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  • 1.
    Arvidsson, P.
    et al.
    Department of Health Sciences, Örebro University, Örebro, Sweden, County Council of Gävleborg, Vuxenhabiliteringen, Lasarettsvägen 4, S-803 24 Gävle, Sweden.
    Granlund, M.
    Department of Social Sciences, Mälardalen University, Västerås, Sweden.
    Thyberg, Mikael
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin.
    Factors related to self-fated participation in adolescents and adults with mild intellectual disability - A systematic literature review2008Inngår i: JARID: Journal of applied research in intellectual disabilities, ISSN 1360-2322, E-ISSN 1468-3148, Vol. 21, nr 3, s. 277-291Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Self-rated participation is a clinically relevant intervention outcome for people with mild intellectual disability. The aim of this systematic review was to analyse empirical studies that explored relationships between either environmental factors or individual characteristics and aspects of participation in young adults with mild intellectual disability. Method Four databases were used, 756 abstracts examined and 24 studies were evaluated in-depth. Results Four aspects of participation were found: involvement, perceptions of self, self-determination and psychological well-being. Reported environmental factors were: social support, choice opportunity, living conditions, school, work and leisure, attitudes, physical availability and society. Reported individual characteristics were adaptive and social skills. Conclusions There is a relative lack of studies of factors influencing self-rated participation and existing studies are difficult to compare because of disparity regarding approaches, conceptual frameworks, etc. For adequate interventions, it seems important to study how profiles of participation are influenced by different patterns of environmental factors and individual characteristics. © 2007 Blackwell Publishing Ltd.

  • 2.
    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.

  • 3.
    Arvidsson, Patrik
    et al.
    University of Örebro, Sweden .
    Granlund, Mats
    University of Örebro, Sweden Jonköping University, Sweden .
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Thyberg, Mikael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    International Classification of Functioning, Disability and Health categories explored for self-rated participation in Swedish adolescents and adults with a mild intellectual disability2012Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, nr 7, s. 562-569Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To explore internal consistency and correlations between perceived ability, performance and perceived importance in a preliminary selection of self-reported items representing the activity/participation component of the International Classification of Functioning, Disability and Health (ICF). Design: Structured interview study. Subjects: Fifty-five Swedish adolescents and adults with a mild intellectual disability. Methods: Questions about perceived ability, performance and perceived importance were asked on the basis of a 3-grade Likert-scale regarding each of 68 items representing the 9 ICF domains of activity/participation. Results: Internal consistency for perceived ability (Cron-bachs alpha for all 68 items): 0.95 (values for each domain varied between 0.57 and 0.85), for performance: 0.86 (between 0.27 and 0.66), for perceived importance: 0.84 (between 0.27 and 0.68). Seventy-two percent of the items showed correlations greater than0.5 (mean =0.59) for performance vs perceived importance, 41% greater than0.5 (mean =0.47) for perceived ability vs performance and 12% greater than0.5 (mean =0.28) for perceived ability vs perceived importance. Conclusion: Measures of performance and perceived importance may have to be based primarily on their estimated clinical relevance for describing aspects of the ICF participation concept. With a clinimetric approach, parts of the studied items and domains may be used to investigate factors related to different patterns and levels of participation, and outcomes of rehabilitation.

  • 4.
    Arvidsson, Patrik
    et al.
    Uppsala University, Sweden; Jonköping University, Sweden; Jonköping University, Sweden.
    Granlund, Mats
    Jonköping University, Sweden; University of Oslo, Norway.
    Thyberg, Mikael
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    How are the activity and participation aspects of the ICF used? Examples from studies of people with intellectual disability2015Inngår i: NeuroRehabilitation (Reading, MA), ISSN 1053-8135, E-ISSN 1878-6448, Vol. 36, nr 1, s. 45-49Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

