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  • 1.
    Brorsson, Anna
    et al.
    1Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet,.
    Öhman, Annika
    1Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet,.
    Cutchin, Malcolm
    University of South Carolina at Chapel Hill.
    Nygård, Louise
    1Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet,.
    Managing critical incidents in grocery shopping by community-living people with Alzheimer's disease.2013In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 4, no 20, p. 292-301Article in journal (Refereed)
    Abstract [en]

    Aim: People with Alzheimer's disease (AD) remain in their ordinary housing and continue to use public space despite increasing disabilities. The aim of this study was to discover and describe problematic situations and critical incidents that took place when people with AD performed the ordinary outside-home activity of grocery shopping and how these were met by them. Methods: Individual interviews (n = 12) and participant observations (n = 8) with six informants were performed and analysed using a grounded theory approach. Results: The findings are presented in six categories and each category describes different critical incidents and actions used to meet these. The categories were: (a) Remembering to bring things when leaving home, (b) Finding the way to and from the grocery shop without getting lost, (c) Finding a way through traffic when not feeling safe, (d) Finding objects when organization is disrupted, (e) Choosing when a lot of objects and products are available, and (f) Finding a method to pay when payment opportunities are restricted. The core category, “A challenging and unstable process of meeting critical incidents in grocery shopping”, was characterised by reflections and creativity to achieve relative harmony in each critical incident. Conclusions: In conclusion, it is important that relatives and professionals take into account relevant actions to help people with AD coordinate with their environment.Read More: http://informahealthcare.com/doi/abs/10.3109/11038128.2012.752031

  • 2.
    Brorsson, Anna
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Öhman, Annika
    Karolinska Institutet, Sweden .
    Lundberg, Stefan
    The Royal Institute of Technology, Sweden .
    Nygård, Louise
    Karolinska Institutet, Sweden .
    Accessibility in public space as perceived by people with Alzheimer's disease.2011In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 4, no 10, p. 587-602Article in journal (Refereed)
    Abstract [en]

    Most people with dementia remain living at home as long as possible after being diagnosed, and hence their lives also include activities in the public space. The aim of this study was to illuminate experiences of accessibility in public space in people with Alzheimer’s disease. A qualitative grounded theory approach with repeated in-depth interviews was used. The core category, accessibility as a constantly changing experience, was characterized by changes in the relationship between informants and public space. Changes in the relationship took place in activities and use of place and related to familiarity and comfort, individual motives and interests, and planning and protecting. Other changes occurred in places and problematic situations related to everyday technologies, crowded places with high tempo and noise, and change of landmarks. These changes reduced feelings of accessibility and increased difficulties in carrying out activities in public space. These findings may be helpful when providing support, and supporting community living.

  • 3.
    Brorsson, Anna
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Sweden .
    Öhman, Annika
    Linköping University, Department of Social and Welfare Studies, NISAL - National Institute for the Study of Ageing and Later Life. Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Lundberg, Stefan
    School of Technology and Health, The Royal Institute of Technology, Sweden .
    Nygård, Louise
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Sweden .
    Being a pedestrian with dementia: a qualitative study using photo documentation and focus group interviews.2016In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 15, no 5, p. 1124-1140Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to identify problematic situations in using zebra crossings. They were identified from photo documentations comprising film sequences and the perspectives of people with dementia. The aim was also to identify how they would understand, interpret and act in these problematic situations based on their previous experiences and linked to the film sequences.

    A qualitative grounded theory approach was used. Film sequences from five zebra crossings were analysed. The same film sequences were used as triggers in two focus group interviews with persons with dementia. Individual interviews with three informants were also performed.

    The core category, the hazard of meeting unfolding problematic traffic situations when only one layer at a time can be kept in focus, showed how a problematic situation as a whole consisted of different layers of problematic situations. The first category, adding layers of problematic traffic situations to each other, was characterized by the informants’ creation of a problematic situation as a whole. The different layers were described in the subcategories of layout of streets and zebra crossings, weather conditions, vehicles and crowding of pedestrians. The second category, actions used to meet different layers of problematic traffic situations, was characterized by avoiding problematic situations, using traffic lights as reminders and security precautions, following the flow at the zebra crossing and being cautious pedestrians.

