, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine, Division of Inflammation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Rheumatology.
    Thyberg, Mikael
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Valtersson, Eva
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Rehabilitation in Central County.
    Stenström, Birgitta
    Swedish Rheumatism Association, Stockholm, Sweden .
    Sverker, Annette
    Linköping University, Department of Social and Welfare Studies, Social Work. Linköping University, Faculty of Arts and Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Rehabilitation in Central County.
    Emotions related to participation restrictions as experienced by patients with early rheumatoid arthritis: a qualitative interview study (the Swedish TIRA project)2014In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 33, no 10, p. 1403-1413Article in journal (Refereed)
    Abstract [en]

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

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  • 7.
    Östlund, Gunnel
    et al.
    Mälardalens högskola, Hälsa och välfärd, Sverige.
    Björk, Mathilda
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Rheumatology. Linköping University, Faculty of Health Sciences.
    Thyberg, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine, Division of Inflammation Medicine. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Rheumatology.
    Thyberg, Mikael
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Valtersson, Eva
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Rehabilitation in Central County.
    Sverker, Annette M.
    Linköping University, Department of Social and Welfare Studies, Social Work. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Rehabilitation in Central County. Linköping University, Faculty of Health Sciences.
    Men’s strategies of handling RA: (The Swedish TIRA study)2014Conference paper (Other academic)
  • 8.
    Östlund, Gunnel
    et al.
    Mälardalens högskola, Hälsa och välfärd, Sverige.
    Björk, Mathilda
    Östergötlands Läns Landsting, Heart and Medicine Center, Rehabilitation Center.
    Valtersson, Eva
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Rehabilitation in Central County.
    Sverker, Annette
    Linköping University, Department of Social and Welfare Studies, Social Work. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Rehabilitation in Central County. Linköping University, Faculty of Health Sciences.
    Intimate relationships as perceived by patients with early rheumatoid arthritis:: A qualitative interview study (The Swedish TIRA study)2014Conference paper (Refereed)
  • 9.
    Östlund, Gunnel
    et al.
    Mälardalens högskola, Hälsa och välfärd, Sweden.
    Björk, Matilda
    Jönköpings hälsohögskola, Sverige.
    Thyberg, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine, Division of Inflammation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Rheumatology.
    Valtersson, Eva
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Rehabilitation in Central County.
    Stenström, Birgitta
    Svenska reumatologförbundet, Sverige.
    Sverker, Annette M.
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Rehabilitation in Central County.
    Emotions related to participation restrictions experienced by patients with early rheumatoid arthritis: A qualitative interview study (The Swedish TIRA study)2013Conference paper (Refereed)
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