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

  • 5.
    Björk, Mathilda
    et al.
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för arbetsterapi.
    Thyberg, Mikael
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Valtersson, Eva
    Linköpings universitet, Institutionen för medicin och hälsa. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Rörelse och Hälsa. Linköpings universitet, Medicinska fakulteten.
    Katz, Patricia
    University of California, San Francisco, USA.
    Validation and internal consistency of the Swedish version of the Valued Life Activities scale.2016Inngår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, nr 12, s. 1211-1219Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

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

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

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

  • 6.
    Dahlström, Örjan
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten.
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Thyberg, Mikael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Factors related to fatigue in women and men with early rheumatoid arthritis (the Swedish TIRA study)2009Konferansepaper (Annet vitenskapelig)
  • 7.
    Hermansson, Ann-Charlotte
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap.
    Carlsson, V.A.
    Hörnquist, J.O.
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Thyberg, Mikael
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    War-wounded refugees in Sweden. Background and flight1995Inngår i: Scandinavian Journal of Social Welfare, ISSN 0907-2055, Vol. 4, s. 255-261Artikkel i tidsskrift (Fagfellevurdert)
  • 8.
    Hermansson, Ann-Charlotte
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Socialmedicin och folkhälsovetenskap. Östergötlands Läns Landsting, PC - Psykiatricentrum, FMC - Flyktingmedicinskt centrum.
    Timpka, Toomas
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Socialmedicin och folkhälsovetenskap. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Socialmed FHVC.
    Thyberg, Mikael
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin. Östergötlands Läns Landsting, Medicincentrum, Smärt- och rehabiliteringscentrum.
    The long-term impact of torture on the mental health of war-wounded refugees: Findings and implications for nursing programmes2003Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 17, nr 4, s. 317-324Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Today, nurses from many disciplines are expected to provide nursing care to refugees severely traumatized in war and conflict. The general aim of this study was to explore the long-term impact of torture on the mental health of war-wounded refugees. The study group consisted of 22 tortured and 22 nontortured male refugees who had been injured in war. Standardized interview schedules, exploring different background characteristics, and three instruments for assessment of mental health were used: the Hopkins Symptom Checklist, the Post Traumatic Symptom Scale and a well-being scale. The prevalence of psychiatric symptoms was high in both groups. However, there were no significant differences in mental health between the tortured and the nontortured refugees. The patterns of associations between background characteristics and mental health were different in the two groups. The strongest associations with lower level of mental health were higher education in the tortured group and unemployment in the nontortured group. Methodological difficulties in research on sequelae of prolonged traumatization remain. Further studies within the caring sciences can broaden the present understanding of the impact of torture and other war traumas. ⌐ 2003 Nordic College of Caring Sciences.

  • 9.
    Hermansson, Ann-Charlotte
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Socialmedicin och folkhälsovetenskap. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Socialmed FHVC.
    Timpka, Toomas
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Socialmedicin och folkhälsovetenskap. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Socialmed FHVC.
    Thyberg, Mikael
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin. Östergötlands Läns Landsting, Medicincentrum, Smärt- och rehabiliteringscentrum.
    The Mental Health of War-wounded Refugees: An 8-year Follow-up2002Inngår i: Journal of Nervous and Mental Disease, ISSN 0022-3018, E-ISSN 1539-736X, Vol. 190, s. 374-380Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The complex nature of recent wars and armed conflicts has forced many war-injured persons into exile. To investigate their long-term mental health, three instruments for assessing mental health (HSCL-25, PTSS-10, and a Well-Being scale) were presented to 44 war-wounded refugees from nine different countries 8 years after arrival in Sweden. The prevalence of psychiatric symptoms was high and corresponds to findings in previous studies of refugee patient populations. A lower level of mental health was associated with higher education, unemployment, and poor physical health. The findings suggest a high psychiatric morbidity and a need for psychiatric interventions in this refugee group. Methodological issues to be considered in research on sequels of war traumas are discussed.