    In conclusion, as community-dwelling people with dementia commonly are pedestrians, it is important that health care professionals and caregivers take their experiences and management of problematic traffic situations into account when providing support.

  • 4.
    Holstein, Jane
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Liedberg, Gunilla M.
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Öhman, Annika
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Kjellberg, Anette
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Validity and utility of the Swedish version of the Cultural Competence Assessment Instrument2019In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 82, no 7, p. 422-432Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 5.
    Nygård, Louise
    et al.
    Karolinska Institutet.
    Öhman, Annika
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Department of Social and Welfare Studies, NISAL - National Institute for the Study of Ageing and Later Life. Linköping University, Faculty of Medicine and Health Sciences.
    Managing changes in everyday occupations: the experience of persons with Alzheimer's disease.2002In: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 22, no 2, p. 70-81Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to uncover how people with dementia respond to the problems and changes they experience in everyday occupations. Seven participants with dementia were included. Data were collected by means of repeated interviews and observations that focused on the person's experiences of competence and management in everyday occupations. The analysis was carried out from within a phenomenological perspective and resulted in a structure describing management strategies. It was concluded that the participants used a wide variety of strategies. Some strategies were directed toward managing the altered conditions caused by the disease while others served the purpose of responding to the occupational problems of everyday life. The latter strategies were of three types based mainly on environment, habituation, and cognition. Overall, the implicit and explicit cognitive awareness underpinning many strategies seems to call for great caution when assuming that people with dementia soon lose their awareness of disability.

  • 6.
    Ryd, Charlotta
    et al.
    Karolinska Institute, Sweden.
    Nygard, Louise
    Karolinska Institute, Sweden.
    Malinowsky, Camilla
    Karolinska Institute, Sweden.
    Öhman, Annika
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Linköping University, NISAL - National Institute for the Study of Ageing and Later Life.
    Kottorp, Anders
    Karolinska Institute, Sweden; Zurich University of Appl Science, Switzerland.
    Associations between performance of activities of daily living and everyday technology use among older adults with mild stage Alzheimers disease or mild cognitive impairment2015In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 22, no 1, p. 33-42Article in journal (Refereed)
    Abstract [en]

    Background: The use of everyday technology (ET) is important for many activities in daily life (ADL) and can be especially challenging for older adults with cognitive impairments. Objective: The aim was to explore associations between ADL performance and perceived ability to use ET among older adults with mild stage Alzheimers disease (AD) and mild cognitive impairment (MCI). ADL motor and process ability, and ability to use ET were also compared between the groups. Methods: Participants with AD (n = 39) and MCI (n = 28) were included. Associations and group differences were explored with nonparametric statistics. Results: Significant correlations were found between ADL process ability and ET use in both groups (R-s = 0.44 and 0.32, p less than 0.05), but for ADL motor ability and ET use, correlations were only found in the MCI group (R-s = 0.51, p less than 0.01). The MCI group had significantly higher measures of ADL process ability (p less than 0.001) and ET use (p less than 0.05). Conclusion: ADL performance ability and perceived ability to use ET are important to consider in evaluations of older adults with cognitive impairments. Group differences indicate that measures of ADL performance ability and ET use are sensitive enough to discriminate the MCI group from the AD group with individually overlapping measures.

  • 7.
    Öhman, Annika
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden.
    Josephsson, Staffan
    Karolinska Insitutet.
    Nygård, Louise
    Karolinska Institutet.
    Awareness through interaction in everyday occupations: experiences of people with Alzheimer's disease2008In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 15, no 1, p. 43-51Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore and describe the characteristics of awareness of the consequences of having Alzheimer's disease on everyday life occupations. Six community-dwelling participants with Alzheimer's disease were interviewed on repeated occasions about their lived experiences of everyday occupations. A phenomenological method was adopted for the analysis. The findings show that the participants discovered and explored the changes in how they performed everyday occupations in the context of their social relations and through immediate reflections on their forgetfulness. They attempted to handle the changes by adapting their behaviour. Awareness of the changes in their lives was evident in their reflections, as they tried to make sense of what was happening to them. This seemed to be related to an elusive perception of change in situations that they found impossible to influence. The participants reflected on the impact their condition had on other people near them. Their reflections also involved emotional reactions to the shortcomings they experienced. In conclusion, the findings show how these people with Alzheimer's disease were able to express awareness of the consequences of their illness through their reflections on their experiences of interaction with the occupations and the social environment.Read More: http://informahealthcare.com/doi/abs/10.1080/11038120701441080