  • 10.
    Johnsen, Vigdis
    et al.
    Sunnaas Rehabilitation Hospital.
    Skattebu, Eli
    Norwegian Assoc Spina Bifida & Hydrocephalus.
    Aamot-Andersen, Astri
    Sunnaas Rehabilitation Hospital.
    Thyberg, Mikael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    PROBLEMATIC ASPECTS OF FAECAL INCONTINENCE ACCORDING TO THE EXPERIENCE OF ADULTS WITH SPINA BIFIDA2009Inngår i: JOURNAL OF REHABILITATION MEDICINE, ISSN 1650-1977, Vol. 41, nr 7, s. 506-511Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To describe problematic aspects of faecal incontinence according to the experience of adults with spina bifida. Design: Qualitative interview study. Subjects: Eleven adults with spina bifida and bowel problems. Method: Semi-structured open-ended interviews and qualitative analysis. Results: Problematic aspects were related to participation in terms of time consumption, communication, social isolation, love and sexuality, and accessibility. Also, to a sense of helplessness in terms of panic and worry, to a sense of shame in terms of impurity, social acceptance and self-image, and to bowel function in terms of decisions about colostomy, voluntary constipation, and changing patterns. Conclusion: The results reveal aspects relevant to supporting clinical practice and suggesting issues for questionnaire studies.

  • 11.
    Samuelsson, Kersti
    et al.
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Larsson, H.
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Thyberg, Mikael
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Tropp, Hans
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Ortopedi. Linköpings universitet, Hälsouniversitetet.
    Back pain and spinal deformity: common among wheelchair users with spinal cord injuries1996Inngår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 3, nr 1, s. 28-32Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    During the past 15 years, wheelchair development has focused on driving properties. Back pain, however, is a problem among wheelchair users. Thirty-one wheelchair users, mean age 46 years (range 21–79), (3 women and 28 men), with spinal cord injuries were studied with regard to back pain and spinal deformity. Sixteen subjects had tetraplegia and 15 had paraplegia; median time since injury was 11 years (range 2–37). Pain was assessed using pain drawings, visual analogue scale and questionnaire. Spinal deformity was examined using X-ray, weight distribution, 3D magnetic motion tracker, photographs and physical examination. Some degree of back pain was found in 84% of the patients. Most patients could modify their pain by changing their sitting posture or by rest in bed, and had some kind of spinal deformity that might be related to neurological injury and sitting posture. Further wheelchair research considering the ergonomics of both driving and sitting seems important.

  • 12.
    Sverker, Anette
    et al.
    Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Rehabgruppen NSC. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten.
    Thyberg, Ingela
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Östlund, Gunnel
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten.
    Waltersson, Eva
    Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Rehabgruppen NSC.
    Thyberg, Mikael
    Linköpings universitet, Institutet för handikappvetenskap (IHV). Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet.
    Participation in work in early rheumatoid arthritis: a qualitative interview study interpreted in terms of the ICF2014Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, nr 3, s. 242-249Artikkel i tidsskrift (Fagfellevurdert)
    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.

     

     

     

  • 13.
    Sverker, Annette
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten.
    Björk, M
    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.
    Valtersson, E
    Östlund, G
    Mälardalen University, Eskilstuna, Sweden.
    AB1154-HPR Men's Strategies of Handling Participation Restrictions Related to Rheumatoid Arthritis (The Swedish Tira Study)2014Konferansepaper (Annet vitenskapelig)
    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

  • 14.
    Sverker, Annette
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten.
    Waltersson, Eva
    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.
    Östlund, Gunnel
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten.
    Deltagande i arbete vid tidig reumatoid artrit – en kvalitativ intervjustudie tolkad i termer av ICF2014Inngår i: Reumatologi, nr 18Artikkel i tidsskrift (Annet vitenskapelig)
  • 15.
    Sverker, Annette
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Rehabgruppen NSC. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Östlund, Gunnel
    Mälardalen University, Eskilstuna, Sweden.
    Thyberg, Mikael
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Thyberg, Ingrid
    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.
    Valtersson, Eva
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Rehabgruppen NSC.
    Björk, Mathilda
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Hjärt- och Medicincentrum, Rehabenheten. Jönköping University, Sweden.
    Dilemmas of participation in everyday life in early rheumatoid arthritis: a qualitative interview study (The Swedish TIRA Project)2015Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, nr 14-15, s. 1251-1259Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 16.
    Sverker, Annette
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten.
    Östlund, Gunnel
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten.
    Thyberg, Mikael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Waltersson, Eva
    Östergötlands Läns Landsting.
    Björk, Matilda
    School of Health Sciences, Jönköping University.
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Reumatologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Dilemmas of participation in everyday life in early rheumatoid arthritis (RA): A qualitative interview study (the Swedish TIRA study)2012Inngår i: Health professionals reumatology: EULAR12-2344, 2012Konferansepaper (Annet vitenskapelig)
  • 17.
    Thyberg, Ingrid
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Reumatologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Dahlström, Örjan
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten.
    Björk, Mathilda
    Department of Rehabilitation, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Arvidsson, P.
    Thyberg, Mikael
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Potential of the HAQ score as clinical indicator suggesting comprehensive multidisciplinary assessments: the Swedish TIRA cohort 8 years after diagnosis of RA2012Inngår i: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 31, nr 5, s. 775-783Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study explores the potential of the health assessment questionnaire (HAQ) score as a clinical indicator that can be used to suggest comprehensive multidisciplinary assessments, by relating it to more general aspects of disability. In a cohort of 132 patients with early RA (mean age 55, 68% women), 28 joint count Disease Activity Scores (DAS-28), HAQ, and Short Form 36 (SF-36) scores were registered at annual follow-up visits 8 years after diagnosis. The patients were tentatively sub-grouped into a high-HAQ group (HAQ ≥1 at the 8-year follow-up) and a low-HAQ group. The high-HAQ group, comprising 36% of the cohort, had a higher mean HAQ score at inclusion and beyond at all visits compared to the low-HAQ group, and 24% of all individual patients in the high-HAQ group had a HAQ score ≥1 at inclusion. Although the DAS-28 improved in both groups, patients in the high-HAQ group also had significantly more persistent disability according to the SF-36: five scales at each follow-up visit and all eight scales at the majority of the visits. Individual RA patients with HAQ ≥1 probably have considerable persistent disabilities according to the SF-36. The HAQ score could be used as a clinical indicator suggesting comprehensive multidisciplinary assessments of the components of disability and corresponding interventions, in addition to the established use of HAQ at group levels and in parallel with the medication strategy based on DAS-28.

  • 18.
    Thyberg, Ingrid
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Dahlström, Örjan
    Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Björk, Mathilda
    Avd. för rehabilitering, HHJ, Hälsohögskolan, Högskolan i Jönköping.
    Arvidsson, Patrik
    Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Thyberg, Mikael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    HAQ scores related to persistent disabilities 8 years efter diagnosis of RA despite reduction of DAS-28.: The Swedish TIRA study2011Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    Background: Early instituted disease modifying anti rheumatic drugs (DMARD:s) leads to reduced disease activity. Critical levels of disease activity measured with Disease Activity Score 28 joint count (DAS-28) are widely used to identify needs and evaluate outcomes of DMARD:s. Early instituted DMARD:s also reduce disability, but some patients still have disabilities and there is a need to establish clinically useful routines to identify patients with different disabilities, and thereby possible unmet needs for rehabilitation as a complement to their medication.Objectives: To discriminate sub-groups of patients due to HAQ levels and relate these sub-groups to disease activity and more comprehensive aspects of disability.Methods: 132 patients (68% women) with recent-onset (≤1 year) RA who fulfilled ≥4/7 RA classification criteria or at least: morning stiffness ≥60 minutes, symmetrical arthritis, and arthritis of small joints, and included in the Swedish TIRA-1 cohort during 1996-1998, constituted the study group. All patients had access to rehabilitation and regular contact with a multi-professional team, but there were no standardized criteria for further assessments or interventions. Anti-CCP antibodies were analysed. Disease activity (DAS-28), Health Assessment Questionnaire (HAQ), Short Form 36 (SF-36) and ongoing DMARD:s were registered at inclusion and thereafter yearly. In the presented analysis, the study group was divided into a high-HAQ group (score≥1) and a low-HAQ group (score<1) based on the HAQ score at the 8 year follow-up (1).Results: The sub-group of 48 patients (36%) with a HAQ score ≥1 at the 8 year follow-up had a higher mean HAQ score already at inclusion and further on at all visits compared to the low-HAQ group. 32 patients (24%) had high HAQ-score both at inclusion and at Year 8. Also, more comprehensive aspects of disability reported with the 8 dimensions of SF-36 differed significantly between these sub-groups at the majority of the visits. Age and Anti-CCP did not differ between sub-groups while the high-HAQ group had a higher DAS-28 at most visits except at inclusion. In accordance with known sex differences, the majority of the patients in the high-HAQ group were women. Despite higher frequencies of DMARD:s, the HAQ-score in the high-HAQ group showed a persistent divergence in contrast to the improvement in the low-HAQ group, and in contrast to the DAS-28 that showed improvement over time in both groups. Thus, a HAQ score ≥1 at the 8 year follow-up indicated persistent and comprehensive disabilities, and supposed needs for more effective or more specific rehabilitation as a complement to the medication in 36% of the study group.Conclusions: The HAQ-score is clinically useful as a complement to DAS-28, especially to identify patients with unmet needs for further rehabilitation assessments.