  • 8.
    Öhman, Annika
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Department of Social and Welfare Studies, NISAL - National Institute for the Study of Ageing and Later Life. Linköping University, Faculty of Medicine and Health Sciences.
    Nygård, Louise
    Karolinska Institutet.
    Meanings and motives for for engagement in self-chosen daily life occupations among individuals with Alzheimer's disease.2005In: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 25, no 3, p. 89-97Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to uncover and describe the meanings and motives for engagement in self-chosen daily life occupations for elderly individuals with Alzheimer's disease dwelling in the community. Six participants with Alzheimer's disease were included. Data were collected through repeated interviews and observations focusing on their motives for their self-chosen occupational engagement and the significance of the daily occupations. The analysis used a qualitative comparative and interpretative method. The findings show that the participants' occupations supported their ordinary pattern of everyday life and provided them with an opportunity to be in a coherent context. The occupations also allowed them to experience and communicate autonomy and certain characteristics of their identity and provided them with a private sphere. The findings revealed certain crucial but double-edged environmental keys to occupation. By identifying and supporting everyday occupations with personal meaning and value, therapists and caregivers may contribute to the well-being of individuals with Alzheimer's disease living in their own homes.

  • 9.
    Öhman, Annika
    et al.
    Division of Occupational Therapy, Karolinska Institutet.
    Nygård, Louise
    Karolinska Institutet.
    Borell, Lena
    Karolinska Institutet.
    The vocational situation in cases of memory deficits and younger-onset dementia.2001In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 15, no 1, p. 34-43Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe how persons with memory deficits or younger-onset dementia perceived and met their problems, with particular reference to their present and future vocational situation, including describing the parallel observations and attitudes of other significant persons in the vocational context. Data were collected through 16 interviews, one with each of nine subjects and seven respondents from the subjects' work-places. All interviews were analysed with a comparative method, searching for themes. In addition, subjects' IADL (instrumental activities of daily living) ability and cognition were assessed. The findings demonstrated that the subjects themselves experienced extensive difficulties before their predicament was defined. The difficulties were met by spontaneous and planned strategies on the part of the subjects and by adaptations at the workplaces, but with limited success. The situation also profoundly affected fellow workers. Overall, both the subjects and the work-place respondents had a positive attitude to continued work as long as the subjects made useful contributions. The possibility of remaining in work seemed to depend on multiple factors, including the individual's apprehension of his or her own ability and the length of the sick-leave.

  • 10.
    Öhman, Annika
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden.
    Nygård, Louise
    Karolinska Institutet.
    Kottorp, Anders
    Karolinska Institutet.
    Occupational performance and awareness of disability in mild cognitive impairment or dementia.2011In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 18, no 2, p. 133-142Article in journal (Refereed)
    Abstract [en]

    Limited awareness of disabilities is common in mild cognitive impairment and dementia. In order to get a broader base in planning interventions, it is important to consider a person's awareness of his/her disability encountered in performance. The aim of this study was to examine the relationship between occupational performance and awareness of disability in older adults with mild cognitive impairment or dementia. Thirty-five older adults were evaluated with the AMPS (Assessment of Motor and Process Skills) and with the AAD (Assessment of Awareness of Disability). Many-faceted Rasch models generated individual measures of ADL performance and awareness of disability. Non-parametric correlation statistics were used to analyse the relationships. The findings showed that there was an overall positive relationship between occupational performance and awareness of disability. However, individual variations in the sample implied that limitations in performance were not equivalent to a limited awareness of disability. In conclusion, awareness of disability should be individually evaluated when planning interventions together with clients and their families.Read More: http://informahealthcare.com/doi/abs/10.3109/11038121003645993

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