  • 19.
    Thyberg, Ingrid
    et al.
    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.
    Dahlström, Örjan
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Björk, Mathilda
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för arbetsterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Stenström, Birgitta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Adams, Jo
    Centre for Innovation and Leadership, Faculty of Health Sciences, University of Southampton, Southampton, UK.
    Hand pains in women and men in early rheumatoid arthritis, a one year follow-up after diagnosis. The Swedish TIRA project2017Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 39, nr 3, s. 291-300Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

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

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

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

    • Implications for Rehabilitation
    • General pain and hand pain remain a problem in RA despite today's early intervention and effective disease control with new era biologics.
    • The extent of hand pain evidenced in our work gives a more detailed and comprehensive account of pain status.
    • Higher hand pain during active grip testing than that during rest indicates a potential relationship to ongoing activity limitation.
    • Hand pain assessment can help guiding multi-professional interventions directed to reduce hand pain and thereby probably reduce activity limitations.
  • 20.
    Thyberg, Ingrid
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Dahlström, Örjan
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten.
    Thyberg, Mikael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Factors related to fatigue in women and men with early rheumatoid arthritis (the Swedish TIRA study)2009Inngår i: Factors related to fatigue in women and men with early rheumatoid arthritis (the Swedish TIRA study)., 2009Konferansepaper (Fagfellevurdert)
  • 21.
    Thyberg, Ingrid
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Dahlström, Örjan
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Thyberg, Mikael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Factors related to fatigue in women and men with early rheumatoid arthritis: The Swedish TIRA study2009Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, nr 11, s. 904-912Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To study whether there are differences between women and men, with regard to the reported level of fatigue, and to explore the strength of the relations between fatigue and disease activity, pain, sleep disturbance, mental health, and activity limitation in early rheumatoid arthritis, and also to explore the consistency of such findings.

    Design: Analyses and comparisons of cross-sectional data.

    Subjects. 276 patients, 191 women and 85 men, with early rheumatoid arthritis were included.

    Method: Patients were examined with respect to 28-joint count disease activity score, and disability variables reflecting pain, sleep disturbance, fatigue, mental health, and activity limitation, at follow-ups at one, two and three years after diagnosis.

    Results: Women reported somewhat more fatigue than men. Fatigue was closely and rather consistently related to disease activity, pain and activity limitation, and also to mental health and sleep disturbance.

    Conclusion: Although this study does not permit conclusions about causal directions, statistical relationships may be related to clinical conceptions about causation: When disease activity can be significantly reduced by pharmacological treatment, this may have a positive effect on fatigue. Specific treatment with respect to the mentioned disability aspects that are related to fatigue is also a clinically reasonable strategy.

  • 22.
    Thyberg, Ingrid
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Sverker, Annette
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten.
    Waltersson, Eva
    Östergötlands Läns Landsting.
    Östlund, Gunnel
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten.
    Thyberg, Mikael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Aspects of participation in work and everyday life in early RA: a qualitative interview study (the Swedish TIRA-study2010Inngår i: Health professionals reumatology: AB1042-HP, 2010Konferansepaper (Annet vitenskapelig)
  • 23.
    Thyberg, Mikael
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Arvidsson, Patrik
    Uppsala University/County Council of Gävleborg, Ga¨vle,Jönköping University, Jönköpng Sweden,.
    Thyberg, Ingrid
    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.
    Nordenfelt, Lennart
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Ersta Sköndal University Colege Stockholm .
    Simplified bipartite concepts of functioning and disability recommended for interdisciplinary use of the ICF.2015Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, nr 19, s. 1783-1792Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

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

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

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

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

  • 24.
    Thyberg, Mikael
    et al.
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Gerdle, Björn
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Samuelsson, Kersti
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Larsson, Harriet
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Neurologi. Linköpings universitet, Hälsouniversitetet.
    Wheelchair seating intervention: Results from a client-centred approach2001Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 23, nr 15, s. 677-682Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose : The aim of this study was to analyse the effects of wheelchair intervention from a client-centred perspective.

    Method : Results from 38 consecutive active wheelchair users visiting the wheelchair-seating department at the University Hospital in Linköping, Sweden, were analysed and described. All clients had defined problems related to wheelchair seating. Back pain was estimated before intervention and at follow-up, using a Visual Analogue Scale. The effect of intervention on different aspects of wheelchair functionality, seating and occupational performance was estimated by the clients at follow-up.

    Results : Two initial main problem areas were identified among the group; seating discomfort (87% ) and back pain (63% ). Back pain was significantly reduced at follow-up (p<0.001). Problems initially defined by the clients, e.g. seating discomfort, were affected positively, in 79% of all clients, as estimated by the clients at follow-up. No significant correlation was found between the initial cause of intervention or the highest ranked wheelchair functionality aspect and final acceptance of intervention.

    Conclusions : The results from this study confirm the possibility of reducing, or even eliminating, common secondary problems such as back pain and discomfort, related to wheelchair seating by individually adjusted measures. Further research and development in this field is both necessary and cost-effective.

  • 25.
    Thyberg, Mikael
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Institutet för handikappvetenskap (IHV). Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Nelson, Marie Clark
    Linköpings universitet, Institutionen för studier av samhällsutveckling och kultur, Enheten för historia. Linköpings universitet, Institutet för handikappvetenskap (IHV). Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten.
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    A definition of disability emphasizing the interaction between individual and social aspects that existed among Scandinavian precursors of rehabilitation medicine as early as 19122010Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 42, nr 2, s. 182-183Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    This article suggests that definitions of disability exphasizing individuals and social context existed much earlier than is most often claimed

  • 26.
    Östlund, Gunnel
    et al.
    Mälardalen University, Eskilstuna, Sweden .
    Björk, Mathilda
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Rehabenheten. 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.
    Valtersson, Eva
    Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Rehabgruppen NSC.
    Stenström, Birgitta
    Swedish Rheumatism Association, Stockholm, Sweden .
    Sverker, Annette
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Rehabgruppen NSC.
    Emotions related to participation restrictions as experienced by patients with early rheumatoid arthritis: a qualitative interview study (the Swedish TIRA project)2014Inngår i: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 33, nr 10, s. 1403-1413Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 27.
    Östlund, Gunnel
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten.
    Sverker, Annette
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten.
    Björk, Mathilda
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet.
    Thyberg, Ingela
    Thyberg, Mikael
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Valtersson, Eva
    Stenström, Birgitta
    Linköpings universitet, Institutionen för medicin och hälsa.
    Känslor relaterade till delaktighet begränsningar – erfarenheter från patienter med reumatoid artrit,en kvalitativ intervjustudie2014Inngår i: Reumatologi, nr 18Artikkel i tidsskrift (Annet vitenskapelig)